Can a 75-year-old female have a breast surgery without getting cardiac clearance?

Hi,

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Cardiac clearance is needed for risk stratification for any surgery. What we need are patient history - whether she has chest pain or breathing difficulty on exertion, ECG (echocardiogram), Echo, and if a patient can do it, then TMT (treadmill test) Or we can ask the patient about their effort tolerance by asking how long they can walk or how many flights of stairs they can climb without any symptoms. TMT can assess effort tolerance very well if the patient can. Angiogram is needed if we cannot say about her effort tolerance in any possible way and the patient has any history of chest pain or breathing difficulty. Renal function (serum creatinine) test must also be done before the angiogram.

Hi,

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Given her age and hypertensive history, any surgery will be of moderate cardiac risk (Risk stratification done as mild, moderate, or severe). Angiogram can tell you an actual picture of any percentage of blockage or coronary artery disease that might be possible with age. So if she undergoes an angiogram and it comes normal, it will be a relief for the future (But still, moderate risk will be there because of age and hypertension). If there is an insignificant disease in coronaries, medicines can be prescribed later to prevent further progression. If there will be significant Coronary disease, they will first ask you to get it treated first, then go for breast surgery. For older patients above 65 and with comorbidities like hypertension, the risk will always be there in any surgery. An angiogram report will help you know her cardiac status; I am still saying TMT will be fine if she can. Thank you.