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805 Anaesthesia

Which of the following statement about the pathophysiology of mitral stenosis is accurate

APatients with mitral stenosis have decreased left atrial pressure.
BPatients with mitral stenosis generally have an under-loaded left ventricle.
CThe increased pressure gradient between the left atrium and left ventricles results in left ventricular hyperophy.
DDiastolic filling of the left ventricle is increased in mitral stenosis because of the increased pressure gradient between the left atrium and left ventricle.
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808 Anaesthesia

A 59-year-old man with a history of myocardial infarction 2 years ago undergoes an uneventful aoobifemoral bypass graft for aooiliac occlusive disease. Six hours later he develops ST segment depression, and a 12-lead electrocardiogram (ECG) shows anterolateral ischemia. His hemodynamic parameters are as follows: systemic BP 70/40 mm Hg, pulse 100 beats per minute, CVP 18 mm Hg, PCWP 25 mm Hg, cardiac output 1.5 L/min, and systemic vascular resistance 1000 (dyne * s)/cm5 . Which of the following is the single best pharmacologic intervention for this patient?

ASublingual nitroglycerin
BIntravenous nitroglycerin
CA sho-acting b-blocker
DDobutamine
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