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Flashcards in ACE Review - Cards Deck (246)
1

In pt with suspected Stemi, what is initial treatment

Cath lab, percutaneous intervention...angioplasty vs stent

2

Mitral stenosis physiologic needs

Slow heart rate. Preload.

3

Is the PAP in mitral stenosis falsely estimating the left ventricle end diastolic pressure to high or too low

Falsely estimates it too hi. Real value is lower

4

Mitral stenosis vasopressor.

Phenylephrine

5

how long does ck and ckmb last in a MI patient

2 days

6

how long does troponin last in a MI patient

10 days

7

what is pulsus paradoxus

an exaggerated decrease in sbp on inspiration

8

what cardiac conditions cause pulsus paradox

tamponade, constrictive pericarditis, heart failure

9

what lung problems can cause pulsus paradox

emphysema, asthma, pneumothorax

10

what misc caues for pulsus paradox

obesity, PE

11

does pna cause pulsus

no

12

what is associated with arterial line occlusion

prolong line, non teflon, size of radial arter, ratio of cath to radial artery, increased attempts, hematoma formation

13

when is an radial artery considered a thromboocclusion

it is considered time after the cath has been removed and a thrombus forms

14

what is the time frame for thromboocclusion of radial artery s/p cath

occurs within 48 hours after decannulation

15

does transfixtion aka through and through methoid increase arterial aa occlusion

no

16

when has heparinization of cathethers been proven useful to prevent thromboocclusion of radial aa

it is beneficial in arterial lines kept in longer than 24 hours

17

following cardiothoracic surgery, how many patients develop afib

30 to 60%

18

what are electrolyte causes for afib in ct surg patients

hypokalemia and hypomag

19

besided elelctrolyte abnorm, what other risk factors for afib s/p ct surg

male, age above 60, preop tachycardia, reduced post op card output, post op increase in b naturetic peptide

20

What is the ACC and AHA recommened about pt who just got drug-eluting stents

wait for 1 year after placement for elective surgeries

21

how much risk reduction do we see with delaying elective surgerys s/p placement of drug eluting stents

50% reduction…from 6.4 to 3.3% of cardiac injury

22

what is the risk of having surgery after having a stent placed

the antithrombotic will be stopped and pt is at increased risk of thrombosing the stent

23

what is the moa of rethrombosing the stent

lack of time for re-endothilization, procoagulant state induced by stress of surgery, rebound of procoagulant state after stopping dual antithrombotic drugs

24

what drugs are used in dual antiplatelet therapy for stented patients

aspirin and clopidogrel

25

how long should dual antiplatelet therapy be used for metal stents

1 month

26

how long should dual antiplatelet therapy be used for drug-eluting stents

12 months

27

what if the surgery is an emergency and pt has a stent…what should be done to the antiplatlete drugs

continuation of asa and stop the clopidogrel

28

what if the surgery is urgent…how should the antiplatelet drugs be dealt with

continue of asa and stop the clopidogrel 5 days prior to surgery

29

in mitral prolapse, what can help you see if a normal ef is really normal

a decrease in cardiac output can tell you how severe the regurge is

30

is tachy or brady bad for mitral regurge

brady is bad because the heart spends more time in systole

31

what is the managment goal of mitral regurge

decrease svr, increase heart rate

32

what virus are tested in donated blood

hiv1 hiv 2 human tcell lymphocyte virus 1 and 2, westnile virus, hep b and c, syphillus

33

is cmv tested for in donated blood

no

34

what is the first line of screening of blood for infectious agents

pre donation period...by a questionaire...eliminates 90% of infected donnors

35

why do we not screen for cmv

50-80% adults carry cmv..sero conversion for cmv is 0.33% if infected w/ blood transfusion

36

which pt must require cmv screening of blood before transfusion

immunocomp, neonates and pregnant pt because of serious cmv mannifestation if infected

