Every year, hundreds of thousands of people in the United States have surgery, most without complication. Patients with a history of heart problems, however, need special consideration before they undergo surgical procedures.
“Heart disease is the most common cause of complications that occur in patients undergoing general surgery or major medical procedures,” said Fredric L. Ginsberg, M.D., a cardiologist at The Cooper Heart Institute. “Heart complications during surgery occur in 1 percent to 5 percent of all operations.”Recently, the American Heart Association and the American College of Cardiology updated and released pre-operative guidelines. “The purpose of the guidelines is to assist physicians in anticipating and preventing cardiac complications during surgery,” explained Dr. Ginsberg.
These guidelines include:
- Patients with heart disease, including conditions such as chest pain, shortness of breath, irregular heart beats and congestive heart failure, need to be effectively treated before anesthesia and surgery can even be considered.
- Patients who need major surgical procedures but who are diabetic or have kidney disease need to participate in pre-operative cardiac testing, which can predict the risk of heart complications during surgery. These tests may include nuclear stress testing and/or an echocardiogram, which can diagnose heart conditions that were not apparent.
- Physicians may recommend the use of effective heart medications, such as beta-blockers and cholesterol-lowering drugs. These medications can reduce the risk of cardiac complications.
- A small percentage of patients who undergo cardiac testing prior to surgery will have very abnormal results. The new guidelines review when it is appropriate to perform cardiac procedures, such as coronary artery stenting or coronary bypass surgery, prior to non-cardiac surgery. For some patients, these cardiac procedures are necessary to ensure a successful surgical outcome.
“These guidelines are based on studies of thousands of patients who underwent all types of surgeries,” Dr. Ginsberg said. “The recommendations are well-substantiated and will help physicians treat their patients more effectively during and after surgery thereby reducing heart-related complications.