Risk of perioperative myocardial event

Risk of perioperative myocardial event

History , physical examination and resting electrocardiogram (ECG) form the basics of assessing perioperative cardiovas - - cular risk. Patients who are found to have an active cardiac condition should be evaluated by a cardiologist and optimised (medical, revascularisation or cardiac surgery) before thoracic surgery . Sur gery should be avoided within 30 days of myocar - dial infarction.

2 14 3 Peripheral zone Station 12: lobar 12 13 Station 13: segmental 7 Station 14: subsegmental 11 Oesophagus 9 AP zone Station 5: subaortic 6 Station 6: para-aortic 5 Left pulmonary artery

Risk assessment for surgery Postoperative cardiac event ACC/AHA risk strati /f_i cation +/– cardiology review Address potentially modi /f_i able risk factors and reassess Does the patient accept the risk in each category +/– potential impact on lifestyle? No Exclude surgery from multimodality management Figure 60.4 Tripartite risk assessment. ACC, American College of Cardiology; AHA, American Heart Association.