# 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.