37

what is hcm

hypertrophich cardiomyopathy

38

should you use nitroglycerine on hcm

no, it vasodilates and decreases svr..drecreasing preload…causing lvot obstruction

39

should you use ephedrine in hcm

no, it increases svr and preload, but acutally also increases contractility and my worsen lvot obsruction

40

what is milrinone

phosphodiesterase III inhibitor

41

how does milrinone work

it increases contractility and decrease svr

42

would you use milrinone in hcm

no,

43

what is a good drug to tx hcm assoc hypotension

betablock

44

what is hcm aka

idiopathic hypertrophic subaortic stenosis, assymetrical septal hypertrophy and hcom,

45

how does hcm cause lvot obstruction

it is the anterior leaflet of the mitral tha comes into contact with the anterior segment of the left ventricle to cause obstruction

46

how to treat hcm

volume and increse svr w phenylephrine and betablockade

47

what are signs of arterial cannula induced dissection

high inflow arterial cath pressures, minimal

48

during a dissection 2ndry to cannula, how should bp be maintained?

lowest viable map should be done to prevent further dissection

49

what should be done after dissection is diagnosed

a distal cannulation should be done, usually at the femoral artery

50

after femoral cannulation is done, what is done next

systemic hypothermia and circulatory arrest and repair of the aortic dissection

51

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52

what are the classifications for aortic dissection

stanford and debakey

53

what is the debakey classification of aortic dissection

I, II, IIIA, IIIB

54

what is debakey I aortic dissection

totall involvement of aorta

55

what is debakey II aortic dissection

ascending aorta involvement

56

what is debakey IIIA aortic dissection

originating at descending aorta, extends to diaphram or extends to arch of aorta

57

what is debakey IIIB aortic dissection

originating at descending aorta, extends past diaphram or extends to arch of aorta

58

how is the stanford classification of aortic dissection

type a and b

59

what is standford type a disscetion of aorta

involvement of aortic arch

60

what is standord type b dissection of aorta

confined to the descend aorta, not passing left subclavian

61

what is a common pathology of stanford type a

percardial effusion

62

does the pericardial effusion of stanford type a cause tamponade

not always lead to tamponade, effusion is more common

63

can you treat the pericardial effusion of stanford type a dissection with a pericardial centesis

no, not advised…because it will promot a pressure gradient…less in the pericardial space that may allow dissection to extend down further into the aortic root

64

what is the mainstay treatment for hcm in pregnant patients

metoprolol

65

are there risk with using beta blocker in hcm pregos?

there are concerns for IUGR and fetal bradycardia, however risk is low compared to benefit of controling maternal hcm

66

what is the goal for hcm treatment of pregos

prevent aortocaval compression, slow sinus hr, volume, maintain svr, prevent increase iontropy

67

can neuraxial approach be used in hcm pregos

yes…but careful titration of local anesthestic to prevent sympathectomy

68

which kind of neuraxia approach is better for hcm pregos

epidural bc that can be titraed…versus one shot spinal that can lead to decrease svr and reflexive tachycardia

69

what is the pressor of choice for hcg pregos

phenylephrine

70

what is added to blood during a TEG to get blood to clot

kaolin

71

how do you measure R time

from the beginning of the test to the start of coagulation

72

what does R time represent

coagulation factors

73

what is K time

it is the beginning of clotting time to the time where coagulation reaches 20mm amplitude

74

what does k time represent

clot kinetics

75

how is alpha angle measure

it is the angle made by the baseline and the line tangent to the coagulation curve

76

what are the things that alpha angle measure

acceleration of fibrin formation and the fibrin crosslinking process

77

what is the max amplituide of the TEG measure

clot stregnth, aka, platelet funx

78

what is the ly30

it is the max amplitude minus the amplitude s/p 30 mins

79

what does ly30 mean

it measures fibrinolysis

80

how many pacemaker codes are there

5. XXXXX

81

what is the first code of the pacemaker

which chambers are paced. A, V, D, or O (none)

