Mnemonic for Revised Cardiac Risk Index: 4CD

The ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery replaced the intermediate-risk category for patient risk with the factors from the Revised Cardiac Risk Index. I had to adjust my PAST mnemonic accordingly - generally speaking, there are 4 major variables in the preoperative evaluation, remembered by the mnemonic PAST:

Patient risk
Activity level - measured in METs
Surgical risk
Test (stress test) or Treat (beat-blocker)?

Revised Cardiac Risk Index (Circulation. 1999;100:1043-1049):

High-risk type of surgery
Ischemic heart disease
History of congestive heart failure
History of cerebrovascular disease
Insulin therapy for diabetes
Preoperative serum creatinine >2.0 mg/dL

4CD is a mnemonic to remember the risk factors in RCRI:

CAD
CHF
CVA
CKD
DM

References:
ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: Executive Summary. Circulation, 2007.
Preoperative Care of Patients with Kidney Disease. Clinical Cases and Images.
Medical Mnemonics

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