J Cardiothorac Vasc Anesth 2025 May 14; doi: 10.1053/j.jvca.2025.05.014.

Highlights from the American College of Cardiology and American Heart Association 2024 Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery.

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Increasing noncardiac surgery volumes globally combined with the growing prevalence of cardiovascular risk factors continues to pose a challenge for anesthesiologists caring for patients in the perioperative period. Forty-five percent of all patients >45 years old have multiple cardiovascular risk factors, with cardiovascular complications reported in three percent of surgical admissions. In 2024, the American College of Cardiology and the American Heart Association, in collaboration with several subspecialty societies, updated the 2014 guidelines on the management of cardiovascular diseases in the perioperative period for patients undergoing noncardiac surgery. Some of the topics covered include perioperative risk calculators, guidelines for diagnostic testing, perioperative considerations for cardiovascular comorbidities, management of medical therapies, and anesthetic/intraoperative management strategies. Since the guidelines are broad and detailed, this article highlights essential recommendations that are especially relevant to the busy perioperative physician.

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