82

what is the second code of the pacemaker

it is which chamber is sensed AVD or O

83

what does sensed mean

if the pacemaker recognizes the intrinsic rate of the chamber

84

what is the third code of the pacemaker

it is the response to the sensed chamber

85

what are the 3 responses of a pacemaker to the sensed chamber

I for inhibit, T for trigger, or O for no response

86

what happens when there is a D in the third code of the pacemaker, such as DDD

if there is a sense of atrial activity, there will be inhibition of the atrium

87

what is the 4th code of the pacemaker

it is the rate modulation of the pacemaker

88

what is rate modulation

it allows the rate of the paced chamber to change to vibration, motion, and minute ventilation

89

what are the 2 values of the 4th pacemaker code

R or O

90

what equation do you use to understand cardiac wall tension

LaPlace's law

91

what is Laplaces law

Tension = Pressure x Radius /2Wall thickness

92

if a mycardium is thickened, is tension increase or decrease

decrease, because it is inversely proportional to tension

93

why is understanding wall tension for heart important

because increase tension increases o2 consumption

94

what cardiac pathology has a treatment dependant on laplace's law

dilated cardiomyopathy 2ndry chf

95

what is the goal of treating chf?

diuresis and venodilation to decrease cardiac radius and prevent further thining of cardiac wall

96

What to do in vtach

Determine if it is stable or not.

97

What to do in stable v tach

Administer IV Amiodarone

98

What use to be the recommended med for stable v tach

Lidocaine

99

At what point does vtach become unstable.

When there is no pulse

100

What is the treatment of choice for pulseless vtach

Synchronized cardio version

101

What is a vtach that is polymorphic rather than monomorphic

Torsades

102

How do you treat torsades

Magnesium

103

What is another name for torsades

Polymorphic ventricular tachycardia

104

What is the danger sign when ventricle tachycardia becomes unstable

One ventricle fibrillation occurs

105

Why do you have to use synchronized cardioversion for ventricle tachycardia

Synchronizing your shock will prevent shocking during the refractory phase

106

What happens if shocks are delivered during the refractury phase

Ventricular fib

107

What kind of shock is used for vfib

Defibrillation, a higher current requiring shock, not synchronized

108

What to do if defibrillation is used for v fib and it fails

Give vasopressin

109

Where is the arterial and venous cannulations in a cabg

The aorta after the aortic clamp is the arterial cannulation. The right atrial appendage is the venous cannulation.

110

Where is the anterograde cannulation of cabg

It is between the aortic valve and the aortic clamp. This will give paraplegic medications to the coronary arteries

111

What valvular abnormalities will make the anterograde cannulation inefficient

Aortic insufficiency. The valve does not close and all the cardioplegic meds go to the left ventricle instead of the coronary arteries

112

What is the retrograde cannulation.

It is through the right atrial into the coronary sinus

113

Where is the cannula during retrograde infusion if you loose pressure

It is in the right ventricle....out of the coronary sinus

114

What happens to the arterial like systolic pressure as you move more peripherally

Increase in pulse pressure - increase in sbp

115

What happens to more peripheral a line upstrokes

Delayed

116

What happens to the dicrotic notch in more peripheral a lines

Delayed, more slurred

117

What happens to the diastolic wave of a more peripheral a line

More prominent

118

How many types of shock are there

4

119

What are the 4 types of shock

Cardiogenic, hypovolemic, distributive, obstructive

120

What are 3 numbers to look for to determine shock

Cvp, paop, svr

121

What numbers would you see in hypovolemic shock

Low cvp, low paop, high svr

122

What numbers would you. See in right sided heart failure shock

Normal cvp, normal paop, high svr

123

What numbers would you see in left sided heart failure

Elevated cvp, elevated paop, high svr

124

What numbers in biventricular failure

Everything is elevated

125

What numbers do you see in distributive shock

Look at the svr. It is always decreased

126

What are examples of distributive shock

Anaphylaxis, spinal shock, sepsis, corticosteroid insufficiency...all lead to peripheral vasodilation

127

What are examples of obstructive shock

Tamponade, pulm embolism, tension pneumo

128

What happens when the diastolic pressure equal that of the chamber pressures

Sign of cardiac tamponade

129

Cardiac tamponade...what is severely reduced in tamponade

Diastolic filling.

