Perioperative Cardiac Risk Management

Steven L. Cohn, MD, FACP, SFHM

SUMMARY

Perioperative cardiac complications are the most widely feared medical issues for the anesthesiologist, surgeon, and medical consultant as they approach a patient in the perioperative period. Only recently have management strategies been addressed in high-quality studies. The following module explains the roles of medical and interventional treatments in lowering perioperative cardiac event rates. This module also discusses the typical presentation of coronary syndromes postoperatively and the management of antiplatelet and cardiac medications.

GOAL

To provide hospitalists with current management strategies to reduce the risk of perioperative cardiac events.

TARGET AUDIENCE

This activity is designed for hospitalists. No prerequisites required.

LEARNING OBJECTIVES 

After participating in this module, the participant will demonstrate the ability to:

  1. Analyze the evidence for beta-blocker therapy in the management of patients at elevated perioperative risk for cardiac events.
  2. Assess the role for statins in perioperative cardiac risk reduction.
  3. Discuss the importance of continuing cardiac medications in the perioperative setting and the role of clonidine, aspirin, and nitrates in reducing perioperative cardiac risk.
  4. Evaluate the role for coronary interventions in preoperative patients with documented ischemia on noninvasive cardiac testing.
  5. Discuss the perioperative management of antiplatelet therapy for patients with cardiac stents.
  6. Elucidate the typical presentation of postoperative myocardial infarctions and realize the utility of screening measures.
ACCREDITATION STATEMENTS

The American Osteopathic Association (AOA) has approved this activity of the Society of Hospital Medicine for XX AOA Category 2-B CME credits.

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CREDIT STATEMENT DESIGNATION

The Society of Hospital Medicine designates this activity for a maximum of 2.00 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release Date: XX/XX/2018    Expiration Date: XX/XX/2021 

Estimated time to complete: 2 hours

CONFLICT OF INTEREST DISCLOSURE POLICY

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

INSTRUCTIONS

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: a pre-test, a study program, a post-test, & CME evaluation. All sections must be completed to receive CME credit.

Additional Information

Course summary
Available credit: 
  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 ABIM MOC Self Evaluation Points
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit
  • 2.00 Non-physician
Course opens: 
08/28/2018
Course expires: 
08/28/2021
Your cost:
$0.00
Rating: 
0
FACULTY & DISCLOSURES 

Steven L. Cohn, MD, FACP, SFHM
Director–Medical Consultation Service
Jackson Memorial Hospital
Professor Emeritus
Department of Medicine
University of Miami – Miller School of Medicine,
Miami, Florida

Dr. Cohn reports having minor stock holdings in AstraZeneca, Bristol Myers Squibb, GlaxoSmithKline, Merck & Co, Inc, Pfizer Inc, and Portola; and serving on the Speakers Bureau for Janssen and Portola.

Leonard Feldman, MD, FACP, SFHM
Associate Professor of Medicine 
Johns Hopkins University School of Medicine 
Urban Health Residency and Track Director
Associate Program Director, Osler Medical Residency
Director, Comprehensive General Medicine Consult Service
Founding Editor-in-Chief, Consultative & Perioperative Medicine Essentials for Hospitalists
Baltimore, Maryland

Dr. Feldman reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

Kurt Pfeifer, MD, FACP, SFHM
Professor of Medicine
General Internal Medicine
Medical Director, Froedtert and Medical College of Wisconsin Eye Institute Perioperative Services
Medical College of Wisconsin
Associate Editor-in-Chief, Consultative & Perioperative Medicine Essentials for Hospitalists
Milwaukee, Wisconsin

Dr. Pfeifer reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

REFERENCE DISCLOSURE

Please note, there is an ongoing inquiry into publications involving Dr Poldermans and his colleagues. The results of this inquiry may affect recommendations regarding perioperative use of β-blockers and statins.

OFF-LABEL PRODUCT DISCUSSION

All faculty have indicated that they have not referenced unlabeled or unapproved uses of drugs or devices.

DISCLAIMER

The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the University of Virginia School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

SHM CONFLICT OF INTEREST DISCLOSURE POLICY

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

ACCREDITATION STATEMENT

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CREDIT STATEMENT DESIGNATION

The Society of Hospital Medicine designates this activity for a maximum of 2.00 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Available Credit

  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 ABIM MOC Self Evaluation Points
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit
  • 2.00 Non-physician

Accreditation Period

Course opens: 
08/28/2018
Course expires: 
08/28/2021

Price

Your cost:
$0.00
Please login or register to take this course.

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: a pre-test, a study program, a post-test, & CME evaluation. All sections must be completed to receive CME credit.

Click START to begin.