Perioperative cardiovascular evaluation and treatment of elderly patients undergoing noncardiac surgery
Cardiovascular morbidity and mortality is of significant concern in patients undergoing noncardic surgery. There is increasing evidence to help guide management of patients perioperatively including risk assessment tools, guidance on testing, and recommendations for medication and device management which practicing clinicians need to know. This chapter emphasizes key points from the American College of Cardiology and American Heart Association (ACC/AHA) 2014 guidelines on perioperative management of patients undergoing noncardiac surgery and the focused ACC/AHA update on dual-antiplatelet therapy in 2016 (1,2). This information was compared and contrasted with recommendations from other guidelines when appropriate. Understanding that care of the elderly involves additional considerations, age-specific management suggestions are discussed throughout the chapter. Additional recommendations for the management of elderly patients are made throughout the chapter to help address age-specific concerns.