Assessment of cardiac risk in surgical patients
A. A. Gage, J. N. Bhayana, V. Balu and N. Hook
Fifty patients admitted to the hospital for elective noncardiac surgery
were carefully assessed for cardiac risk by exercise stress testing.
Twenty-five of 38 (66%) patients with adequate testing had abnormal stress
test results. Patients with symptoms of angina had a high incidence of
abnormal stress test results (15 of 20). In the majority of these patients,
the exercise stress test was true-positive, so that on angiography, severe
coronary artery disease was present. In patients with no cardiac symptoms,
33% (ten of 30) had abnormal stress test results and seven patients had
significant coronary artery disease. Our preliminary data indicate that
exercise stress testing is a good noninvasive screening test to detect
asymptomatic coronary artery disease. Those patients who have an abnormal
stress test or an abnormal ECG or angina should undergo coronary
angiography to determine extent of coronary disease.
