A 72-year-old with controlled hypertension is booked for elective knee replacement. She has no cardiac symptom, can climb two flights of stairs and

Question

A 72-year-old with controlled hypertension is booked for elective knee replacement. She has no cardiac symptom, can climb two flights of stairs and has a low predicted perioperative cardiac risk. What cardiac testing is indicated?

Accepted Answer

No routine stress test or coronary imaging; proceed with standard perioperative assessment and risk-factor management

Answer

Obtain resting echocardiography and exercise stress imaging because a nonzero Revised Cardiac Risk Index indicates occult structural and ischaemic disease

Answer

CT coronary angiography because antihypertensive treatment masks exertional angina

Answer

Exercise stress testing because age above 70 is an independent indication before any major operation

Answer

Invasive coronary angiography because orthopaedic surgery causes a predictable troponin rise

Low Perioperative Risk — RACP Adult Medicine MCQ

A 72-year-old with controlled hypertension is booked for elective knee replacement. She has no cardiac symptom, can climb two flights of stairs and has a low predicted perioperative cardiac risk. What cardiac testing is indicated?