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15 Cards in this Set
- Front
- Back
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What is the grading system for MR? |
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? |
faster HR, decreased SVR, maintain contractility and volume |
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What is the typical MR murmur? |
holosystolic murmur best heard over the LLSB |
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What is the typical AI murmur? |
decresendo diastolic murmur |
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What is the differential diagnosis of a pansystolic murmur? |
AI, IHSS, VSD |
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What is the typical mitral valve prolapse heart sound? |
high pitched systolic murmur best heard at the apex |
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What are the anesthetic management goals for MVP? |
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? |
infective endocarditis, rheumatic myocarditis, systemic emboli, CAD, sudden death due to dysrhythmias |
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What are characteristics of acute MR? |
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? |
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? |
decreases size of LV and lessens regurg, also helps with afib |
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What are the benefits of diuretics in MR? |
decrease preload and thereby lessen pulmonary edema |
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What is the best volatile anesthetic in the setting of MR? |
isoflurane: decreases SVR and increases HR |
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How does MR affect the PA tracing? |
characteristic V wave |
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What is the effect of AI on coronary perfusion? |
aortic runoff decreases diastolic blood pressure and coronary perfusion pressure leading to ischemia and failure |
