American Board of Internal Medicine (ABIM) Certification Practice Exam

According to the ACC/AHA guidelines, what is indicated for patients with coronary artery disease before intermediate-risk surgery?

1. Echocardiography

2. Stress testing

3. Electrocardiography

4. Coronary angiography

The correct answer is: Electrocardiography

In the context of the ACC/AHA guidelines, patients with coronary artery disease (CAD) who are scheduled for intermediate-risk surgery should undergo an assessment that determines their cardiac risk. The guidelines recommend that an electrocardiogram (ECG) is indicated for these patients as part of a preoperative evaluation. The purpose of the ECG is to identify any underlying cardiac ischemia or arrhythmias that could pose a risk during surgery. It helps in assessing the baseline cardiac status of the patient, which is crucial for perioperative management. An abnormal ECG may prompt further evaluation, such as additional cardiac testing. Other options like echocardiography, stress testing, and coronary angiography are generally utilized for evaluating specific cardiac conditions or for assessing significant coronary artery disease, especially in patients with clinical symptoms or high baseline risk. However, the primary and initial assessment recommended for stable patients undergoing non-cardiac surgery is an ECG, making it the correct choice in this scenario.