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Abstract
Proper anesthetic management of IHD patients undergoing noncardiac surgery needs careful preoperative evaluation of the patient which involves risk stratification, evaluation of functional capacity, and evaluation of the surgical intervention which includes the urgency of the operation and the surgical risk. Some patients may need further diagnostic interventions (such as stress ECG, DSE and Radionuclide myocardial perfusion imaging) and therapeutic procedures (such CABG and PCI with or without stents). The decision to stop or continue antiplatelet therapy with aspirin with or without clopidogrel should be weighed carefully and discussed with the surgeon, cardiologists, and anesthesiologist so as to avoid major intraoperative bleeding and in the same time avoid the risk of stoppage of antiplatelet drugs especially in patients with Drug Eluting Stents