Preoperative Cardiac Risk Assessment - Medical Algorithm

Are you evaluating a patient for cardiac risk prior to noncardiac surgery?

Yes

Select an appropriate answer for each finding

Need for surgery

Cardiac risk for procedure

Age of the patient

years

Does the patient have a history of angina?

Yes

Is the angina unstable or severe?

Yes

Does the patient have a history of a prior myocardial infarction?

Yes

Number of weeks since the most recent MI (enter 52 if more than 1 year)

Are Q waves present on the ECG?

Yes

Does the patient have diabetes mellitus?

Yes

Does the patient have a history of ventricular ectopy requiring therapy?

Yes

Does the patient have a history of congestive heart failure?

Yes

Has the heart failure decompensated?

Yes

Does the patient have high-grade AV block, SVT with uncontrolled ventricular rate or other significant dysrhythmia?

Yes

Does the patient have severe cardiac valvular disease?

Yes

Has the patient had a coronary revascularization procedure within the past 5 years?

Yes

Has the patient had the onset of new cardiac symptoms?

Yes

Is a dobutamine stress echocardiogram positive?

Yes

Evaluation

Results

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Therapy

Monitoring

Specialty

Objective

ICD-10

Algorithm of Romero and de Virgilio for Preoperative Cardiac Risk Assessment

Purpose: To evaluate a patient for cardiac risk prior to noncardiac surgery using the algorithm of Romero and de Virgilio.