Case
Exercise intolerance before surgery
A case on how to assess reduced exercise tolerance in preoperative cardiac evaluation.
Teaching points
- Exercise tolerance below 4 METs is associated with higher perioperative cardiac risk.
- Reduced exercise tolerance is a signal requiring further evaluation, not a standalone diagnosis.
- Ask about functional status in daily activities — dyspnea on exertion may not be volunteered.
Next clinical question
If BNP is elevated, what should be assessed next?
Case: Elevated BNP →Apply this in practice
Use the Cardiac Risk Navigator to assess this patient's cardiac risk.
Assess perioperative cardiac risk →