A 60 year female has come for thyroidectomy, on history the patient told that she had chest pain 3 months back for which she sought cardiologist opinion who has prescribed her antianginal medicines. On ECG there are no fresh changes. Echocardiography done at that time showed ejection fraction of 63%. The best decision would be:
|A||To get a TMT done and if comes normal proceed for surgery|
|B||To get a fresh echo and if echo is normal proceed for surgery|
|C||Ask patient not to get the surgery done|
|D||Defer the surgery for another 3 months|
Defer the surgery for another 3 months
Incidence of perioperative MI is 30-40% if time lapsed since last attack is less than 3 months. Chances are still 15% up to 6 months. After 6 months the incidence is reduced to 6%. So elective surgery should be deferred for six months after a myocardial ischemic attack.