Pre-operative Echocardiogram Guidelines

Dr N C Bhaskaran FRCP FRCA, Consultant Anaesthetist Oct. 2016 Guidelines for Pre-operative Resting Echocardiography at Benenden Hospital (1) Previous Cardiac Failure or MI with a reduction in Functional Capacity (less than 4 METs) (2) Dyspnoea not explained by pulmonary disease (on pulmonary function testing) or obesity with an abnormal ECG (3) Cardiac Murmur Only if one or more of the following factors is/are present: (a) Reduced Functional Capacity (less than 4 METs) (b) Chest pain (c) Orthopnea (d) PND (e) Peripheral oedema or on diuretics (unless for HBP eg Bendrofumethiazide 2.5 mg od) (f) Cardiomegaly (on PA Chest X-Ray and/or Clinical examination) (g) Abnormal ECG (arrhythmia, conduction defect. LVH or pathological Q waves) (4) When there is difficulty in eliciting satisfactory history and if there is any clinical suspicion that any of the above may be present. The above guidelines are for undertaking major orthopaedic work, and it may be that an anaesthetist may wish to proceed without an echo if the proposed surgery is a minor one with no major fluid shifts anticipated (e.g., an arthroscopy) Functional Capacity 1 MET: Can you take care of yourself? Walk indoors around the house Walk a block or two on level ground 4 METs: Do light work around the house Climb a flight of stairs or walk uphill? Run a short distance Participate in activities like golf, bowling, dancing etc >10 METs: Participate in strenuous sports like swimming, tennis, football etc

Perioperative Anticoagulation

Hypertension Guidelines

Handdbook of Perioperative Medicines

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