Cardiac Clearance – Proximal Femur Fractures

Summary for cardiac clearance (full HCA protocol below)

(Go down list in order. If patient fulfills criteria, no need to proceed down list) No cardiac workup needed if:

  1. Patient can walk briskly or jog (>4 metabolic equivalents)
  2. If has no history of at least 2
    1. Ischemic heart disease
    2. CHF
    3. Cerebrovascular disease
    4. On insulin
    5. Creatinine >2
  3. No high risk conditions, including
    1. New or worsening chest pain or pain at rest
    2. MI past 45 days
    3. MI past year and not seen by cardiologist with intervention started
    4. New or worsening symptoms of CHF
    5. SIGNIFICANT arrhythmia (2nd or 3rd degree av block, ventricular arrhythmia, hr<45, a-fib with ventricular rate >120)
  4. Further testing will not impact decision to do surgery or change preop care

Full HCA protocol:

Medical City Cardiac ClearanceDownload