Preop Eval for Open heart surgery

Preop Eval for Open heart surgery

Height and weight

HISTORY:

• • Cardiac: HTN, CAD, MIs, CHF, PTCA, and VHD.

  • Pulmonary: smoking, COPD, asthma, penumonia, intubations, and previous anesthesia, sleep apnea.

  • GI: PUD, jaundice, GIB, liver disease

  • Neurologic: TIA, stroke, CVA

  • PVD: PAD, CVI, DVTs, carotid a. dz, and vein stripping (alternative conduits)

  • Endocrine: DM, thyroid d/o, and adrenal insufficiency

  • Hematology: antiplatelet or anticoagulants, bleeding d/o like sickle cell, and previous blood transfusions.

  • Musculoskeletal: arthritis, Fx, back pain, gout, SLE, and rheumatologic d/o.

  • Nephrology: UTI, CKD, dialysis.

  • Urologic: incontinent, urinary obst, CA.

  • Dermatologic: skin rash, infections, decubiti.

  • Dental: carious, tooth abscess.

  • Allergies:

  • Meds: Plavix, coumadin, NSAIDs, chemotherapy, steroids

PMH: Prior CABG, PCI, PPM, AICD, syncope, cancer within 5 years (mediastinal radiation), IABP placement in past

PSH: smoking cigarettes or other tobacco use, illicit drugs, and alcohol consumption.

FH: CAD (males 55 years or less, women 65 years or less)

SH: smoking, alcohol, IVDA, caffeine, occupation, home situation, social support, ADL, IADL, advance directives, and disposition plans.

PE:

• • Skin inf/rash

  • Dental caries (valve surgery)

  • Vascular ex: carotid bruits, abdominal bruit, peripheral pulses

  • BP: differential arm pressures

  • Lungs:

  • Heart:

  • Ext:

  • Neuro:

  • Walking for 5 meters, thrice.

ECG

Carotid doppler

TTE

HbA1C

LFTs

pro-BNP

BUN/Cr

PFTs