Cardiac Clearance for Non-Cardiac Surgery

Preoperative Evaluation

• The American College of Cardiology and American Heart Association recommend that patients with no active cardiac conditions, good functional capacity, and undergoing low-to-intermediate risk surgery do not require additional cardiac testing or workup before proceeding with surgery 1
• Patients who can perform activities requiring ≥4 METs generally have lower perioperative risk and do not require further cardiac stress testing, according to the American College of Cardiology 4
• The American College of Cardiology states that preoperative tests should only be ordered if results will change the surgical procedure, alter medical therapy/monitoring, or lead to postponement until cardiac stabilization 1

Medication Management

• The American College of Cardiology recommends continuing all current cardiac medications perioperatively without interruption, including antihypertensive medications, statin therapy, and beta-blockers 1

Surgical Risk Stratification

• Rotator cuff repair is classified as low-to-intermediate risk surgery, which further supports proceeding without additional testing, according to the American College of Cardiology 1

Postoperative Considerations

• The American College of Cardiology recommends ensuring the patient follows up for scheduled cardiovascular follow-up as planned and continues regular cardiovascular follow-up to reinforce long-term cardiac risk reduction strategies 1