Curious how you guys would take the medical clearance issue:
initial medicine consult states patient not medically cleared for surgery and recommend cardiac consult (just the night before this consult was made)
patient has uncontrolled hypertension (systolic upper 190)
hx of CAD (no recent cardiac cath): patient is a poor historian
health care proxy is the daughter who is not much help esp on the phone
patient is taking amiodarone for which no one knows why
suggested hx of heart failure (ortho note taken with grain of salt)
the ortho attending has good ties with another medical attending...and patient soon the patient is cleared
wanting to have a further work up of this patient... is it simply academic with really not much clinical worth?
afterall the patient did fine
and really i was not troubled enough to even place an A-line
so prob not a major issue but for some reason if it had gone bad...and suffered from a perioperative cardiac event
i would have looked like an idiot
any comments?
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