Millions of Americans who have or are at risk for heart disease have surgery every year that is not related to their heart. And a lot of them - as many as one million - have a significant cardiac complication, including 50,000 who have a heart attack.

Operations that have nothing to do with the heart itself can place a great deal of stress on the heart and blood vessels. If the cardiovascular system is not up to the challenge, then the result can be a heart attack, rhythm disturbances, or death. Experts from the American College of Cardiology and the American Heart Association created these new guidelines to help reduce that risk during the perioperative period - that is, the time before, during, and immediately after surgery.

The guidelines outline a stepwise approach to assessing a patient's heart health before surgery, guiding the doctor in balancing the patient's clinical condition and physical fitness against the risk of a specific surgery. With this information, the doctor can quickly determine whether a patient can safely undergo surgery or whether intensive treatment or additional tests should be done instead.

Wider use of beta-blockers is encouraged to slow the heart rate, lower blood pressure, and protect the heart during stress. Studies have shown that giving beta-blockers before high-risk surgery such as procedures on the blood vessels of the legs or abdomen can reduce the chances of heart attack or death by 80 percent. The guidelines also caution against doing surgery in a patient who has recently undergone angioplasty with stent placement. They also offer new information on safely performing surgery in patients with pacemakers and implanted defibrillators.

If you are facing any kind of surgery, ask your doctor about your risk during the procedure and whether there are steps you can take to reduce that risk.

Related information About cholesterol

Source:  American Heart Association and American College of Cardiology. New guidelines aid in cutting heart-related risk in non-heart-related surgery. News release, Jan. 24, 2002.