40 Questions
What is the primary cause of aortic stenosis in the aging population?
Calcification of the valve
What is the characteristic of the early lesion of aortic stenosis?
Intimal plaque
What is the correlation between coronary calcification and aortic valve calcification?
High correlation
What is the most common risk factor for aortic stenosis?
Increased LDL
What is the primary concern with performing prophylactic AVR in asymptomatic patients?
The risk of complications during the procedure
What is the relationship between aortic stenosis and myocardial oxygen supply and demand?
Aortic stenosis increases oxygen demand
What is the significance of contractile reserve in aortic stenosis?
It is a measure of cardiac function
What is the primary benefit of performing AVR in patients with aortic stenosis?
Reducing the risk of sudden death
What is a characteristic of the volume loop in aortic regurgitation?
Brief isovolumic systolic phase due to low aortic diastolic pressure
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
Why is coronary perfusion pressure decreased in aortic regurgitation?
Increased diastolic aortic runoff and increased diastolic LV pressure
What is the goal of anesthetic management in aortic regurgitation?
Augment forward flow and reduce LV backflow
What is a complication of intraoperative bradycardia in aortic regurgitation?
Prolonged diastolic time
What is the characteristic of symptoms in acute aortic regurgitation?
Refractory to medical management
What is the indication for serial echocardiography in aortic regurgitation?
To assess contractility with pharmacologic afterload enhancement
Why is TEE preferred over Swan in aortic regurgitation?
TEE is better for assessing contractility
What is a major disadvantage of regional anesthesia compared to general anesthesia?
It wears off and is not suitable for certain cases
What is a common cause of acute mitral regurgitation?
Papillary muscle dysfunction
What is the primary effect of mitral regurgitation on the left ventricle?
Volume overload
What is the purpose of the Frank-Starling mechanism in mitral regurgitation?
To augment contractility and maintain ejection fraction
What is a characteristic of the volume loop in chronic mitral regurgitation?
Right shift due to chamber enlargement
What is the most important predictor of long-term survival in mitral regurgitation?
Preoperative ejection fraction
What is a benefit of mitral valve repair compared to replacement in mitral regurgitation?
It provides better long-term outcome
What is a characteristic of functional mitral regurgitation?
Dilitation of the left ventricle due to altered geometry
What is the primary goal of anesthetic management in patients with mitral regurgitation?
Increase preload
What is the significance of V wave in patients with mitral regurgitation?
It indicates compliance-dependent volume trends
What is the characteristic of mitral stenosis that increases the risk of thromboembolic events?
Atrial fibrillation
What is the primary goal of anesthetic management in patients with mitral stenosis?
Control ventricular rate
What is the etiology of mitral valve prolapse?
All of the above
What is the effect of upright posture on mitral valve prolapse?
It worsens the prolapse
What is the recommended anticoagulation therapy for patients with a mechanical valve?
Low-dose aspirin and a vitamin K antagonist
What is the characteristic of the murmur in mitral stenosis?
It has little radiation
What is the primary goal in managing aortic stenosis?
Maintaining coronary perfusion
When should heparin or LMWH be initiated in a patient taking vitamin K antagonist?
When INR falls to subtherapeutic
What is the consequence of decreased preload reserve in aortic stenosis?
Decreased ejection fraction
What is the primary goal in managing aortic regurgitation?
Augmenting forward flow
Why is atrial systole important in left ventricular filling?
It provides a critical component of preload
What is the consequence of right shift in aortic stenosis?
Chamber enlargement
What is the primary goal in managing mitral stenosis?
Maintaining sinus rhythm
Why is preload important in aortic stenosis?
It maintains stroke volume
This quiz covers the main reasons behind aortic stenosis in an aging population, including the role of calcification, atherosclerosis, and concurrent diseases such as CAD. It highlights the identical risk factors and the correlation between coronary and aortic valve calcification. Test your knowledge of the pathological processes involved in aortic stenosis.
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