Perioperative Cardiac Management
Case-based clinical reasoning for cardiac risk assessment — from functional capacity to integration of BNP and RCRI.
Try the tool first
The Cardiac Risk Navigator integrates surgical risk, functional capacity, RCRI, and BNP into a single assessment.
Assess perioperative cardiac risk →Think through cases
② Looks fine… but something is off
Elevated BNP despite apparent functional capacity
A case on how to approach a discordance between self-reported functional capacity and an elevated preoperative BNP.
High RCRI despite adequate functional capacity
A case on how to avoid false reassurance when a patient appears well but carries a high RCRI score.
③ Known risks — what to do next?
Elevated BNP before surgery
A case on how to interpret an elevated preoperative BNP and what steps to take next.
History of ischaemic heart disease: preoperative assessment after PCI
A case on preoperative evaluation of patients with prior coronary stent placement.
Severe aortic stenosis before non-cardiac surgery
A case on managing severe AS in patients scheduled for non-cardiac surgery.
Key decision points
Overview of preoperative cardiovascular risk assessment
A guide to framing cardiac risk before surgery using three dimensions: surgical risk, patient-side risk, and functional capacity.
METs and DASI: assessing functional capacity
How to estimate cardiac reserve from daily activity using METs and the Duke Activity Status Index.
BNP and NT-proBNP in preoperative assessment
Understanding the role and limitations of BNP and NT-proBNP in perioperative cardiac risk evaluation.
Ischaemic heart disease and preoperative evaluation
Preoperative cardiac assessment in patients with coronary artery disease or prior PCI.
Aortic stenosis and perioperative decision-making
Preoperative evaluation approach for patients with severe AS scheduled for non-cardiac surgery.