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 All information contained in and produced by this software is provided for educational purposes only. This information should not be used for the diagnosis or treatment of any health problem or disease. THIS INFORMATION IS NOT INTENDED TO REPLACE CLINICAL JUDGMENT OR GUIDE INDIVIDUAL PATIENT CARE IN ANY MANNER. Only certified physician can use this software.