Lecture Notes on Cardiology

Introduction

• Discussion begins with a reference to a solar eclipse.
• Focus on high-yield cardiology concepts, integrating NVME-style vignettes and multidisciplinary approaches.
• Mention of a giveaway at the end for a cardiology guide.
• Introduction of team members in the Discord community, mentors in dermatology and ophthalmology.
• Description of the Discord community's support services for exams and residency applications.

Lecture Overview

• Topics to be covered:
  • Embryology
  • Cardiac Physiology
  • Vascular Physiology
  • Electrical Conduction
  • Pharmacology
  • Aortic Pathology
  • Hypertension
  • Heart Failure
  • Cardiac Microbiology
  • Shock

Embryology

• Case study of a newborn with cyanotic features and a diagnosis of truncus arteriosus.
• Explanation of right-to-left shunt in the heart.
• Five cyanotic heart diseases mnemonic: Five Ts.
• Discussion of neural crest cell abnormalities such as DeGeorge syndrome.
• Explanation of cyanotic heart diseases like transposition of great vessels and tricuspid atresia.
• Drug exposure effects (e.g., lithium causing Ebstein's anomaly).
• Detailed breakdown of Tetralogy of Fallot using the mnemonic PROVE.
• Integration with DeGeorge syndrome using CATCH-22 mnemonic.

Cardiac Physiology

• Pressure-volume loop and phases of the cardiac cycle explained.
• Discussion of preload, afterload, and contractility effects on the heart.
• Detailed breakdown of cardiac cycle phases using pressure-volume loops.
• Understanding the impact of increased preload, afterload, and contractility on stroke volume and cardiac output.

Vascular Physiology

• Discussion of a case with sublingual nitrate administration.
• Mechanism of nitroglycerin via systemic peripheral vasodilation and decreased preload.
• Discussion of CGMP second messenger system.
• Mention of PDE inhibitors for pulmonary hypertension and erectile dysfunction.

Electrical Conduction

• Case study involving ondansetron leading to polymorphic ventricular tachycardia.
• Explanation of wide and narrow complex tachycardias.
• EKG strips analysis and pattern recognition.
• Discussion of congenital long QT syndrome types (Romano-Ward and Jervell and Lange-Nielsen).
• Detailed understanding of cardiac rhythms and EKG interpretations.

Pharmacology

• Case study with atrial flutter and drug action on myocardial cells.
• Explanation of pacemaker action potentials and antiarrhythmic drugs.
• Breakdown of class-specific effects on cardiac action potentials.
• In-depth look at calcium channel blockers and their contraindications.

Hypertension

• Case study involving a patient with diabetes and hypertension.
• Discussion on ACE inhibitors and ARBs as first-line treatments.
• Integration with the renin-angiotensin-aldosterone system.
• Detailed side effects and contraindications of ACE inhibitors.
• Connection between ACE inhibitors and bradykinin-related side effects.

Heart Failure and Myocardial Infarction

• Case study on myocardial infarction complications.
• Active recall exercise on post-MI timeline and associated findings.
• Discussion of papillary muscle rupture and free wall rupture.
• Contrast between early and late complications such as Dressler syndrome.

Cardiac Microbiology

• Case study on infective endocarditis following dental procedures.
• Breakdown of gram-positive bacteria relevant to cardiology.
• Discussion of rheumatic fever, Jones criteria, and associations.
• First-line treatment for preventing rheumatic heart disease.

Shock

• Case study on anaphylactic shock and its physiological impacts.
• Detailed exploration of shock types and key physiological parameters:
  • Hypovolemic
  • Cardiogenic
  • Distributive
• Understanding of pulmonary capillary wedge pressure and mixed venous oxygen content.
• Importance of pathophysiological mechanisms in shock.

Conclusion

• Encouragement to join the Discord community for more resources and support.
• A QR code and discount for Discord membership.
• Mention of upcoming topics and additional learning opportunities.
• Final words of encouragement for medical students preparing for exams.