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Nine questions to help you protect your heart before having surgery

It's too bad that ticker trouble doesn't guarantee good health elsewhere in the body. Most people with heart disease have other ailments, including some that require surgery. What's needed to protect the heart during such operations? The December 2007 issue of the Harvard Heart Letter offers nine questions to help you and your doctor determine if you need cardiac testing or treatment before undergoing surgery.

New guidelines from the American College of Cardiology and American Heart Association take some of the stress — and stress testing — out of surgery. They limit the use of pre-surgery stress testing, especially before low-risk procedures such as colonoscopy, cataract removal, and most outpatient surgeries. For higher-risk operations, like surgery on the aorta or other blood vessels, prostate surgery, or bone or joint surgery, whether you need testing and preventive care depends on the state of your heart. People with an active heart condition such as unstable heart failure, a significant heart rhythm problem, or severe valve disease need pre-surgery cardiac evaluation, and possibly treatment, more than those with stable, well-controlled heart disease.

The Harvard Heart Letter's questions include these:

How urgent is the operation? In an emergency, there's no time to second-guess cardiac risk. If the surgery can be delayed, cardiac considerations become more important.

What’s your functional status? Can you climb stairs without needing to stop because of chest pain or breathlessness? The more you’re able to do, the less you need a presurgical cardiac evaluation.

Do you have cardiac risk factors? Angina, diabetes, kidney disease, controlled heart failure, or a prior stroke increase the chances of heart trouble during surgery. If you don't have any of these risk factors, you probably don't need special precautions before surgery.

Also in this issue of the Harvard Heart Letter

  • Genetic help for a blood-thinner balancing act
  • A blood pressure problem that's isolated in name only
  • Heart Beat: Teachable moment
  • Heart Beat: Steering clear of pacemaker infections
  • Heart Beat: Newer bypass technique may be safer for women
  • Heart Beat: ACE, ARB duet questioned
  • Heart Beat: Take a shot against heart disease
  • Heart Beat: Too few get the best therapy for an ailing heart
  • Ask the doctor: How do I handle conflicting advice about exercise?
  • Ask the doctor: Is yerba mate good for my heart?

More Harvard Health News »


About Harvard Health Publications

Harvard Health Publications publishes four monthly newsletters--Harvard Health Letter, Harvard Women's Health Watch, Harvard Men's Health Watch, and Harvard Heart Letter--as well as more than 50 special health reports and books drawing on the expertise of the 8,000 faculty physicians at Harvard Medical School and its world-famous affiliated hospitals.