Valve area Flashcards
severe as
AVA less than 1
indexed less than 0.6 cm squared per m2
gradient mean over 40 mmHg IN PATIENT WITH NORMAL CO- can do a dobutamine stress echo to bring out if not sure
MS severe
less than 1cm
gradient over 40mmHg
someone with no diastolic BP and APO?
acute AR from dissection or IE
First in MS, before do valve commisurotomy
beta blockers and diurese
also aim INR 2.5-3.5 once replaced
when do you replace in MR
pulm hypertension
AF
a valve replacement person unstable with a low INR?
prosthetic valve thrombosis
if unstable then thrombolyse
if stable then heparin and aspirin adn watch
how do you tell if should have AVR pre non cardiac surgery
if severe AS and high blood loss procedure, do before hand
otherwise if not major blood loss will probably be ok
FRACTIONAL FLOW RESERVE- EXPLAIN
If 0.8 or under, SIGNIFICANT STENOSIS
pressure transducer above and below and give adenosine
distal compared with proximal flow
superior to use this approach- reduces death
When would you consider multi vessel PCI
least complex 1/3 of non diabetic patients with stable CAD
asymptomatic CAD- stent or medical
zero mortality benefit with stenting if asymptomatic
strongest AF RF
valvular heart disease
what type of AF where pulm vein isolation works?
PAROXYSMAL
Why flutter?
Due to macro re entry circuit in RA between IVC and tricuspid valve
exercise test in WPW looking for what
long (over 250ms) pre -excitation interval
-SCD rare
ARVD see what on echo
poor sensitivity
thinning in non coronary distibution
wall motion abnormality
Thallium–>reverse perfusion scan
MRI most useful
