Pre-surgical cardiac clearance
An estimate of cardiovascular risk before non-cardiac surgery, with recommendations for the surgical team.
What it measures
- What it measures
- Combines history, examination, electrocardiogram, and any further testing needed to estimate the risk of a cardiac event during or after surgery, and defines what reduces it.
- Duration
- Between 30 minutes and 1 hour
- Preparation
- No fasting. Bring any previous test results and the list of medicines you take.
- What it feels like
- It is a consultation. Anything further depends on the individual case.
- Referral from another doctor
- No
- Results
- Same day
- Where it is done
- In the office
What it shows
Time runs to the right. The diagram shows the shape of the decision, not what tips it one way or the other: that is for the doctor to determine in each case. It declares no measurement — there are no timeframes and no percentages.
- 01
- Surgery has already been decided. The assessment does not decide whether there is an operation: it comes after that decision and works on it.
- 02
- The assessment. Not a box to tick: it is the point where the cardiac risk of the operation is estimated and everything possible is done to lower it beforehand.
- 03
- Carry on. With concrete instructions for the surgical team: which medicines to keep or stop, and what to watch during anaesthesia.
- 04
- Or defer, and come back. Deferring does not cancel the operation: it returns to the same point to assess again once whatever needed controlling is under control.
Pre-surgical clearance is not paperwork to be signed. Its purpose is specific: estimate the chance of a cardiac event around the surgery and lower it before the patient reaches the operating room.
Practical decisions for the surgical team come out of it: which medications to stop and which to continue, where anticoagulants and antiplatelets are the delicate part, what to watch during anesthesia, and whether the operation should wait until something is brought under control.
Arriving with prior test results and a complete medication list saves a second visit.