Cardiac Evaluation and Care Algorithm

Cardiac evaluation and care algorithm based on active clinical conditions, known cardiovascular disease, or cardiac risk factors for patients 50 years or older.

Low-risk surgery: Proceed with surgery provided patient has no active cardiac conditions/contradictions. (This is step 3 in the diagram below)
Moderate-high risk & functional capacity ≥ 4 METs, asymptomatic: Proceed with surgery provided patient has no active cardiac conditions/contraindications. (Step 4, below)
Moderate-high risk & functional capacity < 4 METs or unknown. (See Step 5, below)
-No clinical risk factors: Proceed to surgery provided no cardiac contraindications.
-1-2 clinical risk factors: Consider Beta-blocker or stress test if it will change management.
-3 or more clinical risk factors and1)  intermediate-risk surgery: Consider Beta-blocker or stress test if it will change management. 2) Vascular surgery: Consider stress test if it will change management.

**clinical risk factors = RCRI risk factors.

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