Postest
Based on the ACC/AHA guidelines, which of the following statements is not correct regarding management of severe or symptomatic cardiovascular disease in the perioperative period surrounding noncardiac surgery?
A. Statins should be discontinued before surgery
B. Cardiac evaluation and intervention are recommended before noncardiac surgery
C. If cardiac intervention is needed before elective noncardiac surgery, angioplasty with use of a bare-metal stent is recommended, followed by 4 to 6 weeks of thienopyridine plus aspirin
D. Successful perioperative evaluation and management require a multidisciplinary approach
Answer:
Based on the ACC/AHA guidelines, which of the following statements is not correct regarding management of severe or symptomatic cardiovascular disease in the perioperative period surrounding noncardiac surgery?
Answer: A
Statins should be discontinued before surgery.
Based on clinical trial evidence showing a protective effect of perioperative statin use on cardiac complications during noncardiac surgery, statins should not be discontinued before surgery. Optimal dose, target or achieved low-density lipoprotein cholesterol levels, and indications for therapy are still largely unclear.
Based on the ACC/AHA guidelines, which of the following statements is correct regarding management of asymptomatic cardiovascular disease in the perioperative period surrounding noncardiac surgery?
A. All patients should have invasive preoperative cardiac testing before noncardiac surgery
B. Most patients with asymptomatic heart disease can safely undergo elective noncardiac surgery without first requiring angioplasty or coronary bypass grafting
C. All patients should have noninvasive preoperative cardiac testing before noncardiac surgery
D. Preoperative cardiovascular interventions improve surgical outcomes in patients who are asymptomatic.
Answer: Based on the ACC/AHA guidelines, which of the following statements is correct regarding management of asymptomatic cardiovascular disease in the perioperative period surrounding noncardiac surgery?
Answer: D
Most patients with asymptomatic heart disease can safely undergo elective noncardiac surgery without first requiring angioplasty or coronary bypass grafting
Noninvasive and invasive preoperative cardiac testing should not be performed unless results will affect patient management. Because of recent evidence suggesting that surgical outcomes in asymptomatic patients without active cardiac conditions are similar whether cardiovascular interventions are performed, preoperative cardiac screening is not recommended in these patients.
http://www.medscape.com/viewarticle/563640