Anaesthetic goals in patient with mitral stenosis (MS)

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 Anaesthetic goals:


  • Maintenance of acceptable low heart rate 
  • Immediate treatment to atrial fibrillation and reversion to sinus rhythm 
  • Anaesthetic agents causing cardiac depression have to be avoided 
  • Maintenance of adequate SVR
  • Maintenance of adequate venous return 
  • Avoidance of aortocaval compression 
  • Prevention of hypoxaemia, hypercarbia, hypothermia, acidosis which can precipitate increased pulmonary vascular resistance 
  • Prevention of pain and anaemia 
To remember the objectives in sequence:
  • Heart rate and rhythm
  • Preload and afterload
  • Pulmonary vascular resistance 

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