Cardiovascular Disease

Anesthetic management of a dog with severe subaortic stenosis and mitral valve disease complicated with atrial fibrillation undergoing ovariohysterectomy

“…The characteristic uncoordinated atrial activity impedes atrial contraction leading to reduced CO further aggravated in the presence of tachycardia. Usual treatments include digoxin, beta-blockers, and calcium channel blockers to slow AV conduction (Miyamoto et al ., 2001; Congdon, 2014). Lidocaine has been used to treat satisfactorily vagally associated AF (Moise et al ., 2005; Pariaut et al ., 2008) and reduces the sevoflurane MAC in dogs (Wilson et al ., 2008).…”

“…However, lidocaine may cause cardiovascular depression in dogs (Robinson and Borgeat, 2016) and increases in HR, pulmonary arterial pressure, and stroke index (Nunes de Moraes et al ., 1998). Conversion to sinus rhythm with lidocaine in patients suffering an underlying severe cardiac disease is not always possible (Congdon, 2014). In addition, AF was already refractory to medical therapy in the current case, thus lidocaine and any further cardiovascular depression associated to it was avoided.…”

“…Anesthesia in severe cardiac patients is challenging and has special considerations due to their inability to ensure an adequate cardiac output (CO) despite physiological compensatory mechanisms. In addition to physical examination and a complete blood work, including blood count, chemistry panel, and electrolytes, the assessment of the electrocardiogram, blood pressure, thoracic radiographs, and echocardiogram should be accomplished to the patients suffering from heart disease (Congdon, 2014; Robinson and Borgeat, 2016). Heart diseases affect in a variety of ways, the cardiovascular function and anesthetic drugs should be considered based on the cardiovascular-sparing effects.…”

Anaesthetic management for balloon dilation of cor triatriatum dexter in a dog

“…Some reports indicate only which anaesthetic drugs were used [ 8 , 9 , 15 , 16 ]. In our case, the dog was sedated with a combination of a potent opioid (sufentanil) and midazolam in order to preserve the cardiovascular function of the patient [ 17 , 18 ]. Premedication is a crucial phase of anaesthesia for a veterinary patient; it can calm the animal and decrease the amount of induction and maintenance drugs that are needed [ 19 ].…”

“…The main negative cardiovascular effects of these drugs include bradycardia with possible bradyarrhythmias (atrioventricular heart block and ventricular escape rhythm) and a dramatic reduction in CO caused by reduced central sympathetic tone. These molecules also cause an increase in systemic vascular resistance (peripheral action on α-2 receptors) and hypertension, which induces a reflex baroreceptor-mediated physiologic bradycardia and marked reduction in CO, further perpetuated by the central effects of sedation and reduced sympathetic tone [ 17 , 25 ]. Healthy paediatric patients have limited stroke volume and cardiac reserve, and CO is dependent on HR [ 13 ]; therefore, this class of drugs, which causes bradycardia and a decrease in CO, was not considered for the anaesthetic management of this puppy.…”