You have been asked to perform a preoperative consultation on a 65-year-old male who will be undergoing a testicular hernia repair. Of the following findings, which is of most concern in predicting a cardiac complication in this patient undergoing noncardiac surgery?
a) Age over 60
b) History of myocardial infarction 3.5 years ago
c) Harsh systolic crescendo-decrescendo murmur radiating to the carotids
d) ECG and subsequent telemetry showing up to five PVCs per minute
e) Serum creatinine 2.0 mg/dL
Answer:
C - harsh systolic crescendo-decrescendo murmur radiating to the carotids
Reference: http://med-source.blogspot.com/2007/07/shelf-usmle-step-2-practice-questions.html
Image source: http://www.surgical-tutor.org.uk/default-home.htm?system/abdomen/hernias.htm~right
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