Preoperative Anesthesia Referrals to Cardiology and Outcome in a Tertiary care hospital

Objective: This study was designed to assess the outcome of preoperative cardiac consultation on perioperative management for non cardiac surgery patients. Study Design: Prospective, Observational study. Place and Duration of Study: Pakistan Institute of Medical Sciences, Islamabad from Jan 2013 to July 2013. Materials and Methods: Patient with positive cardiac history and symptoms and signs suggestive of cardiac disease were screened by Anesthetist and referred to single Consultant Cardiologist to risk stratify cardiac status and to find out that whether further treatment was required. Results: 59% of patients were female and 41% male. 72% were between 45-75 years of age. It was observed that out of 100 patients only 16% were identified as high risks, even though 55% had cardiac co morbidities including patients with abnormal echo (36) and with abnormal rhythm on ECG (39). Only one patient needed further intervention. Conclusion: An overuse of cardiac review is being done in our set up leading to unnecessary burden on cardiology department and wastage of resources. Besides detection of any clinical abnormality by Cardiologist, it is adding little to further decision making by Anesthetist.