phẫu thuật sẽ được thực hiện nong mạch vành đã được phức tạp bằng cách đóng cửa cấp. Không có dữ liệu từ các thử nghiệm tương lai có hỗ trợ hoặc phá hoại kế hoạch này, vì lý do này, các bác sĩ xem xét thảo luận các chiến lược tiềm năng trước khi thực hiện | Cardiology Core Curriculum bypass surgery would have been performed if the angioplasty had been complicated by acute closure. There are no data from prospective trials that support or undermine this plan for this reason the physicians considered discussion of potential strategies before performance of the non-invasive test for ischemia to be particularly important. Answer to question 4 Hemodynamic monitoring with a pulmonary artery catheter and a radial arterial line can be used to minimize hemodynamic shifts. Hypovolemia due to blood loss can be rapidly detected and treated using such monitoring and hypertension can be reduced with intravenous vasodilator therapy. Case A 76-year-old female with lumbar spinal stenosis was considered for surgery because of intractable pain. The patient had a long history of exertional dyspnea and leg edema. She also had about one episode per week of an epigastric and substernal chest burning that was not associated with exertion. Prior echocardiographic studies had shown a markedly hypertrophied left ventricle with a normal ejection fraction. She had been treated for pulmonary congestion due to presumed diastolic dysfunction with verapamil 240 mg day orally furosemide 180 mg day orally and potassium 20 mEq orally three times daily. Other medical problems included diabetes for which she took daily insulin and restrictive lung disease that was believed to be due to obesity. Examination. Physical examination the patient was obese and in a wheelchair unable to stand. Respiratory rate 18 min. Pulse 70 beats min normal character. Blood pressure 130 80 mmHg in right arm. Jugular venous pulse not visible. Cardiac impulse normal. First heart sound normal. Second heart sound split normally on inspiration. Grade 2 6 murmur at the left sternal border that did not change with handgrip or Valsalva. Chest examination bilateral basal rales. Abdominal examination soft abdomen no tenderness and no masses. Normal liver span. Moderate edema of .
