PRE-OP CARDIAC EVALUATION IN NON-CARDIAC SURGERIES

Views:
 
Category: Entertainment
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

PRE-OP CARDIAC EVALUATION IN NON-CARDIAC SURGERIES:

PRE-OP CARDIAC EVALUATION IN NON-CARDIAC SURGERIES Dr.A.Bhagavati Rao Dept. of Gen. medicine

INTRODUCTION:

INTRODUCTION To prevent any intra/post operative complication. Starts with a systemic approach to history taking and performing a focused clinical examination. Identifies pts.- whose medical cond. Needs optimisation who should be excluded for surgery.

Slide 3:

We will discuss about- - indication & modalities of pre op cardiac stress testing. - indication of PCI prior to NCS. - Discuss role of β blockers, α blockers & statin therapy. - Discuss role of pre-op lab assessment & pre-op medication management.

PRACTICE GUIDELINES:

PRACTICE GUIDELINES Three principal elements of evaluation - Clinical risk predictors. - Surgical specific risks. - Self reported exercise capacity. adequate > 4 METS.

CLINICAL RISK PREDICTORS:

CLINICAL RISK PREDICTORS Active cardiac conditions:- Decompensated CHF (NHYA IV) Unstable or severe angina, recent MI Significant arrhythmias Severe valvular diseases Clinical risk factors: Mild angina pectoris. Compensated or prior CHF. Prior MI by history and Q waves. Diabetes mellitus,Renal disease.

SURGICAL SPECIFIC RISK PREDICTORS:

SURGICAL SPECIFIC RISK PREDICTORS Major risks (risk >5% of CD/non-fatal MI ) -Peripheral vascular surgeries -Emergent major surgeries in elderly. Intermediate risk operations (risk>1%-<5%) -intrathoracic , intraperitoneal -orthpaedic, carotid endarterectomy -endovascular aortic repair.

Slide 7:

Low risk procedure (risk<1%) -Endoscopic procedure -Cataract surgery -Breast surgery

ECG INDICATIONS:

ECG INDICATIONS

INDICATION OF PRE-OP CARDIAC STRESS TESTING:

INDICATION OF PRE-OP CARDIAC STRESS TESTING

BEST MODALITIES OF CARDIAC TESTING:

BEST MODALITIES OF CARDIAC TESTING

HOW SOON AFTER PCI ELECTIVE SURGERY:

HOW SOON AFTER PCI ELECTIVE SURGERY

INDICATIONS OF CORONARY REVASCULARISATION PRIOR TO NCS:

INDICATIONS OF CORONARY REVASCULARISATION PRIOR TO NCS

ROLE OF PRE OPERATIVE β BLOCKER:

ROLE OF PRE OPERATIVE β BLOCKER

MANAGEMENT OF ANTIPLATELET THERAPY IN NCS:

MANAGEMENT OF ANTIPLATELET THERAPY IN NCS

PULMONARY RISK IN PERI-OP PERIOD:

PULMONARY RISK IN PERI-OP PERIOD

ROUTINE PRE-OP INVESTIGATIONS:

ROUTINE PRE-OP INVESTIGATIONS

CHRONIC OUTPATIENTS MEDICATION BEFORE SURGERY:

CHRONIC OUTPATIENTS MEDICATION BEFORE SURGERY

authorStream Live Help