Cardiac Algorithm - Step 5

Functional Capacity Level?

Does the patient have moderate or better functional capacity defined as ability to achieve 4+ METs level of exertion without symptoms?

Choose the patient’s functional capacity level

Excellent Functional Capacity
  • Non-emergency surgery
  • No acute coronary syndrome
  • Elevated risk surgery
  • Moderate or good functional capacity
  • Proceed to operating room, no further testing necessary (ACC IIa)
Moderate or Good Functional Capacity
  • Non-emergency surgery
  • No acute coronary syndrome
  • Elevated risk surgery
  • Moderate or good functional capacity
  • Proceed to operating room, no further testing necessary (ACC IIb)
Poor or Unknown Functional Capacity
(?) functional capacity levels

Poor functional capacity (1-3 METs) activities:

  • Take care of self
  • Eat, dress, use toilet
  • Walk indoors around the house
  • Walk a block or two on level ground at 2-3 mph
  • cardiac symptoms with higher levels of activity

Moderate (4-6 METs) and Good (7-10 METs) functional capacity activities:

  • Do light housework, i.e. dusting or washing dishes
  • Climb a flight of stairs or walk up a hill
  • Walk on level ground @ 4mph
  • Run a short distance
  • Do heavy housework. i.e. scrubbing floors. lifting or moving heavy furniture
  • Moderate recreational activities, ie golf, bowling, dancing, doubles tennis

Excellent (10 METs) functional capacity activities:

  • Strenuous sport, i.e. swim, singles tennis, basketball, skiing.