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Evaluation

Are you evaluating a patient prior to cardiac surgery?

Age of the patient

years

Gender of the patient

Does the patient have angina at rest?

Does the patient have a history of CHF?

Does the patient have a history of diabetes mellitus?

Does the patient have a history of carotid artery disease?

Left ventricular end diastolic pressure

mm Hg

Mean pulmonary artery pressure

mm Hg

Is an intra-aortic balloon pump being used in the patient?

Serum creatinine

Prothrombin time

seconds

Select an appropriate answer for each finding

History of acute myocardial infarction

Timeliness of the surgery

Cardiac surgery to be performed

Results

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