Preop cardiology

Question 1

Small ischemia on stress pre-vascular surgery

Answer 1

No benefit of revasc on top of BB and ASA with stable coronary dz

Survival if >10% myocardium ischemic (this is regardless of planned surgery)

Question 2

> 4 mets in history

Answer 2

ie golfing
vacuuming
2 flights stairs
REVASC/CATH not indicated

Question 3

Non invasive preop testing

Answer 3

patients who have poor fxn status or status can’t be assessed (ie hip replacement can’t walk)

Question 4

High risk pre-op conditions

Answer 4

Recent (<30days) or active MI
unstable severe angina CCS III/IV
decompensated HF NYHA IV or new onset HF
Severe symptomatic AS or valvular lesion - mean aortic gradient >40mm Hg, AVA<1.0
Arrythmias - high grade AVB, sympt ventricular arrythmia, SVT HR>100, Sx brady, new VT