The Cardiology section provides High Yield information for the USMLE, COMLEX, Medical School, Residency, and as a practicing Physicians. Prepare and Learn Ahead! Educating, Preparing, and Proving high-yield content, quizzes, and medical resources. to students who are interested in the medical field.
Chest Pain DDX
| Right | Center | Left | |
| Upper | Sternoclavicular Joint Injury Sternum Fracture Collarbone Trauma | ||
| Middle | Pleuritis Pleurisy Costochondritis Muscle Strain Bronchitis | Heartburn Acid Reflux/GERD Esophageal spasm Esophageal Hypersensitivity Esophageal Rupture Esophageal Perforation Costochondritis | Myocardial Infarction Coronary Artery Disease Angina Myocarditis Pericarditis Hypertrophic Cardiomyopathy Mitral Valve Prolapse Coronary artery dissection Pleuritis Pleurisy Pulmonary HTN Costochondritis Muscle Strain Bronchitis Panic Attack |
| Lower | Pneumonia Lung Abscess Pulmonary Embolism Pneumothorax Gallbladder problems Shingles | Heartburn/ GERD Esophageal spasm Esophageal Rupture Esophageal Perforation Peptic Ulcer Hiatal Hernia Pancreatitis | Pneumonia Lung Abscess Pneumothorax Peptic Ulcer Shingles |
Acute exacerbation of CHF
- Treatment:
- Nitrates (nitroglycerin)
- Oxygen
- Loop Diuretics
- Inotropic Drugs (dobutamine, milrinone, amrinone)
- Positioning (with legs down)
Aortic Dissection
- Stanford type A
- Presentation:
- involves ascending aorta
- Treatment:
- admit to the ICU
- IV B-blocker to control the BP
- emergency surgical repair
- Presentation:
- Stanford type B
- Presentation:
- confined to descending aorta
- Treatment:
- B-blocker
- Presentation:
Aortic Regurgitation
- Cause:
- infective endocarditis
- Treatment:
- Ace inhibitor or CCB
Atrial Fibrillation
- If present > 48 hrs:
- TEE
- if no thrombus is present:
- cardioversion followed by anticoagulation
- if thrombus is present:
- anticoagulate for 3 weeks, then repeat TEE
- If present < 48 hrs:
- Cardioversion +/- anticoagulation depending upon risk
CABG
- Major indications:
- Left main coronary artery stenosis > 50%
- Severe 3 vessel coronary artery stenosis
CHF
- Medication reduce mortality:
- ACE inhibitors and ARBS
- B-blockers
- bisoprolol
- carvedilol
- extended-release metoprolol
- Aldosterone antagonists
- spironolactone
- eplerenone
Myocardial Infarction
| Changes In | Coronary Artery | |
| Anterior MI | V2-5 | LAD |
| Inferior MI | II, III, aVF | RCA |
| Lateral MI | I, aVL | Circumflex |
Pericarditis
- Dx:
- ECG
- diffuse ST elevation
- PR depression
- diffuse T wave inversion (late)
- Echocardiogram
- usuall normal
- +/- pericardial effusion
- Chest Xray
- usually normal
- +/- pericardial effusion
- +/- elevated CRP, ESR, and WBC count
- ECG
Shock
| Shock type | Treatment | ||
| Cardiogenic | Dobutamine or Dopamine | ||
| Septic | IV fluids NE (Pressors) |
Vasculitis
| Presentation | Diagnosis | Treatment | |
| Granulomatosis with polyangiitis (Wegener’s) | Kidney, upper airway, lungs perforation of the nasal septum | ||
| Polyarteritis nodosa | Kidney, GI tract, spares the lungs Hep B Hep C | ||
| Henoch-Scholein purpura | palpable purpura in the leg, IgA nephropathy | ||
| Eosinophilic granulomatosis with polyangiitis (Churg-Strauss) | vasculitis in a young asthmatic | ||
| Thromboangiitis obliterans (Buerger) | vasculitis in a young male smoker | stop smoking | |
| Kawasaki disease | strawberry tongue fever rash lymphadenopathy erythema of the mucus membranes coronary aneurysms young east asian children | ||
| Takayasu arteritis | pulseless disease | ||
| Temporal arteritis (giant cell arteritis) | unilateral HA jaw claudication polymyalgia rheumatica |
