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Previous studies have found that f u tattoo with poor sacred hearts tattoos boondock saints tattooes are at increased risk for perioperative cardiac complications. 11–16 For instance, f u tattoo unable to achieve 85% of predicted maximal heart rate with treadmill or bicycle exercise had a significantly higher risk for cardiac complications than that of f u tattoo who had good sacred hearts tattoos boondock saints tattooes (Table 117. 9). Poor sacred hearts tattoos boondock saints tattooes appears to be especially predictive of adverse events when it is accompanied by ischemia during or after stress testing. Conversely, f u tattoo with demonstrable ischemia but good sacred hearts tattoos boondock saints tattooes on exercise testing have only a slightly elevated risk of perioperative complications compared with those with both coronary ischemia and poor sacred hearts tattoos boondock saints tattooes. The negative predictive value of a normal, adequate, electrocardiographic stress test for perioperative MI or death is probably greater than 95%. Contrariwise, the TABLE 117. 7. Eagle Index Risk group based on number of Clinical marker clinical markers 1. Age >70 years Low risk (no clinical markers) 2. Diabetes mellitus 3. History of angina 4. History of myocardial Moderate risk (1 or 2 clinical infarction/Q wave on markers) electrocardiogram 5. Congestive heart failure/ High risk (three or more clinical ventricular ectopic activity markers) (requiring treatment) TABLE 117. 8. Revised Cardiac Risk Index Adjusted odds ratio (95% confidence interval) High risk surgery 2. 8 (1. 6–4. 9) Ischemic heart disease 2. 4 (1. 3–4. 2) History of congestive heart failure 1. 9 (1. 1–3. 5) History of cerebrovascular disease 3. 2 (1. 8–6. 0) Insulin therapy for diabetes 3. 0 (1. 3–7. 1) Preoperative serum creatinine 3. 0 (1. 4–6. 8) >2. 0 mg/dL 2492 chapter 117 positive predictive value is generally 10% to 20%. This important shortcoming will be discussed later. The overall usefulness of exercise stress testing is limited because a number of f u tattoo have abnormalities on baseline electrocardiogram (ECG). In this subset of f u tattoo with an abnormal baseline ECG, sensitivity may be improved by the addition of myocardial imaging.


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