SEE quick hits Flashcards
Order of G protein?
First Messenger
G protein
Effector
Second messenger
Cellular response
What does S1 heart sound signify?
Closure of Mitral and Tricuspid
Mark of onset of systole
End of LV filling
What does S2 heart sound signify?
Closure of aortic and pulmonic valves
Mark onset of diastole
End of LV ejection
What does S3 heart sound signify?
Flaccid and inelastic heart
Heart failure
Heard after S2
What does S4 heart sound signify?
Atrial systole
Before S1
Heart Sounds
Concentric or eccentric, heart failure with normal EF?
Concentric
Concentric or eccentric, heart failure with reduced EF?
Eccentric
Normal AS valve size? What is considered severe? Gradient?
Normal = 2.5-3.5
Severe <0.8
Also severe with a gradient > 40mmHg
Most common cause of AS? others?
- Bicuspid aortic valve
Others
-Rheumatic fever
-Ineffective endocarditis
Pressure volume loop with AS?
Increased height and shift to the right
What is the classic triad of AS?
SAD
Syncope
Angina
Dyspnea
Anesthetic management of AS? Neuraxial?
Slow/Normal HR
Increase Preload
Increase SVR
NO neuraxial
Art line waveform for AS?
Pulsus parvus
Pulsus tardus
AR on loop?
Anesthetic for AR? Neuraxial ?
Increase HR
Increase preload
Decrease SVR
Neuraxial - okay
Artline for AR?
Bisferiens pulse (Biphasic peaks, Double peak)
Normal MS valve? Severe? Gradient?
Normal, 4-6 cm
Severe, <1 cm
Gradient above 10
Most common cause of MS?
World - Rheumatic fever
USA - Endocarditis
MS on loop?
Anesthesia for MS?
Slow Heart
AVOID PVR
Normal everything else
Possible neuraxial
Most common cause of MR?
- Mitral valve prolapse
What might develop after a Mitral valve repair?
SAM - outflow obstruction
MR on loop
Anesthesia for MR?
Increase HR
Increase Preload
Decrease SVR
AVOID PVR
Okay for neuraxial
Mnemonic for murmurs?
ASSS - aortic stenosis systolic sternal
ARDS - aortic regurgitation diastolic sternal
MSDA - mitral stenosis diastolic axilla
MRSA - mitral regurgitation systolic axilla
What is an acute complication of TAVR?
Aortic regurg
