Hu Said: Cardiology Board Review Series

In this episode, we go over how to localize the origin of ventricular tachycardia (VT) and premature ventricular contractions (PVCs). What clues on ECG allow you to distinguish VT coming from outflow tracts vs the inferior ventricles? What clues on ECG allow you to distinguish VT arising from the LV free wall vs VT arising from the RV or inter-ventricular septum? Which types of VT have the highest...

In this episode, we explore the definitions, mechanisms, and management of ventricular tachycardia (VT). What is the significance of sustained vs non-sustained VT, and monomorphic vs polymorphic VT? How is VT storm defined in patients without implantable cardiac defibrillators (ICDs) vs those with ICDs? What are common doses of medications for VT storm? What are examples of appropriate and inappro...

In this episode, we delve into the mechanisms of arrhythmias, exploring the roles of abnormal automaticity, early afterdepolarizations (EADs), and delayed afterdepolarizations (DADs). What is the difference between disorders of impulse formation and disorders of impulse conduction? How do the phases of the ventricular action potential (0, 1, 2, 3, 4) differ from the phases of the sinoatrial nodal...

In this episode, we delve into the diagnosis and interpretation of left and right bundle branch blocks (LBBB and RBBB) and left and right ventricular hypertrophy (LVH and RVH). At what rate does bifascicular block progress to complete heart block? Can athletes with bundle branch blocks participate in competitive sports? What is the difference in the sensitivity and specificity for LVH of the Sokol...

In this episode, we review the diagnosis and management of atrioventricular blocks (AVB). What are the differences between first-degree, second-degree Mobitz I, second-degree Mobitz II), and third-degree AV blocks? What is Stokes-Adams attack? What are reversible etiologies of AV block other than medications and Lyme disease? What is the role of carotid sinus massage and exercise treadmill testing...

In this episode, we review sinus node dysfunction. What is the difference between sinus arrest, sinus pause, sinoatrial exit block, and non-conducted premature atrial contraction? How is 1st, 2nd, and 3rd degree sinoatrial exit block similar or different from 1st, 2nd, and 3rd degree atrioventricular block, and how is sinoatrial Wenckebach similar or different from atrioventricular Wenckebach? Whi...

In this episode, we review syncope and ambulatory electrocardiographic monitoring. What is the difference between the presentation of syncope, cardiac syncope, reflex syncope, vasovagal syncope, carotid sinus syncope, situational syncope, presyncope, and loss of consciousness? What features suggest that syncope is occurring from an arrhythmogenic cause? What is Stokes-Adams attack? What are the co...

In this episode, we discuss the diagnosis and management of regular narrow complex tachycardias, including atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT), and atrial tachycardia (AT). Which SVTs have an RP interval under vs over 70 ms? Which SVTs require initiation on a PAC with a prolonged PR? Which SVTs initiate on a PVC? Which SVTs terminate...

In this episode, we review atrial flutter, atrial tachycardia, pre-excitation, and inappropriate sinus tachycardia. How do you distinguish between typical and atypical atrial flutter? How do you distinguish between type A and type B Wolff-Parkinson-White pattern? What medications must be avoided in pre-excited atrial fibrillation? Does cardioversion have any role in atrial tachycardia? Tune in for...

In this Part 2 review of review atrial fibrillation, we covering direct current cardioversion (DCCV), bleeding and stroke risks, ablation, and left atrial appendage occlusion (LAAO). What are the situations in which CHA2DS2-VASc does not apply? Do you start anticoagulation on a patient who presents with a smartwatch-identified AF with no prior symptoms or diagnosis? How do you decide whether to re...

In this episode, we discuss terminology, rate control, and rhythm control for atrial fibrillation (AF). What distinguishes subclinical, paroxysmal, persistent, long-standing persistent, and permanent AF? What should you do if AF with rapid ventricular response (RVR) occurs in septic shock, when you may already be dependent on vasopressors? What factors favor rhythm control vs rate control? Which r...