130

Cardiac tamponade...what is the result of decrease diastolic filling in tamponade on a cvp line

Decrease in y descent or even absent

131

Cardiac tamponade...what happens to the pressures on a cvp

Equalization of right atrial pressure, pulm artery diastolic pressure, and pcwp.

132

Cardiac tamponade...what is the triad we see

Becks triad....hypotension, increase cvp,and distant heart sounds

133

Cardiac tamponade...what happens to systolic pressure on inspiration

Decrease on inspiration,,,aka...pulsus paradoxus

134

Cardiac tamponade...what are the EKG findings

Low voltage on qrs and electrical alternans

135

Cardiac tamponade...can you give the patient opiod or benzo before the pericardial centesis

No...they will have sympathy lysis and thus decease heart rate and then hypotension. These patients are dependent on tachycardia

136

Cardiac tamponade....what is a safe form of sedation for tamponade

Ketamine...it will increase sympathetic...as well as as maintains pts ability to creative negative pressure inspiration...positive pressure ventilation has a tendency to decrease preload and cause arrest

137

What is the most common cause do sudden cardiac death in teens

Hypertrophic cardiac myopathy

138

Hcm...what is the inheritance pattern

Autosomal dominance

139

Hcm...what kind of murmur do u have.

Left lower stern all border murmur. And apex murmur.

140

Hcm...what increases the murmur

Decease preload by Valsalva maneuver.

141

Hcm...what decreases the murmur.

Increase preload aka squatting position.

142

Hcm...how do u diagnose it

Tte...left ventricular wall greater than 15mm without enlarged ventricle cavity

143

Hcm...should you pretreat the patient with benzo

Yes...it will blunt sympathetics and allow for slow heart rate and maintained svr

144

Mitral stenosis. What is the physiologic goals for anesthesia

Slow heart rate and increased svr

145

Mitral stenosis. Why do u want high svr

Because a drop in svr will cause a reflex tachycardia

146

Mitral stenosis. What is the problem with tachycardia

Poor time for ventricular filling.

147

Mitral stenosis. What can tachycardia lead to

Atrial fibrillation.

148

Mitral stenosis. What is the problem with atrial fibrillation..

It leads to decrease in cardiac output because there is little ventricular filling

149

Mitral stenosis. What cans atrial fibrillation lead to.

Atrial fibrillation with rvr.

150

Mitral stenosis. What is the volume resuscitation goal for mitral stenosis

Euvolemia. Do not cause too high in central blood volume or else you can overload the right ventricle

151

Mitral stenosis. What is the metabolic goals for ms

Prevent hypoxia and hypercapnia. These can lead to pulmonary hypertension and then lead to right sided heart failure. This would worsen the pulmonary hypertension that is already associated with mitral stenosis.

152

intraop cardiac arrest. what is the most common prodromal sign

bradycardia...shows up 67% of the time

153

intraoperative cardiac arrest. what is the common spo2 reading before arrest

below 90 on the spo2

154

intraoperative cardiac arrest. what are 3 indicators of a possible cardiac arrest

hypotension, bradycardia, hypoxia

155

intraoperative cardiac arrest. what is the first step in management

cardiac compression

156

protamine. what side effects can it cause

severe hypotension, right sided heart failure, pulm htn, bronchospasm

157

protamine. what are independant risk factors to get allergic rxn to it

history of nph use, fish allergy, history of allergies in general

158

protamine. what are theoretical risks are prior use of protamine or history of vasectomy

theoretical risks are prior use of protamine or history of vasectomy

159

protamine. can a protamine reaction be prevented by preadmin with histamine

no

160

protamine. what to do if you only see hypotension

use vasopressors and fluids

161

protamine. what differentiates severe hypotension from non severe

check the cvp...if it is elevated, then there is significant right sided involvement

