Ischemic Heart Disease Flashcards
1
Q
Decreased Supply factors?
A
Tachycardia Hypotension Vasoconstriction O2 carrying capacity Acid/base Anemia Hypoxia Viscosity Arterial patency Coronary spasm
2
Q
Increased Demand factors?
A
Tachycardia Increase Contractility Increased Preload Increased Afterload Shivering Hyperglycemia Hypertension
3
Q
Regional vs. General anesthesia for IHD?
A
Regional
Tx hypotension with phenylephrine
If bradycardia present use ephedrine
General
Maintain balance b/w O2 supply and demand
Do not allow for long periods of hypotension
4
Q
Monitoring for ishcemia?
A
EKG (what leads reflect what? )
Pulmonary Artery Catheter
Transesophageal Echocardiography
5
Q
Induction for IHD goals
A
Minimal hemodynamic effect
Limit duration of larygoscopy
Minimize response
Severe cardiac dysfunction: Etomidate, High opioid technique
6
Q
Goal of Maintenance?
A
AVOID TACHYCARDIAS Preload-normal Afterload-normal Contractility-decrease if LVF is normal HR-avoid increases Rhythm-NSR is best MVO2-Controlling demand is easier than supply, attenuate sympathetic outflow
