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16 Cards in this Set
- Front
- Back
What is a good anesthetic for stenotic valvular lesions?
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halothane(want to avoid increased HR and decreased SVR)
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What are normal mitral valve areas? what valve area and pressure gradient is an indication for surgical treatment?
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4-6cm2; surgical stenosis <1cm2, surgical pressure gradient>10mm Hg
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What are normal aortic valve areas? what valve area and pressure gradient is an indication for surgical treatment?
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2.5-3.5cm2; surgical stenosis<0.75cm2, surgical pressure gradient>50mm Hg
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What are anesthetic considerations in MS?
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avoid increased HR or decreased SVR; problem in MS is fixed CO and increased pulmonary pressures
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What is the typical heart sound for MS?
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rumbling diastolic murmur
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Why should you be cautious about regional in patients with MS?
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patients have fixed CO and may not be able to compensate for the vasodilation
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What heart rhythm is common in MS?
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afib
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When should you consider using a PA catheter in a patient with MS?
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dyspnea, orthopnea, PND, or poor exercise tolerance
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What is dangerous about afib with RVR in patient's with MS?
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pulm edema can develop suddenly; HR must be controlled
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What part of LV filing is more prominent in patients with MS?
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atrial kick account for 35 % of CO(versus 20% in nml patient)
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In a patient with MS what is a good rate controlling medication?
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digitalis(beta blocker are less desirable may exacerbate heart failure)
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What percent of patient's with AS have coexisting CAD?
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30-50%
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What should you avoid in patients with AS?
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increased HR decreases coronary diastolic perfusion time; decreased SVR compromises aortic diastolic blood pressure and coronary perfusion pressure
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Why do patients with AS become syncopal?
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fixed CO
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What is the cause of CHF in patients with AS?
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ischemia, LVH, decreased LV function
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Why is atrial kick important in patients with AS?
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helps maintain CO as ventricular compliance decreases
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