Dr.VENKATESWARAN.G SENIOR CONSULTANT ANAESTHESIOLOGIST, GANGA HOSPITAL, COIMBATORE. TAMILNADU ..read more

Dr.Maheshwari S Kumar MBBS, DA , DNB ( Anaesthesia) Consultant Anaesthesiologist Ganga Hospital Coimbatore, India ..read more

DR S.P. VINOTH KUMAR CONSULTANT ANAESTHESIOLOGIST, GANGA MEDICAL CENTRE & HOSPITALS PVT LTD, COIMBATORE ..read more

DR.SRINIVASAN RAJAN ASST PROFESSOR, KAPV GOVT MEDICAL COLLEGE, TRICHY ..read more

INTRODUCTION: Carotid endarterectomy (CEA) is a prophylactic operation. It is performed in patients who are at risk of stroke from emboli arising from atheromatous plaque at the carotid bifurcation. The indications for CEA in various circumstances were recently reviewed by the American Academy of Neurology. There are two groups of patients to consider: symptomatic patients who have active plaque giving rise to emboli that enter the cerebral circulation and cause transient ischaemic attacks (TIAs) and reversible ischaemic neurological deficits, and asymptomatic patients who have demonstrable di ..read more

Dr Vipin Kumar Goel Consultant Anaesthesiologist, Ganga Hospital, Coimbatore ..read more

1. Why does pregnancy aggravate the symptoms of mitral stenosis? Women with severe mitral stenosis often do not tolerate the cardiovascular demands of pregnancy because 1. Increase in blood volume by 30–50% starting at end of 1st trimester to peak at 20–24 weeks. This increases pulmonary capillary hydrostatic pressure thereby increasing risk of pulmonary edema. 2. Decrease in systemic vascular resistance. (In MS, SVR should be maintained) 3. Increase in heart rate by 10–20 beats/min—reduces diastolic filling time of LV. 4. Cardiac output increases by 30–50% after the fifth month. CO returns to ..read more

DR. RAMYA GNANASEKAR ASST. PROFESSOR, Dept of Anaesthesiology, Kanyakumari Govt Medical College, Nagercoil, Tamilnadu ..read more

ANESTHESIA FOR CESAREAN DELIVERY FOR CARDIAC PATIENTS: •             Patients with mWHO class I or II cardiac disease typically tolerate a traditional intrathecal dose of local anesthesia (eg, hyperbaric bupivacaine 10–15 mg) for cesarean delivery. Depending on the cardiovascular lesion, patients with mWHO class III or IV lesions may benefit from a more gradual-onset sympathectomy. •             Neuraxial anesthesia for most patients with cardiac disease undergoing caesarean ..read more

5. MATERNAL ARRHYTHMIAS DURING PREGNANCY: Management of arrhythmias during pregnancy is similar to that in the non-pregnant patient. Congenital heart block and bradyarythmias If congenital heart block is recognized in a pregnant woman, cardiac consultation should be taken, to determine whether there is need of a pacemaker. A pacemaker is indicated in patients with symptoms, when Q-T interval is prolonged or there is left atrial enlargement. Equipment as CVP access tray, and trans-venous pacing wires should be ready at patient’s bedside during caesarean delivery, in the event of rapid intervent ..read more