Perioperative cardiac assessment for noncardiac surgery: eight steps to the best possible outcome.

The prevalence of cardiovascular disease in the United States1 and the number of noncardiac surgical procedures performed are progressively increasing. Preoperative risk assessment is an important step in reducing perioperative morbidity and mortality in patients undergoing noncardiac surgery. Successful perioperative evaluation is best achieved by combining an integrated multidisciplinary approach with good communication between the patient, primary care physician, anesthesiologist, consultant, and surgeon. The goal of appropriate preoperative evaluation and therapy should be to not only improve immediate periprocedural outcomes but also to improve long term clinical outcome.