162

protamine. what vasopressor is used for severe hypotension in protamine reaction

epinephrine

163

protamine. what side effect seen with hypotension should also be treated with epinephrine

bronchospasm

164

protamine. when should fluids not be used to treat hypotension

when you see right vent failure on TEE...heart is dilated already, so the increase in fluids will cause worsening clinical picture.

165

protamine. what should be done if right heart failure is seen after protamine reaction

reinstitution of cardiopulmonary bypass

166

intraop mi. what is seen first, increase in pa pressures or systemic hypotension

increase in PA pressure is seen before systemic hypotension

167

intraop mi. why is the pa increase seen before hypotension

because diastolic dysfunction during mi occurs before systolic dysfunction. decrease cardiac compliance occurs and back pressure into the pulm artery occurs

168

intraop mi. what valvular lesion may be seen.

mitral regurge...bc papillary muscles may infarc and cause mitral regurge.

169

intaop mi. when the mitral regurge happens, what do u see on cvp tracing

prominent a and v waves

170

intraop mi. what is the most sensitive indicator of MI

TEE

171

intraop mi. if ekg changes is seen and pap increase...but no hypotension...what drug is given

nitroglycerin...to decrease preload to heart to decrease right ventricle straing...and secondly, it dilates coronary arteries to increase coronary blood flow

172

pacemakers with defibrillators. what does placing the magnet do to it

it will stop the defibrilator from functioning

173

pacemaker with defibrillators. so what happens to a ddd pacemaker with defibrillator function

it will become ddd without a defibrillator function

174

pacemaker with defibrillators. what should you look at first to know what to do.

look at the interrogation...see if the patient is pacemaker dependant (seen in pts with no intrinsic cardiac conduction left)

175

pacemaker with defibrillators. what mode should the patient be placed in if they are pacemaker dependant

asynchronous mode...like doo or voo

176

pacemaker with defibrillators. how is a pacemaker placed in doo or voo

magnet does not do this...magnet only turns off the defibrillator...the pacemaker must be reset by cardiology to go into voo or doo

177

pacemaker with defibrillators. why should a pacemaker dependant pt be placed into asynchronous mode

assuming that the magnet has turned off the defibrillator, the pacemaker could still be in a mode where the inhibitor function may still function and get electrocautery interference ...such as ddd modes of pacemaker that still has inhibition function after a magnet is placed

178

mediastinoscopy. what must be available for all these cases

blood for transfusion

179

mediastinoscopy. what is the biggest risk for these cases

bleeding.

180

mediastinoscopy. what may be the cause of bleeding

pulm vv, pulm aa, thoracic duct, innominate vv

181

mediastinoscopy. what nerve injury may be seen

phrenic nerve or recurrent laryngea nerve injury

182

mediastinoscopy. what lung injury may be seen

pneumothorax, or air embolism

183

mediastinoscopy. what limb should be monitored by what

pulse ox or arterial line should be placed on the right side because the innominate compression is commonly compressed during the case.

184

valsalva maneuver. how many phases are there for hemodynamic changes

four

185

valsalva maneuver. what happens in phase 1

the maneuver is initiated with increase in intrab pressure causing increase in preload...the heart reflex bradys

186

valsalva maneuver. what happens in phase 2

valsalva is maintained and now there is a decrease in preload and reflex tacycardia occurs

187

valsalva maneuver. what happens in phase 3

valsalva maneuver is stopped and now pulm vv capacitance is increased....less go to the left atrium and even more tachycardia occurs

188

valsalva maneuver. what happens to phase 4

over shoot. now massive tachycardia and preload occurs and cardiac out and bp are at its highest

189

valsalva maneuver. what medical condition can u diagnose using this

diabetic autonomic dysfunction. they wouuld not be able to do the reflex tachycardia. heart failure pt would also not show the overshoot

190

Mitral stenosis. What is the heart sound that you hear.

