II. Background
- Replaced by ACC-AHA Preoperative Cardiac Risk Assessment
- Listed for historical reasons only
III. Criteria: Eagle and Vanzetto
- Age over 70 years
- Diabetes Mellitus
- Q Waves on ECG
- History of Angina Pectoris
- History of Myocardial Infarction
- History of ventricular ectopy
- History of Congestive Heart Failure
- ST Segment abnormalities on EKG
- Hypertension with Left Ventricular Hypertrophy
IV. Protocol
- Indications for surgery without further evaluation
- Young healthy patient undergoing minor surgery
- Noncardiac emergency surgery
-
Detsky's Modified Cardiac Risk Index
- Class I Risk Index
- Eagle and Vanzetto criteria: 0 to 1 (see above)
- Considered low risk of cardiac event (3%)
- Proceed to surgery without further evaluation
- Eagle and Vanzetto criteria: 2 or more (see above)
- Intermediate risk of cardiac event (3 to 15%)
- Proceed to surgery without further evaluation
- Nonvascular surgery proceeds without evaluation
- Vascular surgery evaluation with Stress Imaging
- Negative test: Surgery may proceed
- Positive test: Manage as high risk below
- Eagle and Vanzetto criteria: 0 to 1 (see above)
- Class II or Class III Risk Index
- Considered high risk of cardiac event (>15%)
- Consider revascularization for CAD
- Manage CHF, Arrhythmia, valve disease
- Minimize Cardiac Risk
- Class I Risk Index