• Pre-op assessment for cardiac surgery
    • Assessment
      • Case note review
        • Risk factors sought
          • Age >60
          • HT
          • PAH
          • BMI >35 or <20
          • CCF
          • PVD
          • DM
          • Acute coronary syndromes
          • Chronic pulmonary disease
        • Medication review
      • Patient review
        • Direct questioning
          • Usual anaesthetic history
          • Symptoms
            • SOB, orthopnoea, PND, ET, syncope, previous MI, brief ROS
        • Examination
          • Usual airway assessment
          • HR, BP, Rhythm, CVP, HS, carotid arteries, peripheral pulses, lung fields
        • Investigations
          • FBC
          • U&E
          • Coagulation screen
          • LFT
          • 12-lead ECG
          • Left heart catheter
          • CXR
          • TTE/TOE
          • ABGs
    • NHYA grading of CCF
      • 1
        • Cardiac disease but no limitation in physical activity
      • 2
        • Slight limitation in physical activity. Ordinary activity results in fatigue, palpitation, dyspnoea
      • 3
        • Marked limitation in physical activity, comfortable at rest
      • 4
        • Inability to carry out physical activity, may have angina at rest
    • Angina scale (Canadian CV society)
      • 1
        • Ordinary activity does not cause angina
      • 2
        • Slight limitation in normal activity
      • 3
        • Marked limitation in normal activity
      • 4
        • Inability to carry out any physical activity without discomfort
    • Risk scoring
      • Parsonnet score
        • Patients commonly now outperform
      • EuroSCORE
        Link:www.euroscore.org
        • More accurate assessment
    • CEACCP
      Link:ceaccp.oxfordjournals.org/content/6/3/109.full.pdf