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Role of multimodality cardiac imaging in preoperative cardiovascular evaluation before noncardiac surgery


1 Department of Medical Imaging Service, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
2 King Faisal Heart Institute, King Faisal Specilaist Hospital and Research Center, Riyadh, Saudi Arabia; The heart Center, St Lukes Episcopal Hospital, Texas Heart Institute, Houston,Texas, USA

Correspondence Address:
Ahmed Fathala
Department of Medical Imaging Service, King Faisal Specialist Hospital and Research Center, P. O. Box 3354,Riyadh 11211, MBC 28, Saudi Arabia

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.81570

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Year : 2011  |  Volume : 14  |  Issue : 2  |  Page : 134-145

 

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The preoperative cardiac assessment of patients undergoing noncardiac surgery is common in the daily practice of medical consultants, anesthesiologists, and surgeons. The number of patients undergoing noncardiac surgery worldwide is increasing. Currently, there are several noninvasive diagnostic tests available for preoperative evaluation. Both nuclear cardiology with myocardial perfusion single photon emission computed tomography (SPECT) and stress echocardiography are well-established techniques for preoperative cardiac evaluation. Recently, some studies demonstrated that both coronary angiography by gated multidetector computed tomography and stress cardiac magnetic resonance might potentially play a role in preoperative evaluation as well, but more studies are needed to assess the role of these new modalities in preoperative risk stratification. A common question that arises in preoperative evaluation is if further preoperative testing is needed, which preoperative test should be used. The preferred stress test is the exercise electrocardiogram (ECG). Stress imaging with exercise or pharmacologic stress agents is to be considered in patients with abnormal rest ECG or patients who are unable to exercise. After reviewing this article, the reader should develop an understanding of the following: (1) the magnitude of the cardiac preoperative morbidity and mortality, (2) how to select a patient for further preoperative testing, (3) currently available noninvasive cardiac testing for the detection of coronary artery disease and assessment of left ventricular function, and (4) an approach to select the most appropriate noninvasive cardiac test, if needed.






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1 Department of Medical Imaging Service, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
2 King Faisal Heart Institute, King Faisal Specilaist Hospital and Research Center, Riyadh, Saudi Arabia; The heart Center, St Lukes Episcopal Hospital, Texas Heart Institute, Houston,Texas, USA

Correspondence Address:
Ahmed Fathala
Department of Medical Imaging Service, King Faisal Specialist Hospital and Research Center, P. O. Box 3354,Riyadh 11211, MBC 28, Saudi Arabia

Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.81570

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The preoperative cardiac assessment of patients undergoing noncardiac surgery is common in the daily practice of medical consultants, anesthesiologists, and surgeons. The number of patients undergoing noncardiac surgery worldwide is increasing. Currently, there are several noninvasive diagnostic tests available for preoperative evaluation. Both nuclear cardiology with myocardial perfusion single photon emission computed tomography (SPECT) and stress echocardiography are well-established techniques for preoperative cardiac evaluation. Recently, some studies demonstrated that both coronary angiography by gated multidetector computed tomography and stress cardiac magnetic resonance might potentially play a role in preoperative evaluation as well, but more studies are needed to assess the role of these new modalities in preoperative risk stratification. A common question that arises in preoperative evaluation is if further preoperative testing is needed, which preoperative test should be used. The preferred stress test is the exercise electrocardiogram (ECG). Stress imaging with exercise or pharmacologic stress agents is to be considered in patients with abnormal rest ECG or patients who are unable to exercise. After reviewing this article, the reader should develop an understanding of the following: (1) the magnitude of the cardiac preoperative morbidity and mortality, (2) how to select a patient for further preoperative testing, (3) currently available noninvasive cardiac testing for the detection of coronary artery disease and assessment of left ventricular function, and (4) an approach to select the most appropriate noninvasive cardiac test, if needed.






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