ECG of the Month: Lung Mass and Abnormal Preoperative ECG
A 71-year-old woman with no history of cardiovascular disease is evaluated for elective thoracotomy with wedge resection of a left lower lobe lung mass. She is an active smoker with a chronic cough, but denies cardiac symptoms. She has no history of hypertension, diabetes, heart failure, or renal disease. A "routine" preoperative electrocardiogram (ECG) is obtained as shown (Figure 1), and she is referred for cardiology consultation to address the result.
You are asked to review the electronic health record and recommend next steps. The anesthesiology service notes that her Duke Activity Score Index estimates 9 METS of daily activity. You choose to do which of the following?