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Notes
- Abnormal ECG
LBBB, LVH with strain (anterolateral ST depression +/- T inversion) or pathological Q waves are predictive of LVSD.
If there has been no change in 12-lead ECG Since the last echo, a clinically relevant change in LV function is very unlikely. - Newly detected AF
Preoperative echo is not routinely indicated, if there are no symptoms or signs of heart failure - Biomarkers
Hs-cTnI or NT-proBNP can be measured in high-risk cases to stratify the risk of perioperative death and CV complications - Valves
Echo surveillance interval depends on severity of valve disease on last echo; at discretion of cardiology/echo department.
Simple congenital1
- Eg: surgically repaired ASD and VSD with normal post-op echo.
Complex congenital2
- More complex congenital cardiac pathology such as Tetralogy of Fallot or Transposition of the great arteries.
- Suggest discussion with Cardiologist in this patient group if Consultant Anaesthetist has concerns.