Preoperative Evaluation: Additional Consults

Cardiology Evaluation
If you suffer from known heart disease, it will be necessary to have a cardiac evaluation prior to bariatric surgery. Similarly, if you have cardiac risk factors, such as age over 40, diabetes, or a strong family history, you will need to get your cardiac health evaluated prior to bariatric surgery.

When you meet with a cardiologist, he or she will take a full medical history and perform a physical examination. You will need to have an EKG, or electrocardiogram, which is quickly done in the office. Many patients will undergo a stress test to see how the heart functions when under stress. If the stress test is positive then additional workup may be required.

Sleep Study
Many obese individuals have sleep apnea. This is a condition where fatty tissue in the neck compresses your airway at night, resulting in such severe snoring that you stop breathing for a short period. This episode (called an "apnea") will usually wake you up so that you start breathing again. However, these frequent awakenings mean that you never get a full night's sleep!

Patients with sleep apnea tend to have trouble sleeping and feel poorly rested in the morning. They are often irritable or sleepy during the day, and may eSven fall asleep while working or driving.

Sleep apnea can be detected by an overnight sleep evaluation, also called polysomnography, or a sleep evaluation. If your surgeon feels that you may have sleep apnea, you will be asked to have a sleep study. If the study shows that you do have sleep apnea, this can be treated with a special breathing mask, known as CPAP or BiPAP, that you wear at night.

For more information about sleep apnea and polysomnography, please visit the Mount Sinai Center for Sleep Medicine's web site:

Pulmonary Evaluation
If you have asthma or some other known pulmonary disease, you will be asked to meet with a pulmonologist, or lung doctor, prior to surgery. The pulmonologist may request additional studies, such as pulmonary function testing, or PFTs. In PFTs, you breath into a machine which measures the size and rate of your breaths. This can give us very helpful information about the state of your lungs.


Q. I've heard that every bariatric patient needs to have an endocrine evaluation to make sure that there is no hormonal reason for their obesity. Does this mean that I need to see an endocrinologist before surgery?

A. All patients will have a thyroid hormone level checked prior to surgery, since hypothyroidism (low thyroid level) can cause obesity. However, this is a simple blood test that does not require a formal consultation with an endocrinologist. If you have a more serious endocrine problem, such as severe diabetes or Cushing's disease, you will be asked to consult with an endocrine specialist before being considered for surgery.

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