In 1977 Goldman, et al., developed the first cardiac risk index for patients above 40 years of age about to be operated by looking at nine variables, which increased the risk of perioperative cardiac complications.[1] These variables are
preoperative third heart sound or jugular venous distention
myocardial infarction in the preceding six months
more than five premature ventricular contractions per minute documented at any time before operation
cardiac rhythm other than sinus rhythm or presence of premature atrial contractions on preoperative electrocardiogram
age over 70 years
intraperitoneal, intrathoracic or aortic operation
emergency operation
important aortic valvular stenosis
poor general medical condition
Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 1977;297:845-50 PMID 904659
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