Cardiac Surgery Pre-Operative Evaluation Checklist

Patient Information

Medical History

History of cardiac disease
Prior cardiac surgery/interventions
Hypertension
Diabetes mellitus
Renal disease
Stroke or TIA
Pulmonary disease
Other significant comorbidities

Current Medications

Allergies

Recent Investigations & Results

ECG
Echocardiography
Laboratory tests (CBC, Renal, Electrolytes, LFTs)
Coagulation profile
Chest X-ray
Coronary angiography
Other relevant tests

Preoperative Assessment

Physical examination completed
Anesthesia assessment done
Airway assessment
Consent obtained
Patient fasting status checked
Blood products arranged
Venous access planned

Special Considerations

Notes