Before the procedure, the patient must clear his doubts to avoid uncertainty and thus anxiety
The importance of the presurgical evaluation lies in the number of surgeries that are done per year. It is estimated that 4% of the population undergoes major surgery per year. Taking into account the number of inhabitants in Argentina, approximately 1,600,000 major procedures are performed per year, and it is estimated that the number of patients who are going to undergo surgery will increase significantly in the coming years.
The risk of complications will depend on multiple factors, including the patient’s disease, the presence of other problems (and even more if they are of the heart), the urgency, the magnitude, the type and the duration of the surgical procedure.
One variable to take into account is the age of the patients. During the next few years, the aging of the population will have an important impact on the preoperative management of patients. It is estimated that the population of patients over 75 years of age requires a surgical intervention 4 times more frequently than the rest of the population.
Surgeries can be divided into three groups: low, moderate or high risk, depending on the probability of presenting a complication. Low-risk ones are those that can present a complication in less than 1 in 100 patients. Fortunately, the majority correspond to this group. Cosmetic surgeries, breast surgeries, endoscopic procedures, dental procedures, superficial surgeries, ocular and gynecological, urological or minor trauma are included.
At the same time, there are factors in patients that must be taken into account to define whether they present an increased number of problems during or after surgery. Patients with advanced age, heart problems, kidney problems, a history of heart attack or stroke, or those with diabetes are considered at risk.
Nicolas Gonzalez Medical specialist in Cardiology MN 126909 IG. @drnigonza
What studies should be done?
The three basic and necessary implications for an adequate cardiological evaluation are the questioning of the patient, a thorough physical examination, and an electrocardiogram.
The preoperative evaluation looks for silent problems or not that may become a source of potential complications both in the surgical act and in the postoperative period.
During the interrogation, it is essential that the patient tells the doctor all his history, especially if they are cardiovascular such as a heart attack or stroke, if he has chest pain in any circumstance of daily life and if he has allergies to any medication , in order to avoid the use of it.
In the physical examination, the detection of murmurs in the heart is important, since if there is a problem in the valves or “gates”, other studies will have to be carried out.
The electrocardiogram is a very simple study to do, it does not harm the patient and it is easy to interpret. It provides information on how the heart works and allows estimating the presence of a problem that may affect the surgery.
There are other studies that should only be done in certain groups of patients or before an altered initial evaluation, such as an ultrasound of the heart, stress tests or studies of the arteries of the heart, but they should not be performed routinely.
It is good practice to educate patients prior to surgery by explaining how it will develop and how the “awakening” will be after the intervention, trying to reduce the anxiety that is generated around it.
Tips to keep in mind for the day of surgery:
– Clear all doubts and concerns with the surgeon.
– Make a list with the medication you use regularly.
– Fasting for at least 8 hours. The time can vary according to the procedure and according to the doctor’s indication.
– Remember to bring the corresponding documentation for hospitalization.
– Have the pre-surgical evaluation done, if possible with your family doctor.
Remember the existence at all times
Dr Nicolas Gonzalez