Review Note

Last Update: 02/17/2025 08:00 AM

Current Deck: BPT Questions

Published

Currently Published Content

Front

A 60 year old female is currently awaiting mastectomy for breast carcinoma. She is well and walks 30 minutes daily. 4 years ago had a RCA stent inserted after she presented with chest pain and the angiogram showed she had RCA vessel disease. Cardiac function is normal. She now reports infrequent angina symptoms, only on exertion or when she is carrying very heavy objects. What is the most appropriate pre-operative management strategy for her ischaemic heart disease?
A. CT coronary angiogram
B. Coronary angiogram
C) Myocardial perfusion scan
D) Proceed to surgery.
E. Stress echocardiogram

Back

Topic: Preoperative cardiac risk assessment
A. CT coronary angiogram -> may overestimate risk so not recommended for preoperative assessment. Also given prior PCI, may have too much artefact to assess properly

B. Coronary angiogram -> low risk patient, would only proceed to this is functional testing positive, no benefit to routine revascularisation preoperatively unless substantial functional ischemia

C) Myocardial perfusion scan -> Given good functional capacity, unlikely to show significant ischemia that would alter preoperative management or considerations

D) Proceed to surgery. -> Goof functional capacity, PCI 4 years ago, somewhat urgent indication for surgery. If had PCI within past 12 months then would consider delaying

E. Stress echocardiogram -> same as myocardial perfusion scanning

Current Tags:

Cardiology Examq

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