Cardiovascular
Hemodynamics, arrhythmias, valvular disease, cardiac surgery anesthesia.
Topics in this tree
- Cardiac cycle + pressure-volume loops
- Coronary perfusion + ischemia
- Conduction system + ECG
- Arrhythmia management + ACLS
- Valvular disease — AS, AI, MS, MR
- Heart failure + EF physiology
- CABG + valve surgery
- TAVR + structural heart
- Hemodynamic monitoring
Crisis algorithms
Rare, often fatal obstetric emergency — anaphylactoid syndrome of pregnancy. Sudden hemodynamic collapse, hypoxemia, and DIC during labor, delivery, or postpartum (within 30 min).
Sudden ↑PA pressure → RV failure → cardiovascular collapse. May be thrombus, fat (long-bone fracture, IM rod), gas (laparoscopy CO₂, sitting craniotomy), or amniotic.
ACLS adapted for the operating room: anesthetic depth, surgical bleeding/positioning/embolism are reversible causes the medicine code team won't think of first.
Surgical cases
Typically male 55–75, multi-vessel CAD, often diabetic, ex-smoker, on dual antiplatelet + statin + β-blocker. May have preserved or reduced EF. Last meal NPO since midnight.
Severe aortic stenosis (AVA < 1.0 cm², peak gradient > 40 mmHg) or aortic regurgitation. Typically 70-85, often with CAD, HTN, AF. May have syncope, angina, or CHF as presenting symptom.
Severe AS with high surgical risk (STS score > 8% historically; expanding to intermediate + low risk). Typically 75-95, multi-comorbid, often deemed too sick for SAVR. Outpatient or 1-night admission becoming common.
Severe mitral regurgitation (degenerative, functional, ischemic) or stenosis (rheumatic — declining incidence). Often AF, pulmonary hypertension, dilated LA. EF preserved early in MR (eccentric hypertrophy compensates), drops late.