SEE quick hits

Question 2

Order of G protein?

Answer 2

First Messenger
G protein
Effector
Second messenger
Cellular response

Question 3

What does S1 heart sound signify?

Answer 3

Closure of Mitral and Tricuspid

Mark of onset of systole

End of LV filling

Question 4

What does S2 heart sound signify?

Answer 4

Closure of aortic and pulmonic valves

Mark onset of diastole

End of LV ejection

Question 5

What does S3 heart sound signify?

Answer 5

Flaccid and inelastic heart

Heart failure

Heard after S2

Question 6

What does S4 heart sound signify?

Answer 6

Atrial systole

Before S1

Question 7

Heart Sounds

Answer 7

Question 8

Concentric or eccentric, heart failure with normal EF?

Answer 8

Concentric

Question 9

Concentric or eccentric, heart failure with reduced EF?

Answer 9

Eccentric

Question 10

Normal AS valve size? What is considered severe? Gradient?

Answer 10

Normal = 2.5-3.5

Severe <0.8

Also severe with a gradient > 40mmHg

Question 11

Most common cause of AS? others?

Answer 11

1. Bicuspid aortic valve

Others
-Rheumatic fever
-Ineffective endocarditis

Question 12

Pressure volume loop with AS?

Answer 12

Increased height and shift to the right

Question 13

What is the classic triad of AS?

Answer 13

SAD

Syncope
Angina
Dyspnea

Question 14

Anesthetic management of AS? Neuraxial?

Answer 14

Slow/Normal HR
Increase Preload
Increase SVR

NO neuraxial

Question 15

Art line waveform for AS?

Answer 15

Pulsus parvus

Pulsus tardus

Question 16

AR on loop?

Answer 16

Question 17

Anesthetic for AR? Neuraxial ?

Answer 17

Increase HR
Increase preload
Decrease SVR

Neuraxial - okay

Question 18

Artline for AR?

Answer 18

Bisferiens pulse (Biphasic peaks, Double peak)

Question 19

Normal MS valve? Severe? Gradient?

Answer 19

Normal, 4-6 cm
Severe, <1 cm

Gradient above 10

Question 20

Most common cause of MS?

Answer 20

World - Rheumatic fever
USA - Endocarditis

Question 21

MS on loop?

Answer 21

Question 22

Anesthesia for MS?

Answer 22

Slow Heart
AVOID PVR
Normal everything else

Possible neuraxial

Question 23

Most common cause of MR?

Answer 23

1. Mitral valve prolapse

Question 24

What might develop after a Mitral valve repair?

Answer 24

SAM - outflow obstruction

Question 25

MR on loop

Answer 25

Question 26

Anesthesia for MR?

Answer 26

Increase HR
Increase Preload
Decrease SVR
AVOID PVR

Okay for neuraxial

Question 27

Mnemonic for murmurs?

Answer 27

ASSS - aortic stenosis systolic sternal

ARDS - aortic regurgitation diastolic sternal

MSDA - mitral stenosis diastolic axilla

MRSA - mitral regurgitation systolic axilla

Question 28

What is an acute complication of TAVR?

Answer 28

Aortic regurg