Guidelines and Implications for Selecting Preoperative Cardiac Stress Tests

Nurse practitioners frequently manage patients who have cardiac risks and need further evaluation before their elective surgery. Cardiac stress testing can provide important needed data. Cardiac stress testing includes exercise treadmill testing; echocardiography, with exercise or pharmacologically; myocardial perfusion stress testing; and magnetic resonance angiography. Although a number of factors need to be considered, including prior cardiovascular history and type of surgical risk, a nurse practitioner's selection of the appropriate cardiac stress test needs to include the benefit-risk ratio and the level of evidence supporting the clinical decision-making process.