🫀 Cardiac Pathophysiology & Pharmacology in Perioperative Practice – Exam Notes

What factors increase surgical risk in patients with cardiac disease?

Ischaemia, arrhythmias, heart failure, valve disorders.

How do anaesthesia and surgical stress affect the heart?

They increase myocardial oxygen demand.

What is monitored during intra-operative care for cardiac patients?

ECG, BP, SpO2, ETCO2, fluid balance.

What should be checked pre-operatively in cardiac patients?

Cardiac assessment including METs, ECG, medications, and cardiac history.

What are the determinants of cardiac function?

Preload, afterload, contractility, heart rate.

What is the normal range for the PR interval in an ECG?

0.12–0.20 seconds.

What does STEMI indicate on an ECG?

ST elevation resulting in myocardial infarction.

What must be done for a patient with atrial fibrillation on warfarin prior to surgery?

Check normalised blood ratio and stop warfarin 5 days pre-op, may require Low-molecular-weight heparins bridging.

What medication may be used in heart failure to monitor potassium levels?

Diuretics.

What characterizes Aortic stenosis in terms of surgical risk?

It has high surgical risk; avoid BP drops and over-sedation.

What does RRRIP in ECG interpretation stand for?

Rate, Rhythm, P waves, PR interval, QRS width.

What is the mechanism of action for alpha blockers?

They block alpha-1 adrenergic receptors, leading to vasodilation and lower blood pressure.

List a common use for antiarrhythmics.

Atrial fibrillation.

What effect do calcium channel blockers have on blood vessels?

They inhibit calcium entry, leading to vasodilation and reduced heart rate.

What do beta blockers do to heart function?

They reduce heart rate, myocardial contractility, and oxygen demand.

What is digoxin primarily used for?

Heart failure and atrial fibrillation to control heart rate.

What is the purpose of statins in cardiac care?

To reduce cholesterol production, decreasing risk of atherosclerosis and cardiovascular events.