Preoperative assessment & management: a free MRCS Part A question

A myocardial infarction, stroke, transient ischaemic attack or coronary stent within the last three months is one of the ASA's examples of severe systemic disease that is a constant threat to life, so he is ASA IV despite being symptom-free. Once more than three months have passed the same history is graded ASA III, which is the closest wrong answer. ASA II would describe mild controlled disease such as treated hypertension. ASA V is a moribund patient not expected to survive without surgery. Grading him correctly matters because it feeds into risk tools such as P-POSSUM and the NELA model and into the consent discussion. Reference: ASA Physical Status Classification System (2020).