4.1 CARDIAC

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What is the primary cause of aortic stenosis in the aging population?

Rheumatic disease

Coronary artery disease

Calcification of the valve (correct)

Bicuspid valve

What is the characteristic of the early lesion of aortic stenosis?

Fibrous plaque

Atherosclerotic plaque

Intimal plaque (correct)

Inflammatory plaque

What is the correlation between coronary calcification and aortic valve calcification?

High correlation (correct)

Inverse correlation

Low correlation

No correlation

What is the most common risk factor for aortic stenosis?

Increased LDL Signup and view all the answers

What is the primary concern with performing prophylactic AVR in asymptomatic patients?

The risk of complications during the procedure Signup and view all the answers

What is the relationship between aortic stenosis and myocardial oxygen supply and demand?

Aortic stenosis increases oxygen demand Signup and view all the answers

What is the significance of contractile reserve in aortic stenosis?

It is a measure of cardiac function Signup and view all the answers

What is the primary benefit of performing AVR in patients with aortic stenosis?

Reducing the risk of sudden death Signup and view all the answers

What is a characteristic of the volume loop in aortic regurgitation?

Brief isovolumic systolic phase due to low aortic diastolic pressure Signup and view all the answers

What is the primary cause of angina in patients with aortic regurgitation in the absence of CAD?

Disproportionate increase in mass relative to increase in coronary blood flow Signup and view all the answers

Why is coronary perfusion pressure decreased in aortic regurgitation?

Increased diastolic aortic runoff and increased diastolic LV pressure Signup and view all the answers

What is the goal of anesthetic management in aortic regurgitation?

Augment forward flow and reduce LV backflow Signup and view all the answers

What is a complication of intraoperative bradycardia in aortic regurgitation?

Prolonged diastolic time Signup and view all the answers

What is the characteristic of symptoms in acute aortic regurgitation?

Refractory to medical management Signup and view all the answers

What is the indication for serial echocardiography in aortic regurgitation?

To assess contractility with pharmacologic afterload enhancement Signup and view all the answers

Why is TEE preferred over Swan in aortic regurgitation?

TEE is better for assessing contractility Signup and view all the answers

What is a major disadvantage of regional anesthesia compared to general anesthesia?

It wears off and is not suitable for certain cases Signup and view all the answers

What is a common cause of acute mitral regurgitation?

Papillary muscle dysfunction Signup and view all the answers

What is the primary effect of mitral regurgitation on the left ventricle?

Volume overload Signup and view all the answers

What is the purpose of the Frank-Starling mechanism in mitral regurgitation?

To augment contractility and maintain ejection fraction Signup and view all the answers

What is a characteristic of the volume loop in chronic mitral regurgitation?

Right shift due to chamber enlargement Signup and view all the answers

What is the most important predictor of long-term survival in mitral regurgitation?

Preoperative ejection fraction Signup and view all the answers

What is a benefit of mitral valve repair compared to replacement in mitral regurgitation?

It provides better long-term outcome Signup and view all the answers

What is a characteristic of functional mitral regurgitation?

Dilitation of the left ventricle due to altered geometry Signup and view all the answers

What is the primary goal of anesthetic management in patients with mitral regurgitation?

Increase preload Signup and view all the answers

What is the significance of V wave in patients with mitral regurgitation?

It indicates compliance-dependent volume trends Signup and view all the answers

What is the characteristic of mitral stenosis that increases the risk of thromboembolic events?

Atrial fibrillation Signup and view all the answers

What is the primary goal of anesthetic management in patients with mitral stenosis?

Control ventricular rate Signup and view all the answers

What is the etiology of mitral valve prolapse?

All of the above Signup and view all the answers

What is the effect of upright posture on mitral valve prolapse?

It worsens the prolapse Signup and view all the answers

What is the recommended anticoagulation therapy for patients with a mechanical valve?

Low-dose aspirin and a vitamin K antagonist Signup and view all the answers

What is the characteristic of the murmur in mitral stenosis?

It has little radiation Signup and view all the answers

What is the primary goal in managing aortic stenosis?

Maintaining coronary perfusion Signup and view all the answers

When should heparin or LMWH be initiated in a patient taking vitamin K antagonist?

When INR falls to subtherapeutic Signup and view all the answers

What is the consequence of decreased preload reserve in aortic stenosis?

Decreased ejection fraction Signup and view all the answers

What is the primary goal in managing aortic regurgitation?

Augmenting forward flow Signup and view all the answers

Why is atrial systole important in left ventricular filling?

It provides a critical component of preload Signup and view all the answers