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Right-sided Endocarditis in IVDU — EECC MCQ

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HardValvular Heart DiseaseRight-sided Endocarditis in IVDUEECC

A 78-year-old with diabetes, CKD stage 3 and previous coronary stenting is scheduled for open aortic surgery. Functional capacity is 3 METs and there are no unstable symptoms. Which biomarker strategy improves detection of perioperative myocardial injury?

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Correct answer: B — Measure baseline high-sensitivity troponin and repeat it for 48–72 postoperative hours

High-risk patients undergoing high-risk surgery may sustain clinically silent myocardial injury. A baseline high-sensitivity troponin permits interpretation of postoperative change, and surveillance over the first 48–72 hours detects most events. CK is less sensitive, natriuretic peptide estimates risk rather than myocardial injury, a single late sample misses the diagnostic window, and ST monitoring does not replace biomarkers.

Reference: 2022 ESC Guidelines for cardiovascular assessment before non-cardiac surgery. https://academic.oup.com/eurheartj/article/43/39/3826/6675076