Pre-operative cardiac assessment

What is a pre-operative cardiac assessment?

Before some types of surgery, particularly major operations, your surgeon or anaesthetist may request a cardiac assessment. The purpose is to check that your heart is healthy enough for the procedure and to identify any heart problems that could increase the risk of complications during or after surgery.

This is especially important if you have a history of heart disease, high blood pressure, diabetes, or if you are over 65.

What does the assessment involve?

The assessment is tailored to your individual risk and the type of surgery planned. It may include:

• A thorough clinical assessment: reviewing your medical history, medications, and symptoms
• ECG: a quick recording of your heart rhythm
• Echocardiogram: an ultrasound of your heart to check how it is pumping and assess the valves
• Exercise stress test: to check for reduced blood flow to the heart during exertion
• Blood tests: including kidney function, blood count, and markers of heart strain
• CT coronary angiogram or coronary angiography: if there is concern about significant coronary artery disease

What happens after the assessment?

After reviewing all the results, a clear report is provided to your surgeon and anaesthetist with:

• An assessment of your cardiac risk for the planned procedure
• Any recommended changes to your medications before surgery
• Whether any further cardiac treatment is needed before the operation can go ahead
• Advice on monitoring during and after the surgery

The goal is to make sure you go into surgery in the best possible condition and that the team looking after you has all the information they need.

How should you prepare?

For any appointment it helps to bring: a list of your current medications and doses; copies or details of any previous heart tests (ECGs, scans, or angiogram reports); a note of your symptoms, when they happen, and what brings them on; and your questions. If you have results from another hospital, ask that clinic to send them ahead of your visit.

When to seek urgent help

If you develop new chest pain, breathlessness, or palpitations while waiting for your surgery, contact your GP or the clinic promptly. If symptoms are severe, call 999 or 112.