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.
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
Since 1977, multiple cardiac risk indices and guidelines for preoperative cardiac evaluation have been developed.