ANESTHETIC MANAGEMENT OF THE CARDIAC PATIENT IN NON-CARDIAC SURGERY: A SYSTEMATIC REVIEW
Keywords:
Perioperative anesthesia, Heart disease, Non-cardiac surgeryAbstract
DOI: https://doi.org/10.46296/yc.v9i17.0769
Abstract
Introduction: Patients with cardiovascular disease account for a significant proportion of perioperative morbidity and mortality. Over the last decade, scientific societies have issued guidelines on cardiovascular assessment, pharmacotherapy, anesthetic techniques, monitoring, management of implantable cardiac devices, and surveillance of postoperative myocardial injury. Objective: To systematically summarize current recommendations for the anesthetic management of adults with heart disease undergoing noncardiac surgery. Methods: Systematic review of guidelines/consensus statements (2015 2025) in the AHA/ACC, ESC, CHEST, ASA/HRS, and ASRA repositories. Official documents with explicit methodology applicable to the adult perioperative period were included. Qualitative synthesis according to PRISMA 2020. Results: Six documents were included (AHA/ACC 2024; ESC 2022; CHEST 2022; AHA 2021 MINS; ASA/HRS 2020-CIED; ASRA 2025). They converge on: step by step algorithm for evaluation and judicious use of tests; continuity/initiation of drugs for cardiovascular indications; discontinuation and restarting of antithrombotics according to risk; hemodynamic targets to avoid sustained hypotension; troponin monitoring in high-risk patients; protocol for CIEDs. Conclusions: The guidelines provide an operational framework for clinical practice; gaps remain in subpopulations (pulmonary hypertension, complex ACHD) and in the superiority of anesthetic techniques.
Keywords: Perioperative anesthesia, Heart disease, Non-cardiac surgery.
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