Does it provide advice for patients on blood thinners?

Yes, it includes specific recommendations for managing aspirin, DAPT (post-stent), warfarin, and DOACs, including timing for holding and resuming medications relative to surgery.

What medical guidelines does this skill follow?

This skill is based on the 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management, supplemented with 2024 ESC recommendations for biomarker-based risk stratification.

How does it help prevent unnecessary preoperative testing?

By following the ACC/AHA stepwise approach, it identifies low-risk surgeries and patients with high functional capacity (≥4 METs) who can proceed to surgery without further cardiac testing.

Can this skill calculate the Revised Cardiac Risk Index (RCRI)?

Yes, it evaluates all six components of the RCRI (Lee Index) to estimate the risk of major adverse cardiac events (MACE) including MI, heart failure, and cardiac death.

Preoperative Cardiac Risk Management

Name: Preoperative Cardiac Risk Management
Author: lev-os

bylev-os

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Productivity & Workflow

Applies ACC/AHA and ESC guidelines to assess and manage perioperative cardiac risk for patients undergoing non-cardiac surgery.

This skill provides a comprehensive clinical framework for evaluating cardiac risk prior to non-cardiac surgery. It implements the ACC/AHA stepwise algorithm to determine the necessity of preoperative testing, facilitates the calculation of the Revised Cardiac Risk Index (RCRI), and assesses patient functional capacity in METs. Beyond risk stratification, the skill guides users through complex perioperative medication management for beta-blockers, statins, and antiplatelets, and outlines postoperative surveillance protocols such as troponin monitoring to identify myocardial injury (MINS). It is designed to reduce unnecessary testing in low-risk scenarios while improving outcomes for high-risk patients.

Key Features

01Functional capacity (METs) assessment and classification

02Postoperative cardiac surveillance and troponin monitoring guidelines

03Perioperative medication protocols for antiplatelets and anticoagulants

042 GitHub stars

05ACC/AHA stepwise cardiac evaluation algorithm implementation

06Revised Cardiac Risk Index (RCRI/Lee Index) scoring

Use Cases

01Stratifying patient risk to determine the necessity of stress testing or echocardiography

02Standardizing preoperative cardiac clearance for elective non-cardiac procedures

03Developing medication management plans for patients on DAPT or anticoagulation undergoing surgery

Key Features

01Functional capacity (METs) assessment and classification

02Postoperative cardiac surveillance and troponin monitoring guidelines

03Perioperative medication protocols for antiplatelets and anticoagulants

042 GitHub stars

05ACC/AHA stepwise cardiac evaluation algorithm implementation

06Revised Cardiac Risk Index (RCRI/Lee Index) scoring

Use Cases

01Stratifying patient risk to determine the necessity of stress testing or echocardiography

02Standardizing preoperative cardiac clearance for elective non-cardiac procedures

03Developing medication management plans for patients on DAPT or anticoagulation undergoing surgery