Gerson M C
Department of Internal Medicine, University of Cincinnati School of Medicine, Ohio.
Clin Chest Med. 1993 Jun;14(2):263-81.
A careful history, physical examination, resting electrocardiogram, and chest radiograph are essential for preoperative cardiac assessment of adult patients. The nine individual Goldman indicators of increased perioperative cardiac risk and evidence of an unstable coronary ischemic syndrome should be specifically sought in each patient and treated when possible. After initial assessment, patients who still have a medium level of perioperative risk can usually be accurately assigned to a high- or low-risk category through the use of exercise testing and the selective use of dipyridamole thallium imaging.
详细的病史、体格检查、静息心电图和胸部X线检查对于成年患者术前心脏评估至关重要。应在每位患者中特别查找九项围手术期心脏风险增加的Goldman个体指标以及不稳定冠状动脉缺血综合征的证据，并尽可能进行治疗。在初始评估后，对于围手术期风险仍处于中等水平的患者，通常可通过运动试验以及选择性使用双嘧达莫铊显像准确地分为高风险或低风险类别。
