Perioperative Cardiac Risk Management

Perioperative cardiac complications are the most widely feared medical issues for the anesthesiologist, surgeon, and medical consultant as they approach a patient with the option of surgery. Yet, only recently have management strategies been addressed in high-quality studies. The following module explains the roles of medical and interventional treatments in lowering perioperative cardiac event rates. This module also discusses the typical presentation of coronary syndromes postoperatively and the management of antiplatelet and cardiac medications.

To provide hospitalists with current management strategies to reduce the risk of perioperative cardiac events.

This activity is designed for hospitalists. No prerequisites required.

After completing the module, the participant should be able to:

1. Analyze the evidence for medical cardiac risk reduction therapies in the management of patients at elevated perioperative risk for cardiac events.
2. Assess the role for statins in perioperative cardiac risk reduction.
3. Evaluate the role for coronary interventions in preoperative patients with documented ischemia on noninvasive cardiac testing.
4. Discuss the perioperative management of antiplatelet therapy for patients with cardiac stents.
5. Elucidate the typical presentation of postoperative myocardial infarctions and realize the utility of screening measures.
6. Discuss the importance of continuing cardiac medications in the postoperative setting.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

Accreditation Statement: The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement: The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)^™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release date: June 2008. Expiration date: June 2012

Estimated time to complete activity: 1 hour

Full Disclosure Policy Affecting CME Activities: As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of The Johns Hopkins University School of Medicine to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following:

^*Assistant Professor of Medicine and Anesthesia, Medical Director, Perioperative Medicine Consult Service, Northwestern University, Feinberg School of Medicine, Chicago, IL.

Conflict of Interest: Dr Kallas reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

Off-Label Product Discussion: All faculty have indicated that they have not referenced unlabeled or unapproved uses of drugs or devices.

Disclaimer: The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Address correspondence to: Peter Kallas, MD, Assistant Professor of Medicine and Anesthesia, Medical Director, Perioperative Medicine Consult Service, Northwestern University, Feinberg School of Medicine, 201 E. Huron Street, Suite 5-110, Chicago, IL 60611. E-mail: pkallas@nmh.org.

Click here to download the references for this educational activity.

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited pre-test, a study program, and a CME post-test. All 3 sections must be completed to receive CME credit.

Supported by an educational grant from Merck & Co., Inc.