37 Questions
What are the goals of cardiovascular assessment?
Identify risk factors, symptoms, and physical exam findings
Which factor is NOT included in the Cardiac Risk Index for predicting complications?
Postoperative serum creatinine >2.0 mg/dL
What percentage of all perioperative deaths are accounted for by cardiovascular disease?
50%
Which statement about hypertension (HTN) is true?
A 10 mmHg increase in DBP doubles the lifetime risk of cardiovascular disease
What is the most common form of end organ damage associated with hypertension?
Ischemic heart disease
How does a 20mmHg increase in SBP correlate with cardiovascular disease risk?
Doubles the lifetime risk of cardiovascular disease
What proportion of patients undergoing major surgery experience serious myocardial injury?
8%
'Sometimes, surgery is necessary and we don’t have time for a huge workup' - Why might this be a challenge in clinical decision-making?
'Vague cardiac symptoms present in patients'
Which exercise tolerance level is associated with increased perioperative risk?
Dyspnea with chest pain during minimal exertion
What does the Duke Activity Status Index (DASI) help to identify in patients?
Patients at risk for myocardial infarction
What is considered a 'positive' result in Exercise EKG testing?
>1 mm of horizontal or down-sloping ST-segment depression after exercise
Which cardiac testing method provides information about coronary perfusion and has greater sensitivity than exercise stress?
Nuclear stress testing
What percentage of MIs occur without symptoms according to the text?
30%
What does the text suggest is NOT possible to predict about coronary plaque?
Stability
'Moving Beyond METS' refers to which index that helps evaluate patients' exercise capacity?
Duke Activity Status Index (DASI)
'Almost two thirds of patients describe new-onset angina pectoris or a change in their angina pattern during the 30 days preceding an acute MI.' This statement implies that:
'MI might be preceded by new-onset angina or angina pattern changes.'
'Likelihood of serious adverse events inversely related to number of blocks a patient can walk.' This implies that:
'Patients who walk fewer blocks have a higher risk of adverse events.'
What is the most significant independent predictor of stent thrombosis?
Clopidogrel discontinuation
How long should a patient wait before undergoing elective surgery after receiving a bare metal stent?
30 days
Which of the following is NOT a preoperative predictor of myocardial infarction?
Hypertension
What is the major cause of heart failure associated with systolic dysfunction?
Ischemia
What does BNP stand for in the context of heart failure assessment?
Brain Natriuretic Peptide
Why is elective surgery contraindicated in the presence of acute heart failure?
Abnormal contractility
'DAPT' in the context of stents stands for:
Dual Antiplatelet Therapy
'DES' is an abbreviation for:
'Drug Eluding Stent'
'EF' in relation to heart failure refers to:
'Ejection Fraction'
What does 'PCI' stand for regarding heart treatment options?
Percutaneous Coronary Intervention
What is the recommended action for elective surgery in patients with hypertension?
Postpone for SBP >200 mmHg or DBP >115 mmHg
Which demographic is identified as having the highest risk for heart disease in the text?
Male
Which condition is characterized by angina at rest or an increase in severity/frequency without elevated cardiac biomarkers?
Unstable angina
Which of these symptoms may indicate cardiovascular risk in a patient's history?
Diaphoresis
What are two common comorbidities mentioned in the text as risk factors for heart disease?
Hypercholesterolemia and diabetes mellitus
What should patients in general do regarding their anti-hypertensive medications before surgery?
Continue taking them
Which medication type does the text suggest holding before surgery despite historical advice?
ACE-I and ARB medications
'DOE, orthopnea?' are questions aimed at determining what aspect of a patient's condition?
'Exercise tolerance'
'Chest pain that does not change appreciably in frequency or severity over 2 months or longer' describes which type of angina?
'Chronic stable angina'
'Heart Disease' accounts for what percentage of patients in the operating room according to the text?
'30%'
Test your knowledge on METS (Metabolic Equivalent) exercise tolerance, its implications in patients with stable angina, and associated perioperative risks. Explore the relationship between exercise capacity and cardiovascular health using the Duke Activity Status Index.
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