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Anesthesiology > Anesthetic Issues in Animals with Cardiac Dysfunction > Flashcards

Anesthetic Issues in Animals with Cardiac Dysfunction Flashcards

1
Q

What are the most common congenital defects?

A

PDA
Septal defects
Stenotic valves

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2
Q

What are some acquired diseases?

A

Valvular dysfunction
Myocardial failure
Conduction disturbances

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3
Q

What is the most common congenital problem in dogs?

A

PDA

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4
Q

What dogs get valve disease?

A

Small, geriatric

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5
Q

What dogs get DCM?

A

Large, giant breeds

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6
Q

What dogs have conduction disturbances?

A

Boxer dogs

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7
Q

What is the common heart problem in cats?

A

HCM

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8
Q

What is a congenital defect in horses?

A

VSD

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9
Q

What are acquired cardiac problems in horses?

A

Conduction disturbances

Valvular disease

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10
Q

What should be done in a physical exam?

A

Quiet room
Auscultate for a long time
Both sides
Feel pulses at the same time
Check for: muffled heart sounds, cough, edema, ascites, jugular pulses, wide forelimb stance, pale MM, cyanosis
Exercise the animal and see who gets tired first

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11
Q

What should be used for objective analyses?

A

ECG, chest rads
Echo
Chem
CBC

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12
Q

What are the anesthetic rules of thumb?

A

Avoid increased myocardial oxygen demand
Avoid fluid overload
Maintain adequate oxygen delivery
Maintain HR near that of awake at rest level
Inotropes are great for poor contractility
Do not suddenly change cardia meds
Correct arrhythmias if possible
Pre-oxygenate
Attention to detail and monitoring are as important as drug choices

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13
Q

How do you calculate CO?

A

CO = HR x SV

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14
Q

How do you calculate MAP?

A

MAP = CO x SVR

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15
Q

What are anticholinergics indicated for?

A

Bradyarrhythmias, cardiac arrest

Useful in patients whose CO tends to be rate dependent (pediatrics, cats)

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16
Q

What can anticholinergics cause?

A

Tachycardia that will not be tolerated by a cardiac patient

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17
Q

What is acepromazine useful in?

A

Animal with dilated cardiomyopathy

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18
Q

What is ace not great to be used in?

A

Animals with HCM or CHF

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19
Q

Which benzo is nice for cardiac patients?

A

Midazolam

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20
Q

What do opioids cause?

A

Bradycardia, otherwise there is minimal impact on CO

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21
Q

What does opioid reduce?

A

Inhalant requirements

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22
Q

Alpha-2 adrenergic agonists (xylazine and dexmedetomidine) are not recommended in cardiac patients except what?

A

HCM cats and horses

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23
Q

What is highly recommended in cardiac patients with local anesthetics?

A

Regional use

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24
Q

What do dissociatives do?

A

Increased cardiac oxygen consumption and HR

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25
Q

Dissociatives are useful in very low doses except in what?

A

Cats with HCM

26
Q

What is the induction drug of choice in animals with significant cardiac dysfunction?

A

Etomidate

27
Q

What does thiopental cause?

A

Tachycardia

Tachyarrhythmias

28
Q

What is the second drug of choice in animals with cardiac dyfunction?

A

Propofol but only in low dosages

29
Q

What is alphaxalone?

A

Synthetic neuroactive steroid that interacts with GABA receptors to produce anesthesia and muscle relaxation

30
Q

What is needed before induction with alphaxalone?

A

Sedation

31
Q

What can alphaxalone cause?

A

Apnea or excitement

32
Q

What do inhalants cause?

A

Dose-dependent reductions in CO and BP

33
Q

What should be avoided with IV fluids?

A

Fluid overload

Hypertonic saline

34
Q

What can be used for monitoring?

A

ECG, blood pressure direct measurement
Central venous pressure
Pulse oximeter
Capnograph

35
Q

What should be used in patients with poor contractility?

A

Inotropes

36
Q

What are inotropes not a good idea to use in?

A

Hypertrophic patients

37
Q

What are the side effects of furosemide?

A

Dehydration and hypokalemia

38
Q

What are the side effects or spironolactone?

A

Hyperkalemia

39
Q

What are side effects of ACE inhibitors (Enalapril/Benazepril)?

A

Arterial vasodilation

Hypotension

40
Q

What are the side effects of digoxin?

A

Positive inotrope

Increased arrhythmogenesis

41
Q

What are the side effects of calcium channel blockers (Diltiazem)?

A

Hypotension/bradycardia

42
Q

What are the side effects of propranolol/sotalol (antiarrhythmic agents)?

A

Bradycardia, hypotension

43
Q

What are the side effects of procainamide (antiarrhythmic agents)?

A

Decreased myocardial contractility, bradycardia

44
Q

What do you medicate with if there is mild to moderate valvular insufficiency?

A

Opioid + benzo or low dose ace

Preoxygenate

45
Q

What is used for induction with mild to moderate valvular insufficiency?

A

Propofol or ketamine/diazepam or alphaxalone

46
Q

What is used for maintenance with mild to moderate valvular insufficiency?

A

Iso or sevo

47
Q

What rate should IV fluids be give with mild to moderate valvular insufficiency?

A

2-5 mg/kg/hr

48
Q

What should be used for premed with dilated cardiomyopathy?

A

Opioid + benzo

Preoxygenate

49
Q

What should be used for induction with dilated cardiomyopathy?

A

Fentanyl/propofol or fentanyl + ketamine/diazepam or etomidate

50
Q

What should be used for maintenance with dilated cardiomyopathy?

A

Minimal iso or sevo

51
Q

At what rate should fluids be give with dilated cardiomyopathy?

A

2-5 mg/kg/hr

52
Q

What should be used for BP support with dilated cardiomyopathy?

A

Inotropes

53
Q

What should be used to premed a puppy with PDA?

A

Opioid + low dose ace or benzo

54
Q

What should be used to maintain HR in a puppy with PDA?

A

Anticholinergics

55
Q

What should be used for induction of a puppy with PDA?

A

Low dose propofol or ketamin/diazepm or etomidate if in failure

56
Q

What should be used for maintenance in a puppy with PDA?

A

Minimal iso or sevo

57
Q

What is the normal HR in a dog?

A

60-160

58
Q

What is the normal HR in a cat?

A

120-220

59
Q

What is the normal HR in a horse?

A

25-45

60
Q

What is the normal HR in a cow, sheep,and goat?

A

60-80

61
Q

What is the normal HR in a pig?

A

60-110

Anesthesiology (27 decks)

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