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Anesthesia and the Patient With Heart Disease

Arch Surg. 1981;116(7):973. doi:10.1001/archsurg.1981.01380190097029.
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This 193-page book by 12 authors presents many important considerations for the patient with heart disease who must undergo general anesthesia. A brief synopsis of the basics of heart rate and rhythm, preload and afterload, and ventricular function is followed by a discussion of the effects of all modern anesthetic agents and adjuvants used in general anesthesia. Data from both animal and human studies are presented. The chapter on monitoring emphasizes the need for ECG monitoring of lead V5 in patients with ischemic heart disease. Monitoring the heart as a pump includes a short discussion of esophageal stethoscope, Doppler flowmeters, and, interestingly, a rather extensive discussion of central venous pressure. It is disappointing that pulmonary artery monitoring is mentioned only in passing. Techniques for external jugular cannulation and percutaneous radial artery cannulation are presented. Several studies that outline the risks of anesthesia in patients with previous myocardial infarction are


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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