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Preop Investigations

  • Measure preop brain natriuretic peptide (BNP) or NT-proBNP to enhance periop cardiac risk estimation in:

    • ≥65 yrs

    • 45-64 yrs w/ sig CVS dz

    • RCRI ≥1

        BNP ≥92 mg/L or NT-proBNP ≥300 ng/L a/w ↑ risk of death or MI 30 days post-noncardiac sx







  • No routine echo, coronary CTA, exercise or cardiopulmonary exercise testing, or pharmacological stress echo or radionuclide imaging

    • Urgent echo if suspected undiagnosed severe obstructive intracardiac abnormality or severe pHTN

    • Consider echo if suspect cardiomyopathy (may be reasonable to do postop)


  • No preop prophylactic coronary revascularization for pts w/ stable CAD undergoing noncardiac sx



Adapted from Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery. Canadian Journal of Cardiology. January 2017, Volume 33, Issue 1, Pages 17–32


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