Loud s1 (opening snap) and a mid diastolic rumble.

191

Mitral stenosis. What diseases can cause this.

Rheumatic fever, sle, amyloidosis.

192

Mitral stenosis. What is the best physiologic conditions for this disease.

Slow and squeeze.

193

Mitral stenosis. What can cause chf in mitral stenosis.

Disease states that cause tachycardia and hypotension. Like thyrotoxicosis, anemia, or sepsis.

194

Mitral stenosis. What is the danger in tachycardia in mitral stenosis.

atrial fibrillation

195

cardiogenic shock. what is the most common risk factor

myocardial infarction...mainly ST elevated MI!

196

cardiogenic shock. when does it occur after mi

50% of patients show shock signs at 6hrs...and 75% show it within 72hrs

197

cardiogenic shock. at what age are pt more prone to get card shock

71 years old

198

cardiogenic shock. males vs females...who are more prone

females

199

cardiogenic shock. what infarc is more prone to shock

anterior infarct

200

cardiogenic shock. what kinda ekg finding makes pt risk for shock

left bbb

201

cardiogenic shock. what is necessary for diagnosis

you need evidence of end organ hypoperfusion...oliguria, altered mentation, severe peripheral vasoconstriction

202

cardiogenic shock. what value of cardiac index dictates cardiogenic shock

end organ hypoperfusion must be diagnosed first....then cardiac index can be used to help establish the diagnosis. with no pressor, a CI less than 1.8, with pressors, a CI less than 2

203

cardiogenic shock. if you already have signs of hypoperfusion. what bp reading can establish the diagnosis

for 30min or greather, sbp 80-90 or less,...or map in 30s

204

cadiogenic shock. what must u not have to diagnose cardiogenic shock

there must be no hypovolemia

205

cardiogenic shock. what is the foundation treatment for this

intaaortic ballon pump

206

cardiogenic shock. balloon pump. when does it inflate

during diastole to increase systemic diastole pressure

207

cardiogenic shock. balloon pump. when will it not improve coronary perfusion

if there was coronary stenosis

208

cardiogenic shock. what does balloon pump do to afterload

it decreases it

209

Prophylaxis infective endocarditis . What is the purpose of prophylaxis.

It is to prevent infections in those who would have great medical detriment if infection happens

210

Prophylaxis infective endocarditis. What is better at preventing infection in pt getting oral procedures.

Oral hygiene is better than antibiotics itself. The risks of of antibiotics is greater than that of the benefits of just prophylactically getting it

211

Prophylaxis infective endocarditis . What cardiac condition that has not had intervention should get prophylaxis.

Those of cyanosis disease should get it because these patients would die if infection occurs.

212

Prophylaxis infective endocarditis. What cardiac conditions that has had intervention done need prophylaxis.

Those who have valvular hardware or valvulopathy or prosthetics or those who had congenital heart problems that still have residual defects.

213

Prophylaxis infective endocarditis. What pmhx would indicate prophylaxis.

If the patient has history of infective endocarditis

214

Prophylaxis infective endocarditis. What 2 kinds of surgery do not need prophylaxis

Gu and gi interventions do not need prophylaxis for infective endocarditis purposes

215

Prophylaxis infective endocarditis. What are the 3 types of surgeries most associated with bacteremia

Skin musculoskeletal surgeries, oral surgeries, lung surgeries

216

Prophylaxis infective endocarditis. If a cyanosis heart disease was repaired but without hardware placement. Should u still prophylax

Only if the intervention has been less than 6 months ago.

