Perioperative Cardiac Risk
Arun Anaesthesia Academy
Surgery
Active
Risk
Function
Tests
Pathway
Plan
1
Surgical Timing
Emergency
<2 h
Urgent
2 to <24 h
Time-sensitive
Delay up to 3 months
Elective
Can be delayed
2
Cardiovascular Risk Profile
Does the patient have cardiovascular risk factors, known disease or symptoms?
Hypertension, smoking, high cholesterol, diabetes, women >65 y, men >55 y, obesity, family history of premature CAD
Yes
No
3
Active Cardiac Conditions
Acute coronary syndrome
Unstable cardiac arrhythmia
Decompensated heart failure
None of these
RCRI
Other calculator
4
Revised Cardiac Risk Index
4
Calculated Risk of MACE
Predicted MACE (NSQIP, MICA, AUB-HAS2 or other)
%
5
Risk Modifiers
Severe valvular heart disease
Severe pulmonary hypertension
Elevated-risk congenital heart disease
Prior coronary stents or CABG
Recent stroke or TIA
Pacemaker or ICD
Frailty
None of these
+
Coronary Revascularisation
Most recent procedure
Balloon angioplasty only
Bare-metal stent
Drug-eluting stent
CABG only
PCI performed for
ACS
Chronic coronary disease
Not known
Time since procedure
Days
Months
Does surgery require stopping an antiplatelet agent?
Yes
No
Current antiplatelet therapy
Aspirin
Clopidogrel
Prasugrel
Ticagrelor
None
+
Stroke / TIA Timing
Time since most recent stroke or TIA
months
DASI
Stairs
Unknown
6
Duke Activity Status Index
6
Stair Climbing
Can the patient climb 2 flights of stairs without stopping?
Yes
No
7
Patient Details
Age
years
8
Stepwise Pathway
Start new assessment
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