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16 Cards in this Set
- Front
- Back
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What is a good anesthetic for stenotic valvular lesions? |
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? |
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? |
2.5-3.5cm2; surgical stenosis<0.75cm2, surgical pressure gradient>50mm Hg |
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What are anesthetic considerations in MS? |
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? |
rumbling diastolic murmur |
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Why should you be cautious about regional in patients with MS? |
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? |
afib |
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When should you consider using a PA catheter in a patient with MS? |
dyspnea, orthopnea, PND, or poor exercise tolerance |
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What is dangerous about afib with RVR in patient's with MS? |
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? |
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? |
digitalis(beta blocker are less desirable may exacerbate heart failure) |
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What percent of patient's with AS have coexisting CAD? |
30-50% |
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What should you avoid in patients with AS? |
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? |
fixed CO |
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What is the cause of CHF in patients with AS? |
ischemia, LVH, decreased LV function |
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Why is atrial kick important in patients with AS? |
helps maintain CO as ventricular compliance decreases |
