Anesthetic Management
The anesthetic management for cardiac tamponade in regards to preload, SVR, and HR.
increase
This structure seen in a transgastric mid papillary short axis view would be the culprit in a patient presenting with significant dyspnea at rest one week following a STEMI in leads II, III, and avF.
Posteromedial papillary muscle.
How do IABP affect coronary perfusion pressure and afterload?
increase and decrease
Three hours after CABG, hypotension develops. PAWP is 27mmHg, CVP is 30mmgHg, and ICU TEE demonstrates right ventricular diastolic collapse - what’s the diagnosis?
Tamponade
A patient undergoing a screening colonoscopy following recent GI bleed is now hypotensive, decreased etco2, progressing hypoxemia, and tachycardic. What could be considered an initial treatment option assuming the diagnosis?
Interventional procedure: Percutaneous mechanical thrombectomy vs catheter directed thrombolysis
Slow, full, and tight…you better watch these hemodynamics during anesthesia or risk death in patients with this?
Aortic Stenosis
This lesion is the most common valvular heart lesion in patients with rheumatic heart disease
Mitral Stenosis
The RAAS system affects sodium, SVR, aldosterone in what way?
Increase sodium reabsorption via AT2, increase SVR via smooth muscle contraction via AT1, increase aldosterone which promotes sodium absorption and smooth muscle proliferation
A patient is in what shock state with a CVP of 20, mPAP of 60, PAWP of 5, and BP of 80/40/60.
Obstructive Shock
VAI…this chamber of the heart is being paced.
Vasopressor of choice in a patient with a SVR of 600, CI of 4.5, and CVP of 5.
Norepinephrine; then vasopressin
McConnell’s sign would often been seen in what pathology?
Pulmonary Embolism
In a CVP waveform, this wave or deflection is a result of tricuspid valve closure.
C wave
After administering protamine, blood pressure is 65/42, HR is 128, and PAP is 16/9; what is the best drug to administer and what type of shock?
Epinephrine
In a non-pacemaker dependent patient, watch out for this arrythmia when a magnet is utilized during surgery.
R-on-T or Torsades
Patient in pre-op has a HR of 180, but otherwise asymptomatic. What is the initial treatment?
Vagal Maneuvers
This tool is utilized to risk stratify patients undergoing non-cardiac surgery and their likelihood of a major adverse cardiac event.
RCRI or Revised cardiac risk index
When observing an arterial pressure waveform, the systolic pressure tends to do this when moving from a central aortic pressure to a peripheral radial pressure.
Increase
A patient who experiences dyspnea on exertion would be said to have this NYHA functional classification.
NYH class 3
This would be the pharmacologic treatment of choice for bradycardia in a patient undergoing anesthesia who previously had a heart transplant
Epinephrine
During inguinal hernia repair under spinal, pt loses consciousness, profound hypotension, bradycardia with SBP of 40 and HR of 30. What is the first drug to administer and how quick?
Epinephrine, quickly
A 63-year-old man with a history of congestive heart failure and left ventricular dilation is scheduled for carotid endarterectomy. During carotid cross-clamping, the surgeon requests that systolic blood pressure be increased from 100 to 160 mmHg. Compared with an identical patient with normal left ventricular size, what is the effect of this change in blood pressure on this patient's myocardial oxygen consumption?
Increase
____ is said to be the primary determinant of myocardial oxygen demand.
Heart Rate
A patient who is receiving ventilatory support after coronary artery bypass grafting has a PaO2 of 132 mmHg, a PaCO2 of 19 mmHg, and a pH of 7.57.What would cerebral blood flow do, and what is patient at risk of?
Reduced, and cerebral ischemia
This imaging modality is considered the gold standard for quantifying both left and right ventricular systolic function.
Cardiac MRI