Pre-operative Cardiac Risk

A 72-year-old woman with a history of myocardial infarction 8 months ago and stable angina on medical therapy presents for elective open abdominal aortic aneurysm (AAA) repair. On pre-operative evaluation, she reports dyspnea on exertion (climbing one flight of stairs), orthopnea, and lower extremity edema. Her ECG shows prior inferior wall MI changes. Echocardiography reveals left ventricular ejection fraction (LVEF) of 35% and moderate mitral regurgitation. BNP is elevated at 450 pg/mL. What is the most appropriate pre-operative cardiac management?

A 58-year-old man with a history of hypertension and type 2 diabetes mellitus presents for elective laparoscopic cholecystectomy. On pre-operative evaluation, his blood pressure is 148/92 mmHg, heart rate 88 bpm, and respiratory rate 16/min. His recent ECG shows left ventricular hypertrophy (LVH) with nonspecific ST-T wave changes. Troponin I and BNP are within normal limits. He denies chest pain, dyspnea, or syncope. He takes amlodipine and metformin. What is his revised cardiac risk index (RCRI) score, and what is the recommended pre-operative cardiac workup?

Which of the following cardiac conditions is considered a major clinical predictor and warrants preoperative coronary revascularization or cancellation of elective surgery according to the ACC/AHA guidelines?

According to the Revised Cardiac Risk Index (RCRI), which of the following is NOT one of the six independent predictors of major cardiac complications in non-cardiac surgery?