With poor functional capacity, symptoms with activity, or unknown functional capacity, further evaluation is indicated by clinical risk factors for cardiac disease:
Non-emergency surgery No active cardiac conditions Mod-to-high risk surgery Poor/unknown functional capacity 1-2 clinical risk factors
Clinician has two options:
1) Proceed to O.R. with beta-blockade for heart rate control -or- 2) Consider non-invasive coronary evaluation, i.e. stress test, if it will change management
