1. In patients who require emergency surgery, we recommend against delaying surgery for a preoperative cardiac risk assessment.
2. In patients who require urgent or semiurgent surgery, we recommend undertaking preoperative cardiac risk assessment only if the patients’ history or physical examination suggests there is a potential undiagnosed severe obstructive intracardiac abnormality, severe pulmonary hypertension, or an unstable cardiovascular condition.
3. In patients who undergo elective noncardiac surgery who are 45 years of age or older or 18-44 years of age with known significant cardiovascular disease, we recommend they undergo preoperative cardiac risk assessment.

Preoperative cardiac risk assessments should be undertaken by a physician or surgeon with substantial knowledge in this area (eg, a thorough understanding of these perioperative guidelines) and who is proficient in cardiac clinical evaluation.