Close cooperation is necessary between the cardiologist and anesthesiologist preoperatively in order to identify the risks associated with a surgical procedure. This article reviews the various types of anesthesia and their effects on the cardiovascular system, in particular in relation to the category of cardiovascular disease. Accurate definition of the operative risk involves thorough evaluation of three essential parameters: cardiovascular status, the type of surgery and the type of anesthesia. These high-risk patients require management not only pre- and peroperatively, but also postoperatively, which is the period when the majority of complications occur. Mention is also made of drug interactions between anesthetic and cardiovascular agents.