Cardiovascular

Question 1

Cause

Clinical Signs: Left ventricle regurgitates into left atrium, high HR,

Concerns: pre-oxygenation, maintain BP

Drug Interactions: opioid only pre-med, minimal induction agents (severe = co-induction), low MAC, Alpha-2s = CAUTION, ACP good at reducing afterload

Answer 1

Mitral Valve Disease

Question 2

Cause: Obstruction of Left ventricular outflow

Clinical Signs: increased HR will make it worse, hypertrophy, ejection murmur,

Concerns: arrhythmias, bradycardia,

Drug Interactions: no arrhythmic drugs, no HR increasing drugs (ketamine/alpha-2s), care with induction

Answer 2

Aortic Stenosis

Question 3

Cause: fusion of pulmonic valve leaflets and congenital abnormalities

Clinical signs: increased resistance in right ventricle (causes hypertrophy), redeuced ventricular filling,

Concerns: reduced IVFT and no colloids

Drug Interactions: NO Alpha-2s (increase R arterial pressure), ACP maybe, Opioid pre-med, Co-inductions (fent, midaz, etomidate), NO Ket, low inhalant

Answer 3

Pulmonic Stenosis

Question 4

Cause: unclosed duct

Clinical Signs: volume overload of L ventricle, atrial and ventricular dilation

Concerns: age related,

Drug interactions: no HR lowering drugs, less reative to +inotropes, consider IM pethidine, co-induction (ket, prop, midaz), avoid vasodilating drugs

Answer 4

Patent Duct Arteriosus

Question 5

Causes: thickening of cardiac muscles, failing to relax

Clinical Signs: decrease ventricular volume, increase in atrial pressure, mitral reguritation, pulmonary oedema , heart failure

Concerns: poor blood flow

Drug interactions: may be on beta-adrenergic receptor blocker or calcium channel blocker, NO Ket, Hypotension drug optimise HR and rhythm, IVFT, low dose medetomidine, alfax IM for fractious patients

Answer 5

Hypertrophic Cardiomyopathy

Question 6

Cause: idiopathic loss of myocardial contractility, systolic dysfunction (reduced ejection fraction, fractional shortening, rate of injection), dilation L ventricle

Clinical signs: irregular pulses, dyspnoea, cough and abdominal distention

Concerns : IVFT low dose, arrhythmias,

Drug Interactions: opioid only pre-med, NO Alpha-2s, TIVA, caution with induction agents, NO Ket,

Answer 6

Dilated Cardiomyopathy