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Biến cố tim mạch được coi là nguyên nhân chính gây tử vong trong giai đoạn chu phẫu. Những sự kiện quan trọng nhất là nhồi máu cơ tim cấp tính (MI), đau thắt ngực không ổn định, suy tim, loạn nhịp tim nặng, ngừng tim nonfatal, và tử vong | 7 Perioperative Cardiac Risk Stratification F.R.B.G. Galas1 L.A. Hajjar1 and J.O.C. Auler JR.2 Introduction Cardiovascular events are considered the main cause of death in the perioperative period. The most important events are acute myocardial infarction MI unstable angina cardiac failure severe arrhythmias nonfatal cardiac arrest and death. Patients experiencing an MI after noncardiac surgery have a hospital mortality rate of 15-25 1 2 and nonfatal perioperative MI is an independent risk factor for cardiovascular death and nonfatal MI during the 6 months following surgery. Patients who have a cardiac arrest after noncardiac surgery have a hospital mortality rate of 65 and nonfatal perioperative cardiac arrest is a risk factor for cardiac death during the 5 years following surgery 3 4 . The objectives of preoperative evaluation are a performing an evaluation of the patient s current medical status b making recommendations concerning the evaluation management and risk of cardiac problems over the entire perioperative period and c providing a clinical risk profile that the patient primary physician anesthesiologist and surgeon can use in making treatment decisions that may influence short- and long-term outcomes. No test should be performed unless it is likely to influence patient treatment 5 . The cost of risk stratification cannot be ignored. Accurate estimation of a patient s risk for postoperative cardiac events mi unstable angina ventricular tachycardia pulmonary edema and death after surgery can guide allocation of clinical resources use of preventive therapies and priorities for future research. 1Surgical Intensive Care Unit and Department of Anesthesiology Hospital das Clínicas InCor Heart Institute University of São Paulo Medical School São Paulo Brazil 2Surgical Intensive Care Unit Department and InCor Heart Institute University of São Paulo Medical School São Paulo Brazil 110 F.R.B.G.Galas L.A. Hajjar J.O.C.Auler jr. The prevalence of cardiovascular .
