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Internal Medicine Board Review – Cardiology II July 17 th , 2014 PowerPoint Presentation
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Internal Medicine Board Review – Cardiology II July 17 th , 2014. Topics. EKG’s and arrhythmias/conduction abnormalities Myocardial Disease and Cardiomyopathies Pulmonary artery catheters and hemodynamic data interpretation Syncope Valvular heart disease. HOLD ON!!!.

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Internal Medicine Board Review – Cardiology II July 17 th , 2014


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    1. Internal Medicine Board Review – Cardiology II July 17th, 2014

    2. Topics • EKG’s and arrhythmias/conduction abnormalities • Myocardial Disease and Cardiomyopathies • Pulmonary artery catheters and hemodynamic data interpretation • Syncope • Valvular heart disease

    3. HOLD ON!!!

    4. Approach to EKG’s • Always read the question stem first to know what you are looking for • Think about the clinical context; may not even need the tracing • Look for patterns that fit the clinical situation • Dissect the EKG in your usual systematic way

    5. EKG interpretation • Use your system, whatever it is • ie. Mechanism, Structure, Function • If the question includes multiple tracings, it is usually looking for a pattern; beware that two are likely very similar. ie. Mitral stenosis • Don’t forget you can use paper/pencil as “poor man’s calipers”

    6. EKG interpretation • May include 12 lead, 6 lead, 3 lead or rhythm strips • Pay attention to which leads you are given (and the order/arrangement) • Look for standardization if voltage is relevant (ie. LVH, tamponade) • Count big blocks for heart rate (300, 150, 100, 75, 60…) • Remember, each small block is 0.04 seconds

    7. Frequently Seen Tracings On Boards • Conduction Abnormalities • AV block, LBBB, RBBB • Bradyarrhythmias • Sinus brady, A-fib with junctional escape • Atrial Tachyarrhythmias • Sinus tach, A-fib, A-flutter, AVNRT, MAT • Ventricular Arrhythmias • VT, AIVR, torsades • Acute Infarction (Identify the vascular distribution) • Pericarditis • Tamponade • WPW (ventricular pre-excitation) • Long QT syndrome • Electrolyte Disturbances • Hyperkalemia, hypo/hypercalcemia

    8. Normal

    9. 1st degree AV block

    10. 2nd degree - Mobitz I(Wenckebach)

    11. 2nd degree (Mobitz II) AV Block

    12. 2:1 AV Block

    13. 3rd degree AV block

    14. Left Bundle Branch Block

    15. Right Bundle Branch Block

    16. Sinus Bradycardia

    17. Sick Sinus Syndrome

    18. Atrial Fibrillation with Heart Block and Junctional Escape

    19. Premature Atrial Contractions

    20. Premature Ventricular Contractions

    21. Sinus Tachycardia

    22. Atrial Fibrillation

    23. Atrial Flutter (2:1 conduction)

    24. Atrial Flutter (4:1 conduction)

    25. Multifocal Atrial Tachycardia

    26. AV Node Reentrant Tachycardia

    27. Ventricular Tachycardia

    28. Frequent PVC’s and Nonsustained Ventricular Tachycardia

    29. Ventricular Tachycardia

    30. Torsades de Pointes

    31. Torsades de Pointes

    32. AIVR (Accelerated Idioventricular Rhythm)

    33. AIVR (Accelerated Idioventricular Rhythm)

    34. LVH with Repolarization Abnormalities or Hypertrophic Cardiomyopathy

    35. Tamponade (low voltage with electrical alternans)

    36. Low voltage (amyloid)

    37. Anterior Acute Infarction (LAD)

    38. Inferior Acute Infarction (RCA)

    39. Posterolateral Acute Infarction (Circumflex)

    40. Pericarditis

    41. Ventricular Pre-excitation (WPW)

    42. Atrial Fibrillation with WPW

    43. Long QT syndrome

    44. Brugada Syndrome

    45. S1Q3T3 (Pulm embolus)

    46. Ventricular Pacemaker

    47. Pacemaker Failure to Capture

    48. Hyperkalemia

    49. Hyperkalemia

    50. Hypo/hypercalcemia