Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

P&P 3 > Cardiac Surgery 2 > Flashcards

Cardiac Surgery 2 Flashcards

1
Q

what are two hemodynamic goals for patients with stenotic lesions?

A

avoid increased HR

avoid decreased SVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the area for the mitral valve, and aortic valve?

A

mitral valve is 4-6 cm squared

aortic valve is 2.5-3.5 cm squared

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the stenotic area and pressure gradient for the mitral valve?

A

area of < 1 cm squared

pressure gradient of > 10 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the stenotic area and pressure gradient for the aortic valve?

A

area of < 0.75 cm squared

pressure gradient of > 50 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what kind of murmur would you hear for mitral stenosis?

A

a rumbling diastolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what two main problems present from mitral stenosis?

A

right ventricular hypertrophy

pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is mitral stenosis most commonly caused by?

A

rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

why should careful consideration be used in patients with mitral stenosis?

A

they have a fixed CO, and may not be able to compensate for vasodilation

epidural is preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what arrhythmia typically forms in patients with mitral stenosis, and why?

A

atrial fibrillation, because increased LA pressure leads to stretching of the pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what drug is good for rate control in patients with atrial fibrillation?

A

digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

in patients with aortic stenosis, why must aortic diastolic pressure be maintained?

A

because aortic diastolic hypotension leads to decreased coronary perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the three main causes of aortic stenosis?

A

calcification of the valve

congenital bicuspid aortic valve

rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the classic triad of symptoms in aortic stenosis?

A

angina
congestive heart failure
syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the survival rate for aortic stenosis patients with angina, CHF and syncope?

A

angina is 5 years
CHF is 3 years
syncope is 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how long is the latent period before aortic stenosis symptoms appear?

A

30 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

why is it so important to maintain sinus rhythm in patients with aortic stenosis?

A

atrial kick is important for ventricular filling, as ventricular compliance decreases

17
Q

in patients with severe LV dysfunction a PA catheter may be used, why would PCWB underestimate LA pressure?

A

because due to overfilling there is decreased LV compliance

18
Q

is nitrous oxide okay in patients with aortic stenosis?

A

yes

19
Q

what murmur would you hear for mitral regurgitation?

A

holosystolic murmur at lower left sternal border

20
Q

what murmur would you hear for aortic regurgitation?

A

decrescendo diastolic murmur

21
Q

what is acute mitral regurgitation?

A

LA and LV are not enlarged

LVEDP and LAP are elevated

patient is in NSR

22
Q

what is chronic mitral regurgitation?

A

LA and LV are enlarged

LVEDP and LAP are high, but not as high as acute condition

a-fib is common

23
Q

what are three signs of right heart failure?

A

hepatic congestion
peripheral edema
JVD

24
Q

how is mitral regurgitation medically treated?

A

digoxin
decrease SVR
SBE prophylaxis

25
Q

what three things should be considered preoperatively for patients with mitral regurgitation?

A

treat a-fib
avoid increased PVR
SBE prophylaxis

26
Q

what two methods decrease regurgitation fraction in patients with mitral regurgitation?

A

small increase in HR, as increased diastolic time worsens regurgitation

decrease SVR

27
Q

what three words do you remember for anesthetic goals in patients with mitral regurgitation?

A

full
fast
vasodilated

28
Q

what kind of murmur would you hear with aortic regurgitation?

A

diastolic murmur at left upper sternal boarder?

29
Q

does aortic regurgitation cause concentric or eccentric hypertrophy?

A

eccentric hypertrophy

30
Q

what are two main hemodynamic goals for patients with aortic stenosis?

A

small increase in HR

decrease SVR

31
Q

what is the most common etiology of congestive heart failure?

A

coronary artery disease

32
Q

what are three classic symptoms of CHF?

A

dyspnea
fatigue
pulmonary congestion

33
Q

patients with compensated CHF have no physical symptoms, but what symptoms would uncompensated patients have?

A

pulmonary rales
pulmonary edema
JVD
ascites and hepatomegaly

34
Q

should beta blockers be used in patients with acute or chronic CHF?

A

chronic, beta blockade can worsen acute heart failure

35
Q

what EF is associated with increased operative risk?

A

< 40%

36
Q

what are three intraoperative hemodynamic goals for patients with CHF?

A

maintain inotropy
reduce afterload
normalize PVR

P&P 3 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions