Perioperative cardiovascular morbidity is a common challenge for the anaesthesiologist, who has daily to manage patients with coronary and/or cardiac insufficiency and/or arrhythmias. Regional anaesthesia (RA), especially epidural could reduce morbidity and mortality in the cardiac patient, but the topic remains controversial. The authors propose a review of the cardiovascular effects of RA and of various RA techniques that can be used in the cardiac patient. Finally, they discuss the choice of the anaesthetic technique according to the cardiac disease.