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diagnosis anesthesiology intraoperative management workup cardiology differential electrocardiogram stemi anaphylaxis cardiacglycoside digitaliseffect digoxin digoxintoxicity embolism embolus evaluation fabfragments interpretation ischaemia
Intraoperative Cardiac Ischaemia - Guidelines for Crises in Anaesthesia If the patient is unconscious, signs of cardiac
is unconscious, signs ... of cardiac ischaemia ... trolley and 12-lead ECG ... CM5 continuous ECG ... Obtain a 12-lead ECG
Approach to ECGs - Ischemia MI = Biomarkers + ECG or echo/angiogram findings Pathologic Q - 1/3 height
= Biomarkers + ECG ... or R/S>I STEMI Equivalents ... / Don't Miss Signs ... bigger than QRS - deWinter ... #ECG #EKG #diagnosis
STEMI Equivalents on ECG • Conventional STEMI - Elevation of ST segment at (or 40-60 ms
on ECG • Conventional ... V2 • Wellens sign ... pain • Wellens sign ... deviation) • Acute ischemia ... #ECG #EKG #diagnosis
Intraoperative Circulatory Embolus - Guidelines for Crises in Anaesthesia Causes: thrombus, fat, amniotic fluid, air/gas. Signs: hypotension, tachycardia,
Signs: hypotension ... unexplained loss of cardiac ... Consider thrombolysis e.g ... over 2 h (>65 kg ... Intraoperative #Checklist
Cardiac Tamponade - Guidelines for Crises in Anaesthesia Caused by an accumulation of blood, pus, effusion fluid
Cardiac Tamponade ... iatrogenic causes, e.g ... pericardiocentesis kit (eg ... examination and vital signs ... Intraoperative #Checklist
Intraoperative Anaphylaxis - Guidelines for Crises in Anaesthesia • Unexplained hypotension • Unexplained bronchospasm (wheeze may be absent
• Unexpected cardiac ... of more of the signs ... surgery. ❷ Call for cardiac ... alternate vasopressor (e.g ... Intraoperative #Checklist
The chemical formula of Digoxin is C41 H64 O14. Digoxin (Cardiac glycoside) reversibly inhibits the sodium-potassium-ATPase, causing
Digoxin (Cardiac ... comorbid conditions (eg ... hypercalcemia, myocardial ischemia ... often the first sign ... effect" on the ECG
Preoperative Risk Evaluation Major Pre-Op Questions: 1. Does the patient have any modifiable risk factors that could be
complications from anesthesia ... Highest metabolic equivalent ... history of: a) Ischemic ... indicated • EKG ... Obtain EKG if:
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