*2.1.1 Preoperative investigation and imaging studies*

Baseline preoperative laboratory investigation include a complete blood count, serum electrolytes, blood urea nitrogen, creatinine, glucose, and coagulation profile. An electrocardiogram (ECG), Echocardiogram, chest x-ray, and arterial blood gases may also be obtained. ECG abnormalities in MMD include ventricular enlargement and hypertrophy, ST-T wave changes, premature ventricular contraction, and right and left axis deviation [24–26]. A review of imaging studies especially cerebral angiography may help to identify the severity of the disease.
