Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Anes101 > Ischemic heart disease (Vadlamudi) > Flashcards

Ischemic heart disease (Vadlamudi) Flashcards

1
Q

Angina

A

Myocardial ischemia which manifests as chest pain

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

Angina is usually caused by

A

CAD; Vasospasm, Low CO state

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

Angina

A

Occurs due to O2 supply and demand imbalance

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

Increased O2 demand

A

Tachycardia; HTN; Increased contractility

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

Decreased O2 supply

A

Anemia; hypoxemia; CAD and acute Thrombosis; Coronary vasospasm and HypoTN

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

Types of Angina

A

Stable and Unstable

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

Stable Angina

A

Exertional; relieved with rest and vasodilators; dzed Cartery is dilated post-stenosis (demand for blood supply to that area is inadequate with exertion

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

Stable Angina

A

Vasospasm possible cause

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

Unstable Angina

A

Inc in hz, severity, or duration of angina; angina occurs at rest (CA plaque rupture, partial thrombosis or vasospasm)

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

Unstable Angina

A

Can occur prior to or after MI

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

Acute Coranary Syndrome (ACS)

A

Unstable Angina; STEMI and NONSTEMI (these pts need further work up because they are at risk for MI

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

CAD

A

Most common cause of heart dz

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

CAD

A

Atherosclerotic plaque build up in CA, limiting blood flow to myocardium

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

Risk Factors for CAD

A

Male, HTN, Hypercholesterolemia, DM, Family Hx, tobacco abuse and Obesity

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

Treatment CAD

A

Lifestyle changes, Medical therapy, PTCA,

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

CABG

A

Gold std for revascularization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Medical Therapy

A

b blockers; CCB, Nitrates, ACE-I, ASA and antiplatelets and statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do we enure MI pt is optimized for surgery

A

Functional status (METS)and physical exam/ recent change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do we enure MI pt is optimized for surgery

A

Hx and records, recent PCI with stent placement?, Dual antiplt therapy?, Prior CABG, significant comorbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

recent PCI with stent placement?

A

balloon angioplasty - wait atleast 2 weeks before elective procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Dual antiplt therapy?

A

BMS = delay elective surgery by 6wks upto 6mnths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Dual antiplt therapy?

A

DES = delay elective surgery by 1 full yr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

PCI with stent

A

Body endotheliolizes stent (covers it) dual therapy ensures a balance between endothelial growth and acute stenosis from too much endothelial growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Patient with CAD

A

Should not ever be off ASA period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do we enure MI pt is optimized for surgery
EKG, echo, stress test, LHC, cardiac MRI/PET, continue appropriate medication in perioperative period)
26
How do we know pt have MI
Symptoms, physical exam and labs
27
EKG MI (printout baseline EKG always)
ST segment elevation, depression, and T wave inversion
28
MI cardiac enzymes
CKmb and troponin I
29
Transmural MI
Involves all 3 layers of heart; 2o to obstruction in major CA ex L main Dz emergence; ST Elevation
30
Subendocardial
Ischemia to endocardium of heart; arteries external with hypertrophy and aortic stenosis so endocardium will not be perfused well
31
Subendocardial
ST depression
32
Periop Management of MI
Echo ==wall abnormality (hypokinetic) or ischemia akinetic and also see valvular dysfunction
33
ID Ischemia and MI in anesthetized pt
use your tools and tx (max o2 delivery and supply
34
Max 02 delivery and reduce o2 demanda
Blood Xfusion, tx HTN and Tachy; Nitrates; stabilize Malignant arrrythmias and Communicate
35
Heart Failure
Inability of the heart to provide adequate CO to maintain the needs of the body
36
Etiology
Most coomon categories Ischemic, HTN (non compliant with medication), dilated cardiomyopathy
37
Systolic HF (impaired contractility)
Contractility is inadequate maintain needed CO (cold in the extremities)
38
Diastolic HF (impaired stretch)
Impaired relaxation leadign to impaired filling and therefore dec CO; inadequate preload
39
AHA Class I
Symptoms of HF at activity levels would limit normal individuals
40
AHA Class 2
Symptoms of HF with ordinary exertion
41
AHA Class 3
Symptoms of HF with less than ordinary exertion
42
AHA class 4
Symptoms of HF at rest
43
LVAD
Continuous flow LVAD
44
Many patients with ESHF
LVAD, IABP, Ionotrope dependent, CIED
45
Anesthetic management HF
Severity of HF and surgical procedure; less reserve than other patients = avoid significant shift (20% of baseline)
46
How can you monitor BP in a patient with LVAD?
A-line, doppler, sphygomonameter; VAD cordinator
47
IABP
increase perfusion pressure in diastole to increase coronary blood flow ==inflates in diastole
48
IABP
Decrease afterload==Deflates in systole
49
IABP counter pulsation
Deflates in systole and inflates in diastole
50
How do you know that the balloon is in the appropriate position?
Chest Xray and Echo balloon distal to left subclavian (2cm)because when it inflates and covers the subclavian can cause ischemia to the left arm
51
CIED
Conduction issue and malignant arrythmia (vtach and vfib) with ESHF
52
Pacemaker
Complete heart block, AV block, symptomatic Brady; do not defibrillate
53
Pacemaker
i. chamber paced, 2. Chmaber sensed, iii. Response to sensing, iv.
54
AICD
ability to pace, anti-tachy pace (to come out of vtach), and defibrillate
55
AICD
indicated for pt with certain cardiomyopathies, low EF, and Hx of malignant arrythmias
56
CRT-D
Pts with HF can have significant conduction delay leads to less effective systole (QRS >120ms) due to ventricular dyssynchrony
57
CRT-D
3 leads=involves RA, RV, coronary sinus leads (resynchronize rv and lv) improves EF from 15% to 35%
58
CIED perop mangmt
magnet off not approriate
59
Is patient pacemaker dependent
100% paced or is it backup
60
what are the current settings
paced at 70 or back up, defib technology==below 40
61
rate responsiveness enabled?
monopolar sensing
62
Monopolar can lead to oversensing
Pacing not delivered when needed or defibrillation when not needed
63
beta blockers
inhibit catecholamine mediated symp stimulation by blocking b adre receptor
64
beta blockers
for HTN, Arrhtmias and HF
65
what are the guidelines
if pt is on a beta blocker keep them on it, if they are not don?t give it
66
valvular disoders
slow hr bad, a fib slow HR bad
67
CCb (PINE)
Dec SVR and vasodilate; reflex tachy which might be a problem with heart dz
68
Nimodipine
used in patients with Sub arachnoid Hemo to prevent cerebral vasospasm
69
Clevidipine
looks like propofol (ultrashort acting IV CCB,) cardiac surgical
70
Nitrates
cause smooth muscle relaxation, dilate CA reducing ischemia with CAD
71
Nitrates
caution with extended use = tachyphylaxis
72
ACEI
angitensin converting enzyme inhibitor
73
ACEI contraindications
Cough (kalokrein interaction) significant angioedema (airway issues)
74
Dual antiplt therapy?
ASA and plavix
75
Statin
HMG - Coa reductase inhibitor (prevent production of cholesterol), anti-inflammatory properties particularyly in vasculature and myocardium

Anes101 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions