Pre-operative cardiac fitness : No, it is not acceptable , you are not authorised to do this !

A 62-year-old man who is being scheduled for prostate surgery with no cardiac risk factors or comorbid status came for surgical clearance. I examined him and took an ECG, everything was fine and gave him clearance for surgery.  I was surprised to spot him the very next day, waiting in the lounge of my office. He said, his anesthetist was not happy with my pre-op-cardiac assessment report, suggested it was incomplete, and sent me back for echocardiography to know the LV ejection fraction. I wanted to clarify with the patient, what exactly happened when he met his anesthesiologist. “I am not sure doctor, the moment he saw your report, he called my urologist. I overheard his call, they were discussing the need for an echocardiogram and they were also wondering,  how could a cardiologist give a  surgical clearance without even an echocardiography”. I wasn’t really surprised by the turn of events and told the patient.  “I am experienced enough to say, your heart is 100 % normal without an echocardiogram”. “I understand doctor, but sorry to bother you. Can you please take it for the sake of my anesthetist and urologist, after all, right now I am worried about their peace of mind”  “You are absolutely right. This is a topsy-turvy world. Investigations are dictated to me in my own field of expertise. Anyway, I am not a fool, to expect a patient’s help to guard my principles of practice. Please check in, l...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: cardiac surgery Cardiac fitness for non cardiac surgery preoperative cardiac risk assesment surgical clearance and cardiac fitness Source Type: blogs