Assessment of elective patients

This article outlines an approach to preoperative assessment of patients presenting for elective surgery. The main focus is on assessment of patients with cardiovascular disease undergoing non-cardiac surgery, with regard to risk assessment, preoperative investigations and perioperative management of cardiovascular medications. Assessment of patients with common respiratory diseases, including obstructive sleep apnoea, is also discussed. The current utility of cardiopulmonary exercise testing in risk assessment and perioperative care planning is summarized. Finally, use of brain natriuretic peptide as a biomarker in risk stratification is considered.