Cardiology>>>>>Assessment for Surgery
Question 3#

You review a 45-year-old man in clinic. He is due to have surgery on his knee ligaments in 4 weeks’ time. He is a smoker and has a strong family history of ischaemic heart disease. He is normotensive. He tells you that he is a keen swimmer and footballer, and injured his knee whilst training for a marathon recently. He currently finds it hard to walk unaided. Routine examination and resting ECG are normal.

Which one of the following statements best describes your approach?

a. He needs no further assessment prior to surgery
b. He should have an exercise tolerance test
c. He should have a myocardial perfusion scan
d. He should have a stress echocardiogram
e. He should have a coronary angiogram

Correct Answer is A


In low-risk surgery, regardless of the patient’s risk factors, good functional status is an indicator of low cardiac risk. No specific investigation is needed but the opportunity should be taken to discuss future risk.