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  • Cardiology Step 2 CK Notes

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    Vidur S Singh
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    This document contains cardiology notes on various arrhythmias and conditions: - Bradycardia can be caused by hypothyroidism, swimming, or vagal tone. Various degrees of heart block are classified based on EKG findings and have different etiologies. - Multifocal atrial tachycardia involves irregular rhythms from different atrial sites and generally affects elderly or those with lung disease. Atrial flutter and fibrillation have associations with lung and heart conditions. - Wolff-Parkinson-White syndrome is best treated with procainamide to avoid inhibiting normal conduction. Ventricular fibrillation involves abnormal ventricular repolarization. Amiodarone is effective but can cause lung issues

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    STEP 2 CK

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    Cardiology Step 2 Ck Notes

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    This document contains cardiology notes on various arrhythmias and conditions: - Bradycardia can be caused by hypothyroidism, swimming, or vagal tone. Various degrees of heart block are classified based on EKG findings and have different etiologies. - Multifocal atrial tachycardia involves irregular rhythms from different atrial sites and generally affects elderly or those with lung disease. Atrial flutter and fibrillation have associations with lung and heart conditions. - Wolff-Parkinson-White syndrome is best treated with procainamide to avoid inhibiting normal conduction. Ventricular fibrillation involves abnormal ventricular repolarization. Amiodarone is effective but can cause lung issues

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    340 views5 pages

    Cardiology Step 2 CK Notes

    Uploaded by

    Vidur S Singh
    This document contains cardiology notes on various arrhythmias and conditions: - Bradycardia can be caused by hypothyroidism, swimming, or vagal tone. Various degrees of heart block are classified based on EKG findings and have different etiologies. - Multifocal atrial tachycardia involves irregular rhythms from different atrial sites and generally affects elderly or those with lung disease. Atrial flutter and fibrillation have associations with lung and heart conditions. - Wolff-Parkinson-White syndrome is best treated with procainamide to avoid inhibiting normal conduction. Ventricular fibrillation involves abnormal ventricular repolarization. Amiodarone is effective but can cause lung issues

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    © All Rights Reserved
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    of 5

    CARDIOLOGY (INTERNAL MEDICINE) NOTES

    CONSTRICTIVE PERICARDITIS
    https://www.youtube.com/watch?
    annotation_id=annotation_4273623953&feature=iv&src_vid=5hX59tIaZcQ&v=FOO
    U8bmtbrc

    BRADYCARDIA
    -

    Depression of sinus automacity


    o Hypothyroidism
    o Swimming and marathon runner
    Excessive vagal tone

    AV block
    -

    May be classified anatomically based on the site of block as determined by


    His Bundle EKG

    FIRST DEGREE HEART BLOCK


    Etiology
    Degenerative changes in the AV conduction system caused by:
    Aging
    Digitalis
    Exaggerated vagal tone
    Ischemia (diaphragmatic infarction)
    Inflammation (myocarditis, acute rheumatic fever)
    Cardiomyopathies
    SECOND DEGREE HEART BLOCK
    -

    Mobitz 1 PR prolongation the dropped beat (causes degenerative changes


    in AV node; diaphragmatic MI; digitalis toxicity; myocarditis; rheumatic fever;
    increased vagal node)
    Mobitz 2 no PR prolongation (causes extensive anterior myocardial infarct;
    degenerative changes in His-Purkinje system; massive calcification of mitral
    or aortic valve annulus)

    THIRD DEGREE HEART BLOCK


    Etiology
    Most common cause in adults is simple fibrous degenerative changes in the
    conduction system that results from aging (Lengre disease)
    Inferior or posterior infarction
    Infectious and inflammatory processes, such as abscesses, tubercles, tumors,
    infiltrative disease of the myocardium, sarcoid nodules, and gummas,
    myocarditis, and rheumatic fever
    Drugs like digitalis
    Ankylosing spondylitis

    (Page 148).
    MULTIFOCAL ATRIAL TACHYCARDIA
    -

    Multifocal atrial tachycardia is characterized by an irregular supraventricular


    rhythm, at rates 100200 beats/min.
    The morphology of the P waves (at least 3 different P wave forms) varies
    from beat to beat, as does the PR interval. Each QRS complex, however, is
    preceded by a P wave.
    Generally seen in elderly patients or those with chronic lung disease
    who are experiencing respiratory failure
    Use diltiazem, verapamil, or digoxin; avoid beta blockers because of lung
    disease
    (Page 149).

    ATRIAL FLUTTER
    ETIOLOGY
    -

    COPD
    P embolism
    Thyrotoxicosis
    Mitral valve disease
    Alcohol

    ATRIAL FIBRILLATION
    Cardiac conditions commonly assoc w the development of AF include rheumatic
    mitral valve disease, coronary artery disease, CHF, and HTN (causes atrial
    structures to dilate)

    The standard of care is to slow the rate and anticoagulated IF the CHADS score is
    <1. As a general concept, rate control alone is considered for the patient who
    notices very little of the symptoms of the arrhythmia, while rhythm control is more
    likely to be applied to the patient who immediately notices the arrhythmia and is
    experiencing consequences of the arrhythmia, such as shortness of breath, or
    development of heart failure.
    Drugs proven effective for pharmacologic cardioversion of atrial fibrillation include:
    amiodarone, dofetilide, flecainide, ibutilide, propafenone, and quinidine.
    Drugs used to maintain sinus rhythm in patients with atrial fibrillation include
    amiodarone, disopyramide, dofetilide, flecainide, propafenone, and
    sotalol. Rate control is the standard of care for most patients.
    The following drugs are recommended for their demonstrated efficacy in rate
    control at rest and during exercise: diltiazem, atenolol, metoprolol, and verapamil.
    Control the heart rate, then anticoagulate. Use aspirin for those with CHADS 0 or 1,
    and dabigatran, rivaroxaban, or warfarin for CHADS 2 or more. Heparin is not
    necessary prior to starting oral anticoagulants.
    WOLFF-PARKINSON-WHITE SYNDROME
    If the patient is hemodynamically stable, then procainamide is the best medication.
    Avoid digoxin, and calcium-channel blockers; these medications can inhibit
    conduction in the normal conduction pathway.
    Ablation is the definitive treatment
    VENTRICULAR FIBRILLATION
    Arrhythmias initiated by a ventricular premature beat in the setting of abnormal
    ventricular repolarization characterized by prolongation of the QT interval.
    PULSELESS ARREST

    AMIODARONE
    The most severe side effects of amiodarone therapy are related to the lungs and
    present as cough, fever, or painful breathing. These reactions can be fatal. About
    20% of patients who receive amiodarone experience some form of nerve toxicity.
    Symptoms may include imbalance or changes in gait, tremor, numbness in the
    fingers or toes, dizziness, muscle weakness, or loss of coordination.

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