Download Anesthesiology and the Cardiovascular Patient: Papers by Dennis T. Mangano PhD, MD (auth.), T. H. Stanley, P. L. PDF

By Dennis T. Mangano PhD, MD (auth.), T. H. Stanley, P. L. Bailey (eds.)

Anesthesiology and the Cardiovascular Patient includes the edited shows of the forty first Annual Postgraduate path in Anesthesiology, February 1996. The chapters replicate new info and ideas in the common framework of the pathophysiology and administration of surgical applicants with heart problems. The textbook will function a motor vehicle to deliver some of the most recent options in anesthesiology to people who didn't attend the convention. each one bankruptcy is a quick yet sharply concentrated glimpse of the present curiosity in anesthesia. This quantity, in addition to earlier and destiny volumes, displays the swift and carrying on with evolution of anesthesiology within the overdue 20th century.

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Additional resources for Anesthesiology and the Cardiovascular Patient: Papers presented at the 41st Annual Postgraduate Course in Anesthesiology, February 1996

Example text

This observation of an effect of ischemia at a distance is not specific to halothane anesthesia; we have observed it in studies carried out using isoflurane or fentanyl anesthesia with or without nitrous oxide. What are the mechanisms of the remote effect of regional ischemia? Decrease in myocardial perfusion cannot be implicated as coronary blood flow is not reduced. Altered metabolism is also unlikely as there is no reason for an imbalance between oxygen demand and supply in a territory perfused by normal 35 coronary arteries.

Alterations in chamber stiffness may cause a change in shape of or shift in the entire diastolic pressure-volume curve. Myocardial ischemia, hypertrophic cardiomyopathy and left ventricular hypertrophy associated with hypertension have all been described to adversely influence diastolic function of the left ventricle (12). For example, myocardial ischemia may cause transient abnormalities in diastolic function, especially in relaxation and ventricular compliance. Ischemia produces an upward shift of the pressure-volume relationship.

Nikolic S, Yellin EL, Tamura K, Tamura T, Frater RWM. Effect of early diastolic loading on myocardial relaxation in the intact canine left ventricle. Circ Res 66:1217-1226,1990 10. Ishida Y, Meisner JS, Tsujioka K, et al. Left ventricular filling dynamics: influence of left ventricular relaxation and left atrial pressure. Circulation 74:187-196,1986 11. Louie EK, Edwards-LC. Hypertrophic cardiomyopathy. Prog Cardiovasc Dis 36:275-308,1994 12. Arrighi JA, Dilsizian V, Perrone-Filardi P, et al. Improvement of the agerelated impairment in left ventricular diastolic filling with verapamil in the normal human heart.

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