Assessment of the patient with known or suspected ischaemic heart disease for non-cardiac surgery.

The perioperative care of the patient with known or suspected ischaemic heart disease requires careful co-ordination among the anaesthetist, surgeon and medical consultant. Careful preoperative evaluation can aid the identification of risk, the selection of preoperative interventions that may reduce risk, and decisions on intraoperative and postoperative monitoring. Although uncontrolled observational data suggest that such careful management allows for improved outcome, more carefully controlled studies are required to determine the precise benefits and cost-effectiveness of many of the expensive and often invasive interventions that are currently available.