Anaesthetic Assessment in Medicine
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Questions and Answers

What are the aspects of the patient's medical history that are relatively more important to the anaesthetist?

Cardiovascular and respiratory systems

Name some symptoms of cardiovascular problems that must be sought in all patients during the anaesthetic assessment.

Ischaemic heart disease, heart failure, hypertension, conduction defects, arrhythmias, peripheral vascular disease

Why are patients with a proven history of myocardial infarction (MI) at a greater risk during the perioperative period?

They are at risk of perioperative reinfarction, related to the time interval between infarct and surgery.

How long may elective surgery need to be delayed for a patient with an uncomplicated MI and a normal exercise test?

<p>6-8 weeks</p> Signup and view all the answers

What is one of the most significant indicators of perioperative complications according to the text?

<p>Heart failure</p> Signup and view all the answers

How is the severity of heart failure best described according to the text?

<p>Using a recognized scale like the New York Heart Association classification</p> Signup and view all the answers

What are the consequences of untreated or poorly controlled hypertension during anesthesia?

<p>Exaggerated cardiovascular responses and increased risk of myocardial and cerebral ischemia.</p> Signup and view all the answers

What is the recommended action for severe hypertension (SBP > 180mmHg, DBP > 109mmHg) before elective surgery?

<p>Postpone elective surgery due to the significant risk of myocardial ischemia, arrhythmias, and intracerebral hemorrhage.</p> Signup and view all the answers

What is the New York Heart Association classification for cardiac function when patients can perform activities requiring >7mets?

<p>Class I</p> Signup and view all the answers

What specific activities can a patient classified as NYHA Class I perform?

<p>Jog/walk at 5 mph, ski, play squash or basketball, shovel soil.</p> Signup and view all the answers

What is the NYHA classification for cardiac disease resulting in slight limitation of physical activity?

<p>Class II</p> Signup and view all the answers

What is the recommended action if an acute upper respiratory tract infection is present before anesthesia and surgery?

<p>Postpone anesthesia and surgery unless it is for a life-threatening condition.</p> Signup and view all the answers

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