Orange Flashcards
What is the most common source of cardiac embolism?
Left atrium
What is the most common cause of isolated aortic insufficiency?
Congenital Bicuspid valve #1
Marfan’s syndrome #2
What are the major clinical predictors of increased peri-operative cardiovascular risk?
Unstable coronary syndromes
Decompensaged heart failure
Significant arrhythmias
Severe valvular disease
What are the intermediate clinical predictors of increased peri-operative cardiovascular risk?
Mild angina Previous MI Compensated or prior heart failure DM Renal insufficiency
What are the minor clinical predictors of increased peri-operative cardiovascular risk?
Advanced age Low functional capacity Uncontrolled systemic HTN Previous stroke Rhythm other than sinus Abnormal EKG
What non-cardiac procedures are stratified as high cardiac risk?
Emergent major operations
Aortic and other major vascular surgery
Peripheral vascular surgery
Anticipated prolonged surgical procedures associated with large fluid shifts and/or blood loss
What non-cardiac procedures are stratified as intermediate cardiac risk?
Carotid endarterectomy Head and neck surgery Intraperitoneal and intrathroacic surgery Orthopaedic surgery Prostate surgery
What non-cardiac procedures are stratified as low cardiac risk
Endoscopic surgery
Superficial procedures
Cataract surgery
Breast surgery
What do you do with a high-risk CV surgical patient?
Hold the surgery -> cardiology work up
What do you do with a intermediate or minor-risk CV surgical patient
Look at the function capacity and surgical risks
What is the Goldman risk assessment
Cardiac risk index
9 variables associated with increased risk of peri-operative cardiac complications
What are the components of the Goldman risk assessment ?
See email Orange 12
What is the associated risk of death with the Goldman Risk Assessment points?
Total points : risk of life threatening cardiac complication / risk of death 0-5 points : 0.7% / 0.2% 6-12 pts : 5% / 2% 13-25 pts : 12% / 2% >25 pts : 22% / 56%
What is the mortality difference between peri-operative MI and non-surgical acute MI pts
Peri-operative mortality: 50-90%
Non-surgical AMI mortality: 12%
What is the most common associated finding with peri-operative MI?
Peri-operative shock (<10mins)
