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Fleisher-Eagle Algorithm for Preoperative Cardiac Risk Assessment
Feb 23, 2013
•
Mark Morgan
categories:
Cardiovascular
Fleisher-Eagle Algorithm for Preoperative Cardiac Risk Assessment
NO
YES
<-- Ischemic heart disease (angina or prior MI)?
NO
YES
<-- Heart failure?
NO
YES
<-- High-risk surgery (including intraperitoneal, intrathoracic, and suprainguinal vascular procedures)?
NO
YES
<-- Diabetes mellitus (especially insulin-requiring)?
NO
YES
<-- Renal insufficiency?
NO
YES
<-- Poor functional status (defined as the inability to walk four blocks or climb two flights of stairs)?
NO
YES
<-- History consistent with coronary heart disease?
------------------------------------------------------------
Interpretation:
score interpretation
score=(ischemic)+(chf)+(riskysurg)+(diabetes)+(renal)+(poorfunc)+(coronary); score>2?'Noninvasive testing should be performed, followed by cardiac catheterization if the results are positive.':score>0?'Perioperative beta blocker therapy may be recommended - see updated 2014 ACC/AHA perioperative guidelines - but no further testing is recommended.':'No further testing or treatment recommended.'
display/hide references
references:
#1
Fleisher (2001) N Engl J Med 345:1677
#2
Fleisher LA et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summary: a report of the AmericanCollege of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Dec 9;130(24):2215-45.
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