Contraindication of major thoracic surgery is
(A) Myocardial infarction in recent 3 months# CARDIOVASCULAR FITNESS:1. All patients for lung resection should have a preoperative ECG.2. All patients with an audible cardiac murmur should have an echocardiogram.3. Patients who have had a myocardial infarction should normally not be operated on for lung resection within 6 weeks.4. Any patient who has had a myocardial infarction within 6 months and is being assessed for thoracic surgery should have a cardiology opinion.5. Patients who have had coronary artery bypass surgery should not be precluded from having lung resection. They should be assessed as for other patients with possible cardiac risk factors.6. The guidelines from the American College of Cardiology and the American Heart Association should be used as a basis for assessing the perioperative cardiovascular risk of patients undergoing lung resection.# Major risk:(a) These patients should have a formal cardiological assessment and their management discussed at a multidisciplinary meeting.(b) Patients found to have significant lesions on coronary angiography should be considered for coronary artery bypass surgery before lung resection.# Intermediate Risk:(a) Patients in this group with reasonable functional capacity (able comfortably to walk up one flight of stairs) should not normally be regarded as at greater than average risk for postoperative complications. They do not need further cardiac testing.(b) Patients with poor functional capacity and those in whom there is doubt about the degree of severity of their angina pectoris or who report breathlessness which may be due to cardiac disease should have an ECG monitored exercise test and echocardiogram and the results should be discussed with a cardiologist.# Minor Risk:> Patients in this group with one risk factor should not normally be considered to be at greater than average risk for postoperative complications.
Myocardial infarction is recent 3 months
Myocardial infarction in recent 9 months
Myocardial infarction in recent 12 months
Myocardial infarction in 18 months
Miscellaneous