Maqsood Ahmad, Fatima Wajahat, Amna Wajahat.
Role of Trans-thoracic Echocardiography in Pre-anesthesia evaluation of Surgical patients undergoing Non-cardiac surgery.
Isra Med J Jan ;13(1):7-10.

Objective: To determine the utility of pre-operative echocardiography in the assessment of cardiac status of patients undergoing non cardiac surgery. Study Design: A retrospective observational study. Place and Duration: The study was conducted at Armed Forces Institute of Urology Rawalpindi from 10 Jan 2016 to 10 Jan 2018. Methodology: Retrospectively, we selected 1000 patients of ASA (American Society of Anaesthesiologist) 2, ASA 3, and ASA 4, who underwent non cardiac surgery under general or spinal anaesthesia. All these patients were advised 2D echocardiography in pre anaesthesia check-up due to their underlying illness, pre-existing ischemic heart disease, previous angioplasty, cardiac bypass, bed ridden old age cases and history of shortness of breath. Young patients having cardiac murmur and history of valvular heart disease were also advised to undergo this test. Moreover the physical efficiency in terms of MET (metabolic equivalent) score was also determined for each patient and their final anaesthesia fitness was given after reviewing the echocardiography report. The risk of surgery and anaesthesia was calculated by finding MET score and 2D echo report. SPSS 16 was used to analyse the data which was presented in percentages, mean and standard deviation. Results: Out of 1000 echo reports, 75.9% were normal, 14.8% had mild change in ejection fraction (EF >40%), 6.5% with moderate heart dysfunction, and 2.8% with severe heart compromise. Conclusion: Although, patient`s history and MET score determines the perioperative risk without history of cardiac illness whereas 2D echocardiography did not provide any help but where indicated it is a useful investigation.

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