2.1 Health Assessment.

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What are the goals of cardiovascular assessment?

Identify risk factors, symptoms, and physical exam findings (correct)

Modify the risk of perioperative cardiac events and preoperative treatment options

Determine the need for further preoperative testing and postoperative care

Identify the type of surgery, diagnostic testing, and preoperative interventions

Which factor is NOT included in the Cardiac Risk Index for predicting complications?

High-risk type of surgery

Preoperative treatment with insulin

Postoperative serum creatinine >2.0 mg/dL (correct)

Previous history of congestive heart failure

What percentage of all perioperative deaths are accounted for by cardiovascular disease?

100%

75%

25%

50% (correct)

Which statement about hypertension (HTN) is true?

A 10 mmHg increase in DBP doubles the lifetime risk of cardiovascular disease Signup and view all the answers

What is the most common form of end organ damage associated with hypertension?

Ischemic heart disease Signup and view all the answers

How does a 20mmHg increase in SBP correlate with cardiovascular disease risk?

Doubles the lifetime risk of cardiovascular disease Signup and view all the answers

What proportion of patients undergoing major surgery experience serious myocardial injury?

8% Signup and view all the answers

'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' Signup and view all the answers

Which exercise tolerance level is associated with increased perioperative risk?

Dyspnea with chest pain during minimal exertion Signup and view all the answers

What does the Duke Activity Status Index (DASI) help to identify in patients?

Patients at risk for myocardial infarction Signup and view all the answers

What is considered a 'positive' result in Exercise EKG testing?

>1 mm of horizontal or down-sloping ST-segment depression after exercise Signup and view all the answers

Which cardiac testing method provides information about coronary perfusion and has greater sensitivity than exercise stress?

Nuclear stress testing Signup and view all the answers

What percentage of MIs occur without symptoms according to the text?

30% Signup and view all the answers

What does the text suggest is NOT possible to predict about coronary plaque?

Stability Signup and view all the answers

'Moving Beyond METS' refers to which index that helps evaluate patients' exercise capacity?

Duke Activity Status Index (DASI) Signup and view all the answers

'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.' Signup and view all the answers

'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.' Signup and view all the answers

What is the most significant independent predictor of stent thrombosis?

Clopidogrel discontinuation Signup and view all the answers

How long should a patient wait before undergoing elective surgery after receiving a bare metal stent?

30 days Signup and view all the answers

Which of the following is NOT a preoperative predictor of myocardial infarction?

Hypertension Signup and view all the answers

What is the major cause of heart failure associated with systolic dysfunction?

Ischemia Signup and view all the answers

What does BNP stand for in the context of heart failure assessment?

Brain Natriuretic Peptide Signup and view all the answers

Why is elective surgery contraindicated in the presence of acute heart failure?

Abnormal contractility Signup and view all the answers

'DAPT' in the context of stents stands for:

Dual Antiplatelet Therapy Signup and view all the answers

'DES' is an abbreviation for:

'Drug Eluding Stent' Signup and view all the answers

'EF' in relation to heart failure refers to:

'Ejection Fraction' Signup and view all the answers

What does 'PCI' stand for regarding heart treatment options?

Percutaneous Coronary Intervention Signup and view all the answers

What is the recommended action for elective surgery in patients with hypertension?

Postpone for SBP >200 mmHg or DBP >115 mmHg Signup and view all the answers

Which demographic is identified as having the highest risk for heart disease in the text?

Male Signup and view all the answers

Which condition is characterized by angina at rest or an increase in severity/frequency without elevated cardiac biomarkers?

Unstable angina Signup and view all the answers

Which of these symptoms may indicate cardiovascular risk in a patient's history?

Diaphoresis Signup and view all the answers

What are two common comorbidities mentioned in the text as risk factors for heart disease?

Hypercholesterolemia and diabetes mellitus Signup and view all the answers

What should patients in general do regarding their anti-hypertensive medications before surgery?

Continue taking them Signup and view all the answers

Which medication type does the text suggest holding before surgery despite historical advice?

ACE-I and ARB medications Signup and view all the answers

'DOE, orthopnea?' are questions aimed at determining what aspect of a patient's condition?

'Exercise tolerance' Signup and view all the answers

'Chest pain that does not change appreciably in frequency or severity over 2 months or longer' describes which type of angina?

'Chronic stable angina' Signup and view all the answers

'Heart Disease' accounts for what percentage of patients in the operating room according to the text?

'30%' Signup and view all the answers