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Functional Capacity METs — FRCA Final MCQ

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EasyPreoperative AssessmentFunctional Capacity METsFRCA Final

A 62-year-old man (ASA III) with a significant cardiac history is being assessed for non-cardiac surgery. His exercise tolerance is less than 4 METs. According to the ESC/ESA 2022 guidelines, 4 METs is equivalent to which activity?

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Correct answer: C — Climbing two flights of stairs

Four metabolic equivalents (4 METs) is a key threshold in perioperative cardiac risk assessment. It equates to climbing two flights of stairs, brisk walking, or performing moderate housework. Patients unable to achieve 4 METs have significantly increased perioperative cardiac risk. Below 4 METs, further risk stratification with biomarkers (BNP/NT-proBNP), ECG, and possibly echocardiography or cardiopulmonary exercise testing is recommended.

Reference: ESC/ESA – 2022 – Non-cardiac surgery cardiovascular assessment guidelines; RCOA – 2023 – Preoperative assessment