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cardiology clearance

Page: http://healingfireisland.com/2013/02/26/cardiology-clearance/
Healing Fire Island | Cardiology Clearance

heart attack

If a patient comes for surgery and has a heart problem often they get an ECG and a basic heart history and things proceed as expected.  But sometimes the patient has zingers that make people nervous and they end up with a Cardiology Clearance.  Here a few things that tip-off the Anesthesiologist and lead to a Cardiology Clearance.  Chest pain that is escalating or unstable, blood pressure that is uncontrolled, obesity that has been uncontrolled, diabetes that has been uncontrolled, abnormal ECG, recent heart attack (within 6 months), poor exercise tolerance, non-compliance with significant medications.  History of significant complications during surgery, ICU admission postop.

A patient will need a Cardiology Clearance before surgery DEFINITELY if they present for preop with unstable angina, heart attack within 6 months, or cardiac surgery within 6-12 months.  Recent pacemaker or AICD placement would require patients to have pertinent details available to the anesthesiologist for appropriate intervention if required.

Rocks had a Cardiology Clearance for hip surgery that ended up getting life flighted off island because of crushing chest pain during her stress test. She was a star within two weeks of starting her job.  The clinic owner was relieved that the patient wasn’t on the table, almost certainly arresting under anesthesia.  She had already impressed the unimpressable orthopedist Walter, and the owner was sending out a very sick patient for an emergency cardiac cath to the Heart Institute of Miami by LifeFlight.  Rocks had picked it up.

The clinic was going to need some ‘Cardiac Guidelines’ to avoid cardiac cripples from ending up on the schedule and to educate the community docs as well.  Rocks was already working on a document.  She understood the need for education and the value of avoiding cancellation just before scheduled surgery.

Healing Fire Island.  A work in progress!  By Chery Fee

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