FOR APPs & PRIMARY CARE CLINICIANS
Perioperative cardiac assessment — Quick reference
First steps, urgent findings, referral guidance, and handoff essentials.
First steps
Identify the operation/urgency, active disease, functional capacity, validated risk estimate, medications, recent PCI, and any device.
Recognize the urgent patient
Active ACS, decompensated HF, unstable arrhythmia, or important symptomatic valve disease needs evaluation before an elective timeline proceeds.
When to refer
Coordinate complex risk, recent PCI/antiplatelets, anticoagulation, significant disease, or device planning with cardiology/EP and anesthesia.
What to send with the referral
Procedure/date; risk estimate; symptoms and function; PCI records; medication plan; recent studies; device details.
Avoid this pitfall
Routine testing is not a prerequisite for every operation. Specify coordinated hold/restart and device-restoration plans rather than blanket clearance.
Reviewed October 11, 2026. This quick reference summarizes the linked guide; use the full guide for context and clinical references.