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Continuing Education in Anaesthesia, Critical Care & Pain 2006 6(3):109-113; doi:10.1093/bjaceaccp/mkl013
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Continuing Education in Anaesthesia, Critical Care & Pain | Volume 6 Number 3 2006 © The Board of Management and Trustees of the British Journal of Anaesthesia [2006]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Preoperative assessment for cardiac surgery

Heinrich Cornelissen, MB ChB FANZCA
Clinical Fellow, Department of Anaesthesia, Papworth Hospital Cambridge, UK

Joseph E Arrowsmith, MD FRCP FRCA
Consultant, Department of Anaesthesia, Papworth Hospital Cambridge CB3 8RE, UK Tel: +44 (0)1480 364406/364381 Fax: +44 (0)1480 364936 E-mail: Joe.Arrowsmith@papworth.nhs.uk (for correspondence)
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Key points

Preoperative anaesthetic assessment of the cardiac surgical patient remains an essential component of perioperative care.

Despite extensive preoperative investigation, a small number of cardiac surgical patients may have significant undiagnosed cardiovascular pathology.

Conventional indices and scales should be used when documenting symptoms, functional capacity and physical signs.

Some understanding of the basic principles, sensitivity and specificity of routine cardiac investigations is essential.

Some of the most sophisticated risk assessment tools in medicine are available for these patients.

 

Cardiac surgical patients are one of the most extensively investigated group of patients that an anaesthetist will encounter. However, evidence from studies using intraoperative transoesophageal echocardiography (TOE) suggest that as many as 5% of patients have additional and hitherto undocumented pathology (e.g. valvular disease, patent foramen ovale).1 2 Therefore, there is no place for complacency and a thorough preoperative evaluation by the anaesthetist remains an essential component of perioperative care. Apart from . . . [Full Text of this Article]


   Case note review
 

   Direct questioning
 

   Physical examination
 

   Investigations
 

   The emergency patient
 

   Risk assessment
 

   Conveying information
 

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