Ischemic Heart Disease

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Which of the following is NOT a characteristic of patients who would have limited value in cardiac function assessment?

Stable cardiac function
Cardiac function is unstable
Cardiac function cannot be assessed (correct)
Able to be assessed clinically

Which of the following is NOT a component of the Revised Cardiac Risk Index as described in the text?

Insulin-dependent diabetes
Preoperative serum creatinine > 3.0 mg/dl (correct)
Ischemic heart disease
Congestive heart failure

According to the ACC/AHA guidelines mentioned in the text, which of the following is the recommended non-invasive cardiac testing method for patients who are unable to exercise?

Stress Echo
Stress ECG
Positron emission tomography
Dipyridamole-thallium scintigraphy (correct)

Which of the following is NOT mentioned in the text as a preoperative cardiac intervention option?

Implantable cardioverter-defibrillator (ICD) placement (D) Signup and view all the answers

Which of the following is the recommended timeframe for initiating statin therapy prior to surgery?

At least 45 days preoperatively (D) Signup and view all the answers

Which of the following is the recommended class of evidence for the use of calcium channel blockers in the perioperative period?

Class IIb (D) Signup and view all the answers

Which of the following statements about the coronary arterial system is correct?

The left anterior descending artery supplies the anterior wall of the left ventricle and the anterior two-thirds of the interventricular septum. (A) Signup and view all the answers

In the context of coronary circulation, what is meant by 'dominance'?

The determination of which artery, the right coronary artery or the left circumflex, supplies the posterior descending coronary artery. (A) Signup and view all the answers

Which of the following structures is typically supplied by the right coronary artery?

The atrioventricular node (C) Signup and view all the answers

What is the approximate ratio of myocardial capillary blood vessels to myofibrils in the coronary microcirculation?

1:1 (C) Signup and view all the answers

What is the primary function of the collateral circulation in the coronary arterial system?

To supply oxygenated blood to the myocardium when the main coronary arteries are occluded. (D) Signup and view all the answers

Which of the following statements accurately describes the coronary venous system?

It is a complex network of veins that follow the same distribution pattern as the coronary arteries. (A) Signup and view all the answers

Why is Atracurium associated with histamine release?

It increases heart rate and blood pressure (C) Signup and view all the answers

Which monitoring method is considered the gold standard for intraoperative diagnosis of ischemia?

Transesophageal echocardiography (B) Signup and view all the answers

What is a major disadvantage of using pulmonary artery occlusion pressure as a monitoring tool?

Insensitive in the absence of global ischemia (C) Signup and view all the answers

How should hypotension be managed during surgery in the presence of ischemia?

Fluids and inotropes (C) Signup and view all the answers

What are some specific concerns in the postoperative management of patients with increased potential for myocardial ischemia?

Pain and inadequate ventilation (D) Signup and view all the answers

Why may a transplanted heart show higher than normal resting heart rate and lack sympathetic response to laryngoscopy?

Due to complete denervation (A) Signup and view all the answers

Which of the following statements regarding preoperative evaluation of cardiac patients is correct?

Asking the patient if they wake up at night short of breath or sleep flat on their back can provide valuable information. (C) Signup and view all the answers

Which of the following statements regarding preoperative medication management is correct?

Hypoglycemic agents and drugs affecting coagulation are typically continued throughout the perioperative period. (B) Signup and view all the answers

Which of the following is an essential component of the preoperative physical exam for cardiac patients?

All of the above are essential components of the preoperative physical exam for cardiac patients. (D) Signup and view all the answers

Which of the following statements regarding preoperative testing for cardiac patients is correct?

Preoperative testing is only indicated if the results will change the management of the patient. (B) Signup and view all the answers

Which of the following statements regarding preoperative medication management for cardiac patients is incorrect?

Hypoglycemic agents should be continued throughout the perioperative period to maintain blood sugar control. (C) Signup and view all the answers

Which of the following findings during the preoperative physical exam would be of particular concern for a cardiac patient undergoing surgery?

Presence of jugular venous distention (JVD). (C) Signup and view all the answers

Which of the following is true regarding the coronary venous system?

The great cardiac vein runs with the left anterior descending (LAD) artery. (D) Signup and view all the answers

Which of the following factors does not directly affect left ventricular blood flow?

Myocardial contractility (D) Signup and view all the answers

Which of the following statements accurately describes the effects of extravascular compression on coronary blood flow?

All of the above statements are accurate. (D) Signup and view all the answers

Which of the following factors does not further compromise subendocardial blood flow?

Increased aortic diastolic pressure (D) Signup and view all the answers

Which of the following is not a major determinant of myocardial oxygen consumption?

Coronary perfusion pressure (A) Signup and view all the answers

Which of the following statements about metabolic control of coronary blood flow is accurate?

Potential mediators of vasodilation include adenosine, bradykinin, nitric oxide, carbon dioxide, and hydrogen ions. (A) Signup and view all the answers

Which of the following statements about neural control of coronary blood flow is accurate?

α-adrenergic receptors are more prevalent in the intramuscular arteries, while β-adrenergic receptors are more prevalent in the epicardial vessels. (A) Signup and view all the answers

Which of the following statements about atherosclerosis is accurate?

A vulnerable plaque is characterized by a high lipid content, thin fibrous cap, decreased number of smooth muscle cells, and increased macrophage activity. (D) Signup and view all the answers

Which of the following statements about acute coronary syndromes is accurate?

The extent of plaque rupture and duration of occlusion are more important than the degree of stenosis in determining the severity of acute coronary syndromes. (A) Signup and view all the answers

Ischemic Heart Disease - Coronary Circulation Anatomy and Pathophysiology

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