Peri-op cardiac complication prophylaxis

• reduce the incident of cardiac events
• increase the incidence of stroke and mortality (bradycardia, hypotension)

• beta blocker IF person is already on one going into surgery (goal HR < 65)
• high risk patient going into high or intermediate risk surgery

• unstable coronary syndrome (acute or recent MI or unstable/severe angina)
• significant arrhythmia
• severe valvular disease

intermediate: carotid endarterectomy, head & neck surgery, orthopedic surgery, prostate surgery

high: aortic or other major vascular surgery