Internal Medicine Preoperative Consultation

Cardiopulmonary risk assessment and medication management before non-cardiac surgery.

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 11, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Internal Medicine Preoperative Consultation?

Preoperative consultation by internal medicine evaluates cardiopulmonary risk, regulates chronic medications and aims to reduce perioperative complications before non-cardiac surgery.

Use the Revised Cardiac Risk Index (RCRI) for cardiac risk; an exercise capacity (METs) below 4 increases risk. Antiplatelets, anticoagulants and DM medications are reorganised according to surgery type.

Symptoms

Existing cardiac/pulmonary disease in the patient

Limited functional capacity (METs <4)

Use of antiplatelet/anticoagulant medication

Preoperative ECG abnormality

Risk Factors

Previous coronary artery disease

Heart failure (HFrEF)

Chronic kidney disease (creatinine >2)

Stroke history

Insulin-treated diabetes

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

Cardiac risk assessment in elective surgery
Suspected unstable angina or new-onset cardiac symptoms
Bleeding risk planning in a patient on anticoagulant therapy
Pulmonary risk in known COPD/asthma patient

Treatment Methods

RCRI calculation and risk stratification (low/medium/high)

METs and DASI assessment

Appropriate stress test (ETT, dobutamine echo, MPI)

Aspirin continuation/discontinuation decision (procedure dependent)

Stopping P2Y12 inhibitor (clopidogrel 5-7 days, ticagrelor 5 days)

Anticoagulant bridging (LMWH bridge in high risk)

Beta-blocker continuation (start 30 days before surgery if needed)

Statin continuation (especially in vascular surgery)

Insulin/SGLT2 management plan

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.