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)
56 secs
12 Lead Contiguous Leads - Inferior Wall MI
Leads Elevated
Lead II
Lead III
Lead aVF
Artery Affected
Right Coronary Artery (RCA)
56 secs
12 Lead Contiguous Leads - Lateral Wall MI
Leads Elevated
Lead I
Lead aVL
Lead V5
Lead V6
Artery Affected
Circumflex
1 min
12 Lead Contiguous Leads - Septal Wall MI
Elevated Leads
Lead V1
Lead V2
Artery Affected
Left Anterior Descending (LAD)
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
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
2 mins
Cardiac Enzyme Evaluation: Troponin
Measures
Cardiac Muscle Injury
Time Ranges
Detection in Blood: 4 Hours
Peak: 24 - 36 Hours
Return to Normal: 5 - 14 Days
Considerations
Most Specific for Cardiac Muscle
Treat Aggressively
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
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
1 min
Dilated Cardiomyopathy
Chronic Alcohol Abuse
Doxorubicin Toxicity
Cocaine Use
Wet Beriberi
Hemochromatosis
Coxsackie B
Chagas Disease
Peripartum
S3
Eccentric Hypertrophy
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
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
2 mins
Restrictive Cardiomyopathy
Sarcoidosis
Amyloidosis
Post-radiation Fibrosis
Endocardial Fibroelastosis
Löffler's or Loeffler's Syndrome with Eosinophilia
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