30 Questions
What is the natural history of valvular heart disease important for determining?
The timing of intervention
What does an acute increase in volume, like in acute aortic insufficiency, lead to?
Impaired ventricular relaxation
Which indices are relatively insensitive to loading conditions, making them a poor reflection of basal contractility?
Isovolumetric Indices (Vmax, dP/dT)
What does chronic pressure overload lead to in terms of ventricular compliance?
Inverse linear relationship with hypertrophy
Which measure provides a more precise estimate of contractility and is independent of preload?
End Systolic Pressure Volume Relationship (ESPVR)
What does contractility refer to in the context of valvular heart disease?
The ability to generate force at a given preload
What is a primary goal in the anesthetic management of mitral stenosis?
Controlling ventricular rate
All procedures are recommended for mild mitral stenosis with few or no symptoms, EXCEPT?
Atrial fibrillation ablation
What is a potential cause of mitral valve prolapse according to the text?
Rheumatic disease
What 2 factors are reduced in patients with decreased preload reserve due to mitral stenosis?
Stroke volume
Approximately what percentage of the population does mitral valve prolapse affect?
1-2.5%
What should be avoided during the anesthetic management of mitral stenosis to minimize risks?
Tachycardia
Mitral valve prolapse is more common in young men than in young women.
False
Patients with mild mitral stenosis and no symptoms should undergo immediate surgical intervention.
False
In the anesthetic management of mitral stenosis, tachycardia should be avoided as it can help improve LV function.
False
Mitral stenosis leads to an increase in preload reserve, contributing to higher stroke volume.
False
Mitral stenosis leads to a decrease in preload reserve and a reduction in ______
stroke volume
Atrial fibrillation and LA distention increase the risk of ______ events
thromboembolic
What is a common complication that approximately 1/3 of patients with severe mitral valve disease develop?
Atrial fibrillation
Which procedure is NOT recommended for patients with mild mitral stenosis and few or no symptoms?
Immediate surgical intervention
What is the primary concern regarding sedation in the anesthetic management of mitral stenosis?
Avoiding tachycardia
What is a possible etiology associated with mitral valve prolapse according to the text?
Thyrotoxicosis
In the anesthetic management of mitral stenosis, which type of induction is generally acceptable except for one specific agent?
Ketamine induction
What is the purpose of understanding the natural history of valvular heart disease?
To determine the timing of surgical intervention
How does mitral stenosis affect preload reserve and stroke volume?
Decreases preload reserve and stroke volume
In patients with chronic pressure overload, what relationship is observed between hypertrophy and compliance?
Inverse linear relationship
Which phase of cardiac function indices are unreliable in most valvular diseases?
Ejection phase indices
What does contractility refer to in the context of valvular heart disease?
Ability to generate force at a given preload
Which measure provides a more precise estimate of contractility and is independent of preload?
End systolic pressure volume relationship
What effect does an acute increase in volume, such as in acute aortic insufficiency, have on left ventricular end-diastolic pressure (LVEDP)?
Increases LVEDP remarkably
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