“Assessment of Cardiovascular Risk for Noncardiac and Nonsurgical Activities” was originally published in the April 2023 issue of The American Journal of Medicine.
Cardiovascular risk stratification is a frequent evaluation performed by health professionals. Not uncommonly, requests for risk stratification involve activities or procedures that fall outside of the scope of current evidence-based guidelines. Estimating risk and providing guidance for these requests can be challenging due to limited available evidence. This review focuses on some of these unique requests, each of which are real examples encountered in our practice. We offer guidance by synthesizing the available medical literature and formulating recommendations on topics such as the initiation of testosterone and erectile dysfunction therapy, SCUBA and skydiving, polygraphy, and electroconvulsive therapy.
Clinical Significance
- Clinicians are sometimes asked to assess cardiovascular risk for nonoperative procedures or activities that fall outside of the scope of current evidence-based guidelines.
- Cardiovascular testing is rarely beneficial for many of these situations.
- Informed, patient-centered conversations about cardiovascular risk are preferred and should be based on the best available medical literature.
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