TY - CHAP M1 - Book, Section TI - Chapter 9. Evaluation of the Patient with Cardiovascular Disease A1 - Olson, Ronald P. A1 - Rawlings, Ron A2 - Longnecker, David E. A2 - Brown, David L. A2 - Newman, Mark F. A2 - Zapol, Warren M. PY - 2012 T2 - Anesthesiology, 2e AB - Perioperative ischemia results from an imbalance of oxygen supply and demand of the myocardium during perioperative stress, rupture of a vulnerable plaque with subsequent thrombosis of a coronary artery, endothelial dysfunction, or some combination of all of these.The history and physical examination, along with limited indicated tests, are often adequate to determine the general perioperative risk of a patient.Preoperative cardiac testing is usually not needed in patients who have good functional status or are undergoing low-risk procedures. Further testing is unlikely to change management, and these patients may proceed directly to surgery.Many interventions, such as control of diabetes, hypertension, stable coronary artery disease, congestive heart failure, and endothelial function, can be well within the scope of an anesthesiologist's skill set. If anesthesiologists wish to consider themselves perioperative clinicians, they must be active in these well-established aspects of medicine.The attending anesthesiologist of a specific patient, not a consultant, is in the best position to balance the risks and determine the best anesthesia techniques for that case. Other clinicians and consultants are often needed to ensure optimization, although increasingly, the anesthesia team can do at least some of this. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=56622072 ER -