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Aug 01, 2014

Reducing Risk of Heart Complications During Surgery

New guidelines help doctors and patients make the best possible decisions related to non-cardiac surgery.

All types of surgery put added stress on the heart, increasing risk of heart related complications. That’s why the American College of Cardiology and American Heart Association use the latest evidence to continuously update guidelines to help doctors and patients make decisions related to surgery. The latest update, released today, provides new insights that all patients should be aware of as they weigh the risks and benefits associated with non-cardiac surgery. 

Most importantly, the new guidelines emphasize the key role that providers play in minimizing heart risks associated with surgery. All patients should have a team of healthcare providers, such as a surgeon, anesthesiologist, primary caregiver and consultants, who work together to make treatment decisions together with the patient. Together, this team should always consider a patient’s preferences and goals to come to the best possible decision regarding treatment. 

New guidelines also underscore the importance of using risk calculators to estimate an individual’s risk of heart complications from non-cardiac surgery. These tools can help determine whether a patient is low, intermediate or high risk for heart complications. Patients with intermediate or high risk should undergo further testing to better assess their risk prior to making decisions related to surgery. 

Finally, guidelines recommend that certain patients wait to undergo elective non-cardiac surgery, such as heart attack patients or patients with drug-eluting stents. And continuing or prescribing blood pressure-lowering medication called beta-blockers is only appropriate in select patients, like those who take beta blockers regularly to control blood pressure. Although beta blockers are sometimes used to reduce risk of heart attack, they carry risks of side effects and require careful monitoring. 

With these updated guidelines, experts hope to provide clear standards for evaluating and minimizing patients’ risk for heart complications related to non-cardiac surgery. By closely evaluating cardiovascular risk, patients can work with their doctors to make the best possible decisions related to treatment and reduce risk as much as possible during and after surgery.

Read the full guideline in the Journal of the American College of Cardiology.

Questions for You to Consider

  • How common are heart complications from non-cardiac surgery?
  • All surgery carries risk of complications, some of which can be serious. Although heart complications can be common, risk varies depending on the characteristics of each patient. Using risk calculators, doctors can determine whether a patient is low risk, with less than 1% chance of heart complications from surgery, or considered to have elevated risk for complications. Patients should always weigh the risks and benefits of surgery with their doctor before making treatment decisions.

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