Assessment Of Patient With Cardiac Disease

ASSESSMENT OF PATIENT WITH CARDIAC DISEASE The main objects in assessment of patients with cardiac : disease are a-to determine the capibilty of the heart and circulation to withstand the stresses which accompany anaesthesia and surgery , not only during the operative period but equally .in the post –operative period b- to make alogical choice of anaesthetic techniques and supportivetherapy, based on an understanding of the .patient's haemodynamic state

:DIAGNOSIS Assessment involves firstly the nature and severity of the spescific lesion present.Then we can determine the .complication which might occur

: So assessment include

.a-The state of myocardiam .b-The state of the vesseles .c-The conditions of the lungs .d-The functions of the other organs .e-The neurological function

:CLINICAL ASSESSMENTS BY a-history .b- examination :Observation of the patient By simple measures like ability to claim strains .without stop, doing housework normally :SYMPTOMS .angina-1 dyspnoea-2 cough-3 .palpitation-4 .syncope-5 .haemoptysis -6 .peripheral odema -7 .hepatic pain-8 .medication history,eg:digoxine-9

: EXAMINATION OF THE PATIENT .jeneral appearance; eg: cynosis, obesity-1 .blood pressure , if hypertension-2 .cardiac palpation if cardiomegaly-3 cardiac auscultation: if murmurs are present for -4 .eg lungs:if pleural effusion, cripitation, incraesed-5 .bronchial secretion, wide spread rhonchi .liver:if palpable or jaundice-6 .odema-7

;ESPECIAL TESTS .Chest radiography-1 blood test :eg,Hb, potassium level , liver function-2 .test , creatinine, urea, TFT .ECG-3 .Cardiac catheterisation andangiocardiography-4

.PREOPERATIVE TRATMENT

Depend upon type of cardiac disease and the type .of operation In jeneral treatment is directed to the correction of cardiac failure, prevention or treament of dysrhythmias , the symptomatic mangment of coronary artery disease and the treatment of .hypertension