By Roberta L. Hines, Katherine Marschall
With Stoelting's Anesthesia and Co-Existing ailment, you'll have the succinct, but thorough counsel you want to effectively steer clear of or deal with issues stemming from pre-existing health conditions. complicated learn from specialists within the box may also help you conquer the hardest demanding situations in perform, letting you supply your sufferers the simplest care, each time.
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Additional resources for Stoelting's Anesthesia and Co-Existing Disease (6th Edition)
Treatment consists of cardioversion or intravenous administration of amiodarone, β-blockers, calcium channel blockers, or digoxin. Excessive perioperative fluid administration, placement in Trendelenburg's position, or 36 STOELTING'S ANESTHESIA AND CO-EXISTING DISEASE TABLE 2-5 n Intraoperative events that have a significant impact on mitral stenosis Sinus tachycardia or a rapid ventricular response during atrial fibrillation Marked increase in central blood volume, as associated with overtransfusion or head-down positioning Drug-induced decrease in systemic vascular resistance Hypoxemia and hypercarbia that may exacerbate pulmonary hypertension and evoke right ventricular failure autotransfusion via uterine contraction increases central blood volume and can precipitate CHF.
Long-term corticosteroid use may result in skeletal demineralization and glucose intolerance. Late complications of cardiac transplantation include development of coronary artery disease in the allograft and an increased incidence of cancer. Diffuse obliterative coronary arteriopathy affects cardiac transplant recipients over time, and the ischemic sequelae of this form of coronary artery disease are the principal limitations to long-term survival. The arterial disease is restricted to the allograft and is present in about one half of cardiac transplant recipients after 5 years.
The regurgitant valvular lesions such as aortic and mitral regurgitation require afterload reduction and a somewhat faster heart rate to shorten the time for regurgitation. Atrial fibrillation requires a controlled ventricular response so that activation of the sympathetic nervous system, as during tracheal intubation or in response to surgical stimulation, does not cause sufficient tachycardia to significantly decrease diastolic filling time and stroke volume. Laboratory Data The electrocardiogram (ECG) often exhibits characteristic changes due to valvular heart disease.