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15 Cards in this Set
- Front
- Back
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What is the grading system for MR?
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1+: jet extends immediately behind the valve; 2+: if the jet extends up to 1/3 the length of the atrium; 3+ if the jet extends up to 2/3 the length of the atrium; 4+ if it extends more than 2/3s into the atrium
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What are anesthesia goals with MR?
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faster HR, decreased SVR, maintain contractility and volume
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What is the typical MR murmur?
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holosystolic murmur best heard over the LLSB
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What is the typical AI murmur?
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decresendo diastolic murmur
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What is the differential diagnosis of a pansystolic murmur?
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AI, IHSS, VSD
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What is the typical mitral valve prolapse heart sound?
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high pitched systolic murmur best heard at the apex
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What are the anesthetic management goals for MVP?
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avoiding events which increase cardiac emptying; increases in HR and decreases in SVR must be avoided
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What are complications of MR?
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infective endocarditis, rheumatic myocarditis, systemic emboli, CAD, sudden death due to dysrhythmias
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What are characteristics of acute MR?
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no enlargement of LA or LV, left ventricular end diastolic and LAP are higher, rhythm is usually sinus
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What are characteristics of chronic MR?
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LA and LV are typically enlarged, pressure are higher than normal but not as high as in acute MR, frequently associated with afib
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What are the benefits of digitalis in MR?
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decreases size of LV and lessens regurg, also helps with afib
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What are the benefits of diuretics in MR?
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decrease preload and thereby lessen pulmonary edema
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What is the best volatile anesthetic in the setting of MR?
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isoflurane: decreases SVR and increases HR
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How does MR affect the PA tracing?
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characteristic V wave
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What is the effect of AI on coronary perfusion?
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aortic runoff decreases diastolic blood pressure and coronary perfusion pressure leading to ischemia and failure
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