CARDIAC RISK ASSESSMENT BEFORE NON-CARDIAC SURGERY

The preoperative cardiac risk assessment of patients undergoing non-cardiac surgery is common daily practice of medical consultants. At present, there are several noninvasive diagnostic methods for cardiac risk evaluation. In daily practice, common used methods are stress test with myocardial imaging (stress-Echo; myocardial perfusion imaging with gated-SPECT, etc.). Recently, some studies demonstrated that both coronary angiography by multidetector computed tomography and magnetic resonance with stress test have a good prognostic value in cardiac risk evaluation. A common question that arises between medical specialists in preoperative assessment is which of noninvasive diagnostic methods should use for cardiac risk evaluation. The easiest one is standard stress test. However, the preoperative evaluation has some difficulties in elderly because of reduced physical activity and inability to achieve the submaximal heart rate during stress test. For this category of patients, stress test with pharmacological agents followed by gated-SPECT or Echo-CG is to be considered. This article provides medical specialists to assess cardiac risk with appropriate non-invasive diagnostic methods in patients undergoing non-cardiac surgery.

внесердечные операции, оценка риска, сцинтиграфия миокарда, ОФЭКТ, non-cardiac surgery, myocardial perfusion imaging, gated-SPECT, cardiac risk

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