Noncardiac Surgery in Patients with Coronary Artery Disease: Risks, Precautions, and Perioperative Management

Patients with coronary artery disease face increased risks when they undergo noncardiac surgery. This is attributable to the cardiovascular stress imposed by the surgical procedure and the effects of anesthetic agents on the cardiovascular system. Several approaches to managing patients with coronary artery disease before, during, and after noncardiac surgery include "prophylactic" myocardial revascularization procedures, digitalization, use of propranolol hydrochloride, and insertion of temporary intravenous pacemakers. (Arch Intern Med138:972-975, 1978)