George Shared "Step 2 - Cardiology" - 107 Picmonics

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Step 2 - Cardiology

12 Lead Contiguous Leads - Anterior Wall MI
Leads Elevated
Lead V3
Lead V4
Artery Affected
Left Anterior Descending (LAD)
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55 secs
12 Lead Contiguous Leads - Inferior Wall MI
Leads Elevated
Lead II
Lead III
Lead aVF
Artery Affected
Right Coronary Artery (RCA)
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55 secs
12 Lead Contiguous Leads - Lateral Wall MI
Leads Elevated
Lead I
Lead aVL
Lead V5
Lead V6
Artery Affected
Circumflex
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1 min
12 Lead Contiguous Leads - Septal Wall MI
Elevated Leads
Lead V1
Lead V2
Artery Affected
Left Anterior Descending (LAD)
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48 secs
Stable Angina
Assessment
Chest Pain with Exertion
Relieved within 15 Minutes
ST Depression
Interventions
Nitroglycerin
Up to 3 Doses q 5 Minutes
Rest
Antiplatelet Medication
CABG
Angioplasty
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2 mins
Unstable Angina
Assessment
Chest Pain with Rest or Exertion
Limits ADLs
> 15 Minutes
Less Likely Relieved by Nitroglycerin
ST Depression
Fatigue
Considerations
Acute Coronary Syndrome (ACS) Treatment
Emergency Treatment
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2 mins
Cardiac Enzyme Evaluation: Troponin
Measures
Cardiac Muscle Injury
Time Ranges
Onset: 1 Hour
Peak: 10 - 24 Hours
Return to Normal: 5 - 14 Days
Considerations
Most Specific for Cardiac Muscle
Treated Aggressively
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2 mins
Cardiac Enzyme Evaluation: Myoglobin
Measures
Skeletal or Cardiac Muscle Injury
Time Ranges
Onset: 1 - 4 Hours
Peak: 12 Hours
Return to Normal: 24 Hours
Considerations
Elevation After 24 Hours: Reinfarction
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2 mins
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
Measures
Skeletal or Cardiac Muscle Injury
Time Ranges
Onset: 4-8 Hours
Peak: 12-24 Hours
Return to Normal: 2-3 Days
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1 min
Dilated Cardiomyopathy
Chronic Alcohol Abuse
Doxorubicin Toxicity
Cocaine Use
Wet Beriberi
Hemochromatosis
Coxsackie B
Chagas Disease
Peripartum
S3
Eccentric Hypertrophy
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2 mins
Hypertrophic Cardiomyopathy Mechanisms
Pathophysiology
2/3 Autosomal-Dominant
1/3 Sporadic Type
Mutation in Gene for Sarcomere Protein
Cardiac Myosin Binding Protein C
Asymmetric Septal Hypertrophy
Outflow Tract Obstruction
Diastolic Dysfunction
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2 mins
Hypertrophic Cardiomyopathy Signs, Symptoms and Treatment
Signs and Symptoms
Sudden Death Of Young Athlete
Heart Failure
Angina
Arrhythmias
Syncope
Harsh Systolic Ejection Murmur
S4 Heart Sound
Treatment
Beta Blocker
Non-dihydropyridine Calcium Channel Blocker
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2 mins
Restrictive Cardiomyopathy
Sarcoidosis
Amyloidosis
Post-radiation Fibrosis
Endocardial Fibroelastosis
Löffler's or Loeffler's Syndrome with Eosinophilia
Hemochromatosis
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2 mins
Heart Failure Interventions
Diagnostic Tests
Echocardiogram
Invasive Hemodynamic Monitoring
Improve Gas Exchange
High Fowler's Position
Oxygen
Advanced Airway
Drugs and Devices
Diuretics
Beta Blockers
Angiotensin II Receptor Blockers (ARBs)
ACE Inhibitors
Digoxin (Lanoxin)
Pacemaker
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2 mins
Left Heart Failure Assessment
Pulmonary Assessment
Pulmonary Congestion
Pink Frothy Sputum
Wheezing or Crackles
Dyspnea with Exertion
Cough
Systemic Assessment
Fatigue
Tachycardia
Weak Peripheral Pulse
S3, S4 Heart Sounds
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1 min
Right Heart Failure Assessment
Jugular Venous Distention (JVD)
Peripheral Edema
Hepatosplenomegaly
Nocturia
Weight Gain
Ascites
Fatigue
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1 min
Types of Heart Failure
Left Sided
Pulmonary Congestion
Right Sided
Peripheral Edema
High Output
Unable to Meet Metabolic Needs
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1 min
Atrial Septal Defect (ASD)
Pathophysiology
Hole in Septum between the Atria
Symptoms
Often Asymptomatic
Wide and Fixed Split S2
Cyanosis and Dyspnea
Easily Fatigued
Diagnosis
Chest X-ray shows Increased Pulmonary Vascular Markings
Echocardiogram
Treatment
Surgery if CHF as Child
Antibiotic Prophylaxis
Most Close Spontaneously
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2 mins
Coarctation of The Aorta
Pathophysiology
Constriction of a Portion of Aorta
Turner Syndrome
Symptoms
Asymptomatic Hypertension
BP Higher in Upper Extremities, Right Arm
CHF
Diagnosis
Echocardiogram
Cardiac Catheterization
3 Sign on Chest X-Ray
Rib Notching
Treatment
Surgical Correction
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2 mins
Left-to-Right Heart Shunts
The 3 Ds
Ventricular Septal Defect (VSD)
Atrial Septal Defect (ASD)
PDA
Associations
Later Cyanosis
Clubbing
Eisenmenger's Syndrome
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2 mins

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