Cardiovascular Disease Flashcards
What is the ultimate goal of the Cardiovascular system?
Oxygen delivery to tissues
What is the equation for DO2?
CO x CaO2
What is the equation of Cardiac Output?
HR x SV
What does increased preload cause?
Increased CO
What does Increased afterload cause?
Decreased CO
What does increased contractility cause?
Increased CO
What is the equation of BP?
Cardiac Output x Systemic vascular resistance
What is the goal of anesthesia in a cardiac patient?
Maintain heart rate, vascular volume, SVR, and contractility as close to awake values as possible
What patients are invasive arterial BP required for?
Patients in shock PDA ligation Balloon treatment for pulmonic stenosis Pacemaker placment heartworm retrieval
Why do Septic patients have decreased cardiac contractility?
inflammatory mediators
How do you treat Sinus tachycardia?
volume resuscitation and analgesics
What are the indications for treating VPCs?
Rate greater than 180
R on T phenomenon
multiform VPCs
What is the range of HR for a patient with Cardiac disease to go into surgery?
120-140
What does the BP of an animal with Cardiac disease need to be above to go into surgery?
above 90
What drugs should you avoid in Shock patients?
Phenothiazines
Alpha 2 agonists
Propofol
Pre-operative atropine
Why do you avoid Phenothiazines in Cardiac disease patients?
Vasodilation
Decreased BP
Prolonged action
no reversal agent
Why do you avoid Alpha 2 agonists in Cardiac Disease patients?
Profound vasoconstriction
bradycardia
decreased CO
Why do you avoid Propofol in Cardiac Disease patients?
Vasodilation
Decreased contractility
Why do you avoid Pre–op atropine in Cardiac Disease patients?
Patients often are tachycardic already
What drugs should you use with Cardiac Disease patients?
Opioids and Benzos
Etomidate and Alfaxalone
Ketamine
What fluids do you use with cardiac disease patients?
Crystalloi +/- colloid boluses
Hypertonic NaCl
What is the treatment for Vasodilation in patients with Cardiac Disease?
Dopamine
Norepinphrine
ephedrine
vasopressin
What is the treatment for poor cardiac contractility in patients with cardiac disease?
Dobutamine
Dopamine
What do you do to patients with Mitral Valve disease the morning of surgery?
Withhold ACE inhibitors
What is the fluid rate for patients with Mitral Valve Disease?
3-5mL/kg/hr crystalloid and limit cystalloid boluses
What drugs should you avoid in Mitral Valve Disease?
Phenothiazines
Alpha-2 agonists
Propofol
Pre-op atropine
Why do you avoid Phenothiazines in patients with Mitral Valve Disease?
Vasodiatlion
Long action
No reversal
Why do you avoid Alpha 2 Agonists in patients with Mitral Valve Disease?
Increased afterload
may worsen regurgitant function
Why do you avoid Propofol in patients with Mitral Valve Disease?
Vasodilation
Decreased contractility
Why do you avoid Pre-op atropine in patients with Mitral Valve Disease?
Tachycardia will increase myocardial O2 demand
What drugs do you use in patients with Mitral Valve Disease?
Opioids + Benzos
Etomidate or Alfaxalone
Ketamine
Dobutamine or Dopamine
What patients do you not use Ketamine in with Mitral Valve disease?
Patients with pre-existing tachycardia or A-fib
What should you do before induction with DCM?
Pre-oxygenate
What drugs should you avoid with DCM?
Acepromazines Alpha-2 agonists Propofol Pre-op atropine Ketamine Anticholinergics High dose volatile anesthetics
What drugs do you use for DCM?
Opioids + Benzos Alfaxalone Etomidate Dobutamine Dopamine for hypotension
What drugs should you avoid in HCM in cats?
Acepromazines Alpha-2 agonists Propofol Pre-op atropine Ketamine Anticholinergics High dose volatile anesthetics
What drugs should you use in HCM in cats?
Opioids + Benzos
Alfaxalone
Etomidate
Dopamine for hypotension
What are the options for treatment of PDA?
Surgical: Thoracotomy with PDA ligation
Occlusion under fluoroscopic guidance
What will happen at the time of PDA occlusion?
Diastolic BP increase dramatically
resulting in reflex bradycardia
Branham’s sign
Reflex bradycardia from the diastolic BP increase
What drugs should you avoid in PDA?
Acepromazine
Alpha 2 Agonists
What drugs should you use in PDA?
Opioids + Benzos Alfaxalone Etomidate Ketamine Propofol Pre-anesthetic anticholinergic
What should you avoid in Pulmonic Stenosis?
excessive fluid administration
What drugs should you avoid in pacemaker placement?
Acepromazines
Alpha-2 agonists
Pure Mu agonists
What drugs can you use with Pacemaker placement?
Anticholinergics Butorphanol + Benzos Ketamine Etomidate Alfaxalone Local Anesthesia
2nd degree AV Block
P waves do not conduct
2nd degree AV block Mobitz type I
Progressively longer P-R interval until conduction does not occur
2nd degree AV block Mobitz type II
Equal P-R Intervals
3rd degree AV block
N P waves are conducted
Ventricular escape beats present
Atrial Fibrillation
No P waves
Fibrillating baseline
Irregularly irregular R-R interval
Ventricular premature complexes
QRS complexes arising from ventricles arrives early with a compensatory pause following
Maybe uniform or multifactorial
ventricular tachycardia
QRS complexes arising from ventricle (no P wave, wide and bizarre)
Rate is greater than 160-180
Accelerated idioventricular rhythm
QRS complexes arising from ventricle (no P wave, wide and bizarre)
Rate: 100-140
Will not respond to lidocaine
What are the 3 arrest rhythms?
V-Tach
Pulseless electrical activity
Asystole
