PAEA Surgery End Of Rotation (EOR) Practice Exam

When assessing cardiac disease prior to surgery, what is the most critical factor to evaluate?

1. Family history of heart disease

2. ECG findings

3. Aortic stenosis

4. Chest X-ray results

The correct answer is: Aortic stenosis

In evaluating cardiac disease prior to surgery, the most critical factor to assess is the presence and severity of aortic stenosis. Aortic stenosis significantly impacts cardiac function and can pose substantial risks during surgical procedures, particularly in patients who may already have compromised cardiac reserve. Aortic stenosis leads to increased left ventricular afterload, which can result in heart failure symptoms, arrhythmias, and even sudden cardiac death if not properly addressed prior to surgery. Understanding whether a patient has this condition and how severe it is allows for appropriate perioperative risk stratification and management plans to be tailored to the patient's specific needs. Other factors, such as ECG findings, family history, and chest X-ray results, provide valuable information; however, they do not directly assess the current state of the heart's function in the way that evaluating aortic stenosis does. Aortic stenosis can significantly affect a patient's ability to tolerate both the stress of surgery and anesthesia, making its assessment paramount in the preoperative setting.