Cardiac lecture shannon Flashcards
High risk cardiac surgeries
> 5%
Aortic
Major vascular (AAA, )
Peripheral vascular (stent, bypass, aneurysm,
Long procedure with significant blood loss (knees, hips, liver)
CAROTID ENDARECTOMY IS INTERMEDIATE
Highest risk for perioperative MI
unstable angina
risk of mi
gen pop .3
6 months 6%
3 months- 15%
1 month- 33%
Inability to climb 2 flights of stairs showed positive predcition of what?
postop pulmonary or cardiac complicaitons
METS
1- poor functional capacity, self care, eating, using toilet
4- good functional capacity light housework, golf, baseball
NYHA
1- no symptoms
2- symptoms at normal activity
3- symptoms at low activity
4- inability to carry on physical activity without discomfort, symptoms at rest
HF consists of
chf
pulmonary edema
paroxysmal dyspnea
bilat rales, s3 gallop, cxr pv redistribution
pacemaker and icd should be interrogated within how long of surgery
12 months
6 for icd
who is pharmacologic stress test for
cant exercise or on digoxin
exercise stress ecg
coronary disease present if:
st depression >.2mV
ST depression early in test
HOTN may require cath immediate
pharm stress tests meds
Adenosine redistributes coronary blood flow without direct negative inotropy
dobutamine for inotropy test
Risk factors for cardiovascular surgery
Aortic, major vascular surgery
creat >2
Unstable angina
CHF
DM
MI recently
>65
Emergency surgery
If a reinfarct does occur, mortality is ___
50%
AHA recommends waiting at least ___ before elective surgery
60 days (8 weeks)
or 4-6 weeks
MET is defined as oxygen consumption while resting and is defined as ___
3.5 ml O2/kg/minute