217

Cardiac transplant. How should the volume status of the pt be kept under ga

The patients heart are de-enervated. They usually can't raise heart rate sufficiently to compensate for hypovolemia. They are volume dependent pts. Keep them euvolemic. Do not restrict fluids and treat them like heart failure pts.

218

Cardiac transplant. How do u increase the heart rate in these patients.

Epinephrine or isoproterenol.

219

Cardiac transplant. Why do u have to monitor st-segment during surgery for these patients.

Bc transplant pt is very prone to getting cad. Their chronic steriods for immunosuppression may pedispose them to htn and diabetes.

220

Cardiac transplant. If a pt is on immunosuppressants, should u avoid giving them steriods in the case?

No. Some of the immunosupressants are steriods to prevent rejection of the heart. Avoiding steriods will not improve their infection rate...actually they may require stress dose steriods bc they are usually. Chronic steroid users.

221

mitral regurgitaiton. if there was an ischemic event. what is the most common mechanism of action for mitral regurge to develop

after cardiac infarc...remodeling occurs and causes distortion of the myocardium and annulus of the mitral valve...this causes mitral regurg...this mech is more common than papillary rupture

222

mitral regurgitaiton. ischemic form. what is the severity of mitral regurge needed to have exercise induced pulmonary edema

any amount of mitral regurge can cause pulm edema associated with exercise. any high level of catecholamine states may cause dysrythmia that can cause mr to be exacerbated

223

mitral regurgitation. ischemic form. what are good medications to use to prevent remodeling

beta blockers and ace inhibitors.

224

mitral regurgitation. ischemic form. what interventions can be done to reduce mr

biventricular pacing can help reduce distortion upon the mitral valve

225

lbbb. what do u look out for first on ekg.

must look for qrs greater than 0.12 seconds

226

lbbb. where is st depression and twave inversion

I v5 v6

227

lbbb. where is st elevation upright t wave

v1 v2

228

rbbb. what do u look out for first on ekg

qrs greater than 0.12

229

mitral stenosis. what is the normal valve area

4-6 cm2

230

mitral stenosis. what is considered mild stenosis

any value between 2 and 4 cm2

231

mitral stenosis. what is considered severe mitral stenosis

less than 1cm 2

232

mitral stenosis. what are they at risk for

since there is low forward flow, the stasis makes clots can can make emboli

233

aortic stenosis. valve area. mild/mod/sever

>1.5cm2, 1.5-1.0, <1.0

234

aortic stenosis. gradient mmHg. mild/mod/severe

40

235

aortic stenosis. jet velocity. m/s mild/mod/severe

4

236

persistent left SVC. where does this left svc drain into

directly into the coronary sinus

237

peristent left svc. why does it drain into the coronary sinus

because this is a where embryonically at 8 weeks it is joined to drop venous drainage to the right side of the heart

238

perisstent left svc. where does the left side of the svc drain in normal people

in normal people, an innominate vv would form at 8 weeks...connecting both right and left caval viens. the left svc that would connect to the coronary sinus would then dissentegrate

239

persistent left svc. what happens to cardioplegia

cardioplegia placed for retrograde cannula might not work so well because blood would rather go up toward the left svc rather than down the coronary sinus

240

oxygen consumption. what is oxygen delivery

DO2

241

oxygen consumption. what is the equation for oxygen delivery

DO2 = CO X CaO2 X10

242

oxygen consumption. if u plug in all normal values for calculating oxygen delivery, what is the average value u get

about 988ml O2/min

243

oxygen consumption. what does an SVO2 of 75% mean

that your consumption of oxygen is only 250cc/min...aka 25% of your DO2 because 250cc/988cc is roughly 25%

244

oxygen consumption. how does cyanide affect svo2

it increases SVO2 because mitochondria are not able to utilize oxygen and extract it off the rbc

245

oxygen consumption. what kind of shunt will cause a decrease in svo2

a left to right shunt ...

246

oxygen consumption. what does an av fistula do to svo2

decreases it