Medical clearance or optimization before surgery is necessary for patients to be able to have surgery safely. Without medical evaluation prior to surgery, patients that have underlying conditions that may not be well controlled would be at a much higher risk of heart attack, stroke, or even death, during or immediately after surgery. For example, a patient that has high blood pressure that is not well controlled with medications in the weeks prior to surgery would be at much higher risk of a heart attack or stroke during or after surgery as compared to someone that has high blood pressure, but is well controlled with medications. The same is true for other conditions, including asthma, heart disease, COPD, and diabetes. This is why the preoperative evaluation is so important. Often this evaluation can help identify underlying medical conditions that may need further testing or treatment before the patient can have surgery. Occasionally this evaluation may also discover new conditions that the patient did not know about, but that also need to be further evaluated before they can have surgery safely.
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