December 28, 2020/Heart Health

How to Know If Your Heart Can Handle Non-Cardiac Surgery

Before agreeing to surgery, ask about cardiac risk

caregiver speaking with a patient in a doctor's office

Many surgical procedures are very safe. But any type of surgery carries risks along with it.


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In particular, doctors and surgeons want to find out about any potential heart or cardiovascular risks that you might have before deciding whether you are a good candidate for any kind of surgery.

Ask questions and stay involved

Before you have any type of surgical procedure, it’s important to ask questions and to understand the answers to those questions. It’s also important to discuss the reason and urgency for surgery.

Cardiologist Maan Fares, MD, says that you, the patient, are an important part of any treatment. “Patients should consider themselves part of the team that evaluates the risk of any upcoming surgery.”

Guidelines and assessment

Associations such as the American College of Cardiology (ACC) and the American Heart Association (AHA) regularly publish and update guidelines that help physicians determine who is at cardiac risk for non-cardiac surgery.

Your primary care physicians can assess your risk factors.


“Most patients who need a surgical procedure should undergo an evaluation by their primary care physician,” he says. “If your doctor finds problems, or knows of an existing heart condition, they should refer the patient to a cardiologist for further investigation.”

In assessing surgical risks, your primary care doctor considers different factors, such as:

  • The type of surgery scheduled and the risk factors associated with it.
  • Your age.
  • Prior heart disease or stroke.
  • Cardiac risk factors such as diabetes, hypertension or heavy smoking.
  • Kidney function.
  • Exercise tolerance, specifically the ability to climb two flights of stairs.
  • Tests performed.

Your doctor will perform a physical exam and take notes on the details of your health history. You may also have testing such as a chest X-ray and blood work during this visit.

If there are any concerns about your heart health, your doctor will order an electrocardiogram (ECG). This looks at your heart’s electrical pulses and signals in detail.

Your doctor will ask you about any existing heart disease or about any other type of risk factors you might have. They will also check the results of the ECG. And of course, a physical exam will help uncover any physical abnormalities. These may include a heart murmur, irregular heart rhythm or a weak pulse.


If you have known heart disease such as coronary artery disease (CAD), heart valve disease or congestive heart failure or if you show new signs or symptoms that may suggest heart disease, your doctor should refer you to a cardiologist for further investigation. Your doctor may also talk to you about any medications you’re taking and if they may need to be interrupted.

Finally, anyone over the age of 50 should have an extensive assessment of their medical history and a thorough medical exam. This is because of the increased risk during surgery that comes with age.

Make your surgery an opportunity

“Your pre-operative appointments are very beneficial,” says Dr. Fares. “A pre-surgery evaluation is an ideal opportunity to evaluate the long-term treatment of a patient with significant cardiac disease or risk of disease.”

By asking questions and actively communicating with all members of your treatment team, you become your best health advocate. It’s important to also extend the conversation to your next of kin or family members when having a conversation regarding surgery. Also, you will ensure that you will have the best possible outcome before, during and after any surgical procedures.

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