Cardiovascular disease is the number one killer of men and women in the US. For that reason cardiac complications are the most common surgical and post–surgical problems.
Often times the cardiac status of a patient is known ahead of time. Sometimes, it is silent and no one knows about it. It is important to have a good cardiac evaluation prior to surgery whenever possible. What does it entail?

The History

It is important to tell the surgeon and anesthesiologist about any symptoms that you may have. Shortness of breath, chest pain, pain when walking, and even a cough can be indicative of underlying heart disease. It is also important for them to know about whether you smoke, have high blood pressure, high cholesterol, diabetes, known heart disease and if you have sleep apnea. Don’t hold anything back!

The Evaluation

The initial evaluation may include an EKG and a CXR. If there is a suspicion of heart disease, a stress test may be ordered. Usually they order an echocardiogram with the stress test or a nuclear study called a thallium stress test. If the index of suspicion for heart disease is really high, they may recommend a cardiac catheterization. The more information that the doctors have (especially the anesthesiologist) the better they can tailor your care.

Complications

The most crucial time for the heart after surgery is the first 48 hours. Some patients may find themselves in the intensive care unit where they (and their hearts) can be monitored more closely.

Bottom Line

The best way to prevent cardiac complications as a result of surgery is to prevent cardiac disease. The way to do this is to make healthy choices, exercise and address health issues as they arise. Don’t wait for a surgery to force you to deal with problems that could have been evaluated and treated well beforehand! It is never too late to make changes. If you haven’t already, start now!