A pre-operative evaluation is usually necessary before an operation. The need to perform a pre-operative evaluation as well as how extensive it should be depend on the medical history of the patient as well as the type of the operation. A basic pre-operative evaluation consists of a cardiac medical exam and an electrocardiogram. Further exams can be recommended whenever is necessary. After completing the evaluation, we define the cardiac risk of the upcoming procedure and we give instructions in order to maximize safety during and after the operation. Our findings and instructions are given to the patient and are also sent to the surgeon.