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Perioperative Cardiac Risk Assessment

Learning Objectives
1. Tailor the perioperative evaluation based on the urgency of the procedure
2. Determine if there are red flag issues that may necessitate delaying nonemergent surgery
3. Estimate the combined clinical/surgical risk based on validated modules
4. Determine functional status using metabolic equivalents
5. Assess the appropriate uses for cardiac stress testing and coronary revascularization
6. Evaluate the role of the perioperative biomarkers for cardiac risk assessment
2 Credits CME

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. To assess for the preoperative cardiac risk, hospitalists should follow a step-wise algorithm. The following module reviews the risk assessment process and enables the hospitalist to order appropriate preoperative testing.

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Activity Information

Accreditation Statement: The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Statement Designation: The Society of Hospital Medicine designates this activity for a maximum of 2.00 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosure Statement: Author: Dr. Cohn reports owning stock in AstraZeneca, Bristol-Myers Squibb Company, GlaxoSmithKline, Merck & Co, Inc, Pfizer Inc, and Portola; and reports serving on the speakers bureau for Janssen and Portola. Editors (Leonard Feldman, MD, FACP, SFHM and Kurt Pfifer, MD, FACP, SFHM) Dr. Feldman reports having no relevant financial or advisory relationships with corporate organizations related to this activity. Dr. Pfeifer reports having no relevant financial or advisory relationships with corporate organizations related to this activity. The planners and faculty for this activity have no relevant relationships to disclose unless otherwise listed.

SHM COI Policy: In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity. Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

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