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RUSVM Anesthesiology 2016 > Cardiovascular Disease > Flashcards

Cardiovascular Disease Flashcards

1
Q

What is the ultimate goal of the Cardiovascular system?

A

Oxygen delivery to tissues

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2
Q

What is the equation for DO2?

A

CO x CaO2

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3
Q

What is the equation of Cardiac Output?

A

HR x SV

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4
Q

What does increased preload cause?

A

Increased CO

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5
Q

What does Increased afterload cause?

A

Decreased CO

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6
Q

What does increased contractility cause?

A

Increased CO

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7
Q

What is the equation of BP?

A

Cardiac Output x Systemic vascular resistance

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8
Q

What is the goal of anesthesia in a cardiac patient?

A

Maintain heart rate, vascular volume, SVR, and contractility as close to awake values as possible

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9
Q

What patients are invasive arterial BP required for?

A 
Patients in shock 
PDA ligation 
Balloon treatment for pulmonic stenosis 
Pacemaker placment 
heartworm retrieval
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10
Q

Why do Septic patients have decreased cardiac contractility?

A

inflammatory mediators

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11
Q

How do you treat Sinus tachycardia?

A

volume resuscitation and analgesics

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12
Q

What are the indications for treating VPCs?

A

Rate greater than 180
R on T phenomenon
multiform VPCs

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13
Q

What is the range of HR for a patient with Cardiac disease to go into surgery?

A

120-140

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14
Q

What does the BP of an animal with Cardiac disease need to be above to go into surgery?

A

above 90

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15
Q

What drugs should you avoid in Shock patients?

A

Phenothiazines
Alpha 2 agonists
Propofol
Pre-operative atropine

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16
Q

Why do you avoid Phenothiazines in Cardiac disease patients?

A

Vasodilation
Decreased BP
Prolonged action
no reversal agent

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17
Q

Why do you avoid Alpha 2 agonists in Cardiac Disease patients?

A

Profound vasoconstriction
bradycardia
decreased CO

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18
Q

Why do you avoid Propofol in Cardiac Disease patients?

A

Vasodilation

Decreased contractility

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19
Q

Why do you avoid Pre–op atropine in Cardiac Disease patients?

A

Patients often are tachycardic already

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20
Q

What drugs should you use with Cardiac Disease patients?

A

Opioids and Benzos
Etomidate and Alfaxalone
Ketamine

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21
Q

What fluids do you use with cardiac disease patients?

A

Crystalloi +/- colloid boluses

Hypertonic NaCl

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22
Q

What is the treatment for Vasodilation in patients with Cardiac Disease?

A

Dopamine
Norepinphrine
ephedrine
vasopressin

23
Q

What is the treatment for poor cardiac contractility in patients with cardiac disease?

A

Dobutamine

Dopamine

24
Q

What do you do to patients with Mitral Valve disease the morning of surgery?

A

Withhold ACE inhibitors

25
Q

What is the fluid rate for patients with Mitral Valve Disease?

A

3-5mL/kg/hr crystalloid and limit cystalloid boluses

26
Q

What drugs should you avoid in Mitral Valve Disease?

A

Phenothiazines
Alpha-2 agonists
Propofol
Pre-op atropine

27
Q

Why do you avoid Phenothiazines in patients with Mitral Valve Disease?

A

Vasodiatlion
Long action
No reversal

28
Q

Why do you avoid Alpha 2 Agonists in patients with Mitral Valve Disease?

A

Increased afterload

may worsen regurgitant function

29
Q

Why do you avoid Propofol in patients with Mitral Valve Disease?

A

Vasodilation

Decreased contractility

30
Q

Why do you avoid Pre-op atropine in patients with Mitral Valve Disease?

A

Tachycardia will increase myocardial O2 demand

31
Q

What drugs do you use in patients with Mitral Valve Disease?

A

Opioids + Benzos
Etomidate or Alfaxalone
Ketamine
Dobutamine or Dopamine

32
Q

What patients do you not use Ketamine in with Mitral Valve disease?

A

Patients with pre-existing tachycardia or A-fib

33
Q

What should you do before induction with DCM?

A

Pre-oxygenate

34
Q

What drugs should you avoid with DCM?

A 
Acepromazines
Alpha-2 agonists
Propofol 
Pre-op atropine
Ketamine
Anticholinergics 
High dose volatile anesthetics
35
Q

What drugs do you use for DCM?

A 
Opioids + Benzos
Alfaxalone 
Etomidate
Dobutamine
Dopamine for hypotension
36
Q

What drugs should you avoid in HCM in cats?

A 
Acepromazines
Alpha-2 agonists
Propofol 
Pre-op atropine
Ketamine
Anticholinergics 
High dose volatile anesthetics
37
Q

What drugs should you use in HCM in cats?

A

Opioids + Benzos
Alfaxalone
Etomidate
Dopamine for hypotension

38
Q

What are the options for treatment of PDA?

A

Surgical: Thoracotomy with PDA ligation

Occlusion under fluoroscopic guidance

39
Q

What will happen at the time of PDA occlusion?

A

Diastolic BP increase dramatically

resulting in reflex bradycardia

40
Q

Branham’s sign

A

Reflex bradycardia from the diastolic BP increase

41
Q

What drugs should you avoid in PDA?

A

Acepromazine

Alpha 2 Agonists

42
Q

What drugs should you use in PDA?

A 
Opioids + Benzos
Alfaxalone 
Etomidate
Ketamine
Propofol
Pre-anesthetic anticholinergic
43
Q

What should you avoid in Pulmonic Stenosis?

A

excessive fluid administration

44
Q

What drugs should you avoid in pacemaker placement?

A

Acepromazines
Alpha-2 agonists
Pure Mu agonists

45
Q

What drugs can you use with Pacemaker placement?

A 
Anticholinergics
Butorphanol + Benzos
Ketamine
Etomidate
Alfaxalone
Local Anesthesia
46
Q

2nd degree AV Block

A

P waves do not conduct

47
Q

2nd degree AV block Mobitz type I

A

Progressively longer P-R interval until conduction does not occur

48
Q

2nd degree AV block Mobitz type II

A

Equal P-R Intervals

49
Q

3rd degree AV block

A

N P waves are conducted

Ventricular escape beats present

50
Q

Atrial Fibrillation

A

No P waves
Fibrillating baseline
Irregularly irregular R-R interval

51
Q

Ventricular premature complexes

A

QRS complexes arising from ventricles arrives early with a compensatory pause following
Maybe uniform or multifactorial

52
Q

ventricular tachycardia

A

QRS complexes arising from ventricle (no P wave, wide and bizarre)
Rate is greater than 160-180

53
Q

Accelerated idioventricular rhythm

A

QRS complexes arising from ventricle (no P wave, wide and bizarre)
Rate: 100-140
Will not respond to lidocaine

54
Q

What are the 3 arrest rhythms?

A

V-Tach
Pulseless electrical activity
Asystole

RUSVM Anesthesiology 2016 (38 decks)

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