The AHA, ACC and seven partner societies in surgery, anaesthesia, imaging and rhythm have published a guideline on perioperative cardiovascular evaluation and management for adults undergoing non-cardiac surgery. It explicitly supersedes the 2014 ACC/AHA guideline.
According to its summary, it updates the earlier recommendations with newer evidence and adds management strategies covering drug therapy, perioperative monitoring and devices for cardiovascular and related conditions. The evidence search ran to March 2023.
The summary does not set out which specific recommendations changed. Departments that use the 2014 algorithm in preoperative clinics or referral pathways should review the full document before updating local protocols, rather than rely on secondhand summaries.
- Local preoperative assessment pathways based on the 2014 guideline should be reviewed against the new document.
- Anaesthetists, surgeons and physicians who share perioperative care should agree on one version locally.
- The evidence search closed in March 2023, so later trials are not reflected.
- Read the full recommendations before changing routine testing or medication management.
Why it matters
Preoperative cardiac referrals and tests in many hospitals still follow an algorithm that is now officially superseded.
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