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RUSVM Anesthesiology 2016 > Cardiovascular Disease > Flashcards

Cardiovascular Disease Flashcards

1
Q

What is the ultimate goal of the Cardiovascular system?

A

Oxygen delivery to tissues

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2
Q

What is the equation for DO2?

A

CO x CaO2

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3
Q

What is the equation of Cardiac Output?

A

HR x SV

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4
Q

What does increased preload cause?

A

Increased CO

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5
Q

What does Increased afterload cause?

A

Decreased CO

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6
Q

What does increased contractility cause?

A

Increased CO

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7
Q

What is the equation of BP?

A

Cardiac Output x Systemic vascular resistance

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8
Q

What is the goal of anesthesia in a cardiac patient?

A

Maintain heart rate, vascular volume, SVR, and contractility as close to awake values as possible

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9
Q

What patients are invasive arterial BP required for?

A 
Patients in shock 
PDA ligation 
Balloon treatment for pulmonic stenosis 
Pacemaker placment 
heartworm retrieval
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10
Q

Why do Septic patients have decreased cardiac contractility?

A

inflammatory mediators

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11
Q

How do you treat Sinus tachycardia?

A

volume resuscitation and analgesics

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12
Q

What are the indications for treating VPCs?

A

Rate greater than 180
R on T phenomenon
multiform VPCs

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13
Q

What is the range of HR for a patient with Cardiac disease to go into surgery?

A

120-140

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14
Q

What does the BP of an animal with Cardiac disease need to be above to go into surgery?

A

above 90

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15
Q

What drugs should you avoid in Shock patients?

A

Phenothiazines
Alpha 2 agonists
Propofol
Pre-operative atropine

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16
Q

Why do you avoid Phenothiazines in Cardiac disease patients?

A

Vasodilation
Decreased BP
Prolonged action
no reversal agent

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17
Q

Why do you avoid Alpha 2 agonists in Cardiac Disease patients?

A

Profound vasoconstriction
bradycardia
decreased CO

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18
Q

Why do you avoid Propofol in Cardiac Disease patients?

A

Vasodilation

Decreased contractility

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19
Q

Why do you avoid Pre–op atropine in Cardiac Disease patients?

A

Patients often are tachycardic already

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20
Q

What drugs should you use with Cardiac Disease patients?

A

Opioids and Benzos
Etomidate and Alfaxalone
Ketamine

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21
Q

What fluids do you use with cardiac disease patients?

A

Crystalloi +/- colloid boluses

Hypertonic NaCl

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22
Q

What is the treatment for Vasodilation in patients with Cardiac Disease?

A

Dopamine
Norepinphrine
ephedrine
vasopressin

23
Q

What is the treatment for poor cardiac contractility in patients with cardiac disease?

A

Dobutamine

Dopamine

24
Q

What do you do to patients with Mitral Valve disease the morning of surgery?

A

Withhold ACE inhibitors

25
What is the fluid rate for patients with Mitral Valve Disease?
3-5mL/kg/hr crystalloid and limit cystalloid boluses
26
What drugs should you avoid in Mitral Valve Disease?
Phenothiazines Alpha-2 agonists Propofol Pre-op atropine
27
Why do you avoid Phenothiazines in patients with Mitral Valve Disease?
Vasodiatlion Long action No reversal
28
Why do you avoid Alpha 2 Agonists in patients with Mitral Valve Disease?
Increased afterload | may worsen regurgitant function
29
Why do you avoid Propofol in patients with Mitral Valve Disease?
Vasodilation | Decreased contractility
30
Why do you avoid Pre-op atropine in patients with Mitral Valve Disease?
Tachycardia will increase myocardial O2 demand
31
What drugs do you use in patients with Mitral Valve Disease?
Opioids + Benzos Etomidate or Alfaxalone Ketamine Dobutamine or Dopamine
32
What patients do you not use Ketamine in with Mitral Valve disease?
Patients with pre-existing tachycardia or A-fib
33
What should you do before induction with DCM?
Pre-oxygenate
34
What drugs should you avoid with DCM?
``` Acepromazines Alpha-2 agonists Propofol Pre-op atropine Ketamine Anticholinergics High dose volatile anesthetics ```
35
What drugs do you use for DCM?
``` Opioids + Benzos Alfaxalone Etomidate Dobutamine Dopamine for hypotension ```
36
What drugs should you avoid in HCM in cats?
``` Acepromazines Alpha-2 agonists Propofol Pre-op atropine Ketamine Anticholinergics High dose volatile anesthetics ```
37
What drugs should you use in HCM in cats?
Opioids + Benzos Alfaxalone Etomidate Dopamine for hypotension
38
What are the options for treatment of PDA?
Surgical: Thoracotomy with PDA ligation | Occlusion under fluoroscopic guidance
39
What will happen at the time of PDA occlusion?
Diastolic BP increase dramatically | resulting in reflex bradycardia
40
Branham's sign
Reflex bradycardia from the diastolic BP increase
41
What drugs should you avoid in PDA?
Acepromazine | Alpha 2 Agonists
42
What drugs should you use in PDA?
``` Opioids + Benzos Alfaxalone Etomidate Ketamine Propofol Pre-anesthetic anticholinergic ```
43
What should you avoid in Pulmonic Stenosis?
excessive fluid administration
44
What drugs should you avoid in pacemaker placement?
Acepromazines Alpha-2 agonists Pure Mu agonists
45
What drugs can you use with Pacemaker placement?
``` Anticholinergics Butorphanol + Benzos Ketamine Etomidate Alfaxalone Local Anesthesia ```
46
2nd degree AV Block
P waves do not conduct
47
2nd degree AV block Mobitz type I
Progressively longer P-R interval until conduction does not occur
48
2nd degree AV block Mobitz type II
Equal P-R Intervals
49
3rd degree AV block
N P waves are conducted | Ventricular escape beats present
50
Atrial Fibrillation
No P waves Fibrillating baseline Irregularly irregular R-R interval
51
Ventricular premature complexes
QRS complexes arising from ventricles arrives early with a compensatory pause following Maybe uniform or multifactorial
52
ventricular tachycardia
QRS complexes arising from ventricle (no P wave, wide and bizarre) Rate is greater than 160-180
53
Accelerated idioventricular rhythm
QRS complexes arising from ventricle (no P wave, wide and bizarre) Rate: 100-140 Will not respond to lidocaine
54
What are the 3 arrest rhythms?
V-Tach Pulseless electrical activity Asystole

RUSVM Anesthesiology 2016 (38 decks)

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