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Lead aVR on EKG Lead aVR can provide some unique insight into 5 different conditions: - Acute
Lead aVR on EKG ... Lead aVR can provide ... Differentiating VT from SVT ... EKG #ECG #Lead #AVR
Pressors and Inotropes Norepinephrine • alpha1 > beta 1 • Increase SVR > Inotropy Vasopressin • V1 •
1 • Increase SVR ... V1 • Increase SVR ... 1 • Increase SVR ... Inotropy > Increase SVR ... Inotropy, Decrease SVR
Right Heart Catheterization Cheat Sheet: Interpretation of Pressures and Waveforms Direct measurements ● Central venous pressure
1500 d/s/cm5) (SVR ... -120 d/s/cm5) (PVR ... ml/beats/m2) (SVI ... [MAP – PCWP] x SVI ... mean PAp – CVP] x SVI
Shock Classification and Differential Diagnosis SHOCK • MAP <65, SBP <90, drop in SBP > 40 •
High CO / Low SVR ... Low CO / High SVR ... Low CO / High SVR ... Low CO / High SVR
Shock - Differential Diagnosis Framework MAP = CO x SVR Hypovolemic (↓ Intravascular volume): • Hemorrhage, dehydration due
Framework MAP = CO x SVR ... third-spacing • ↓ CO, ↑ SVR ... arrhythmia • ↓ CO, ↑ SVR ... PAH • ↓ CO, ↑ SVR ... toxins • ↑ CO, ↓ SVR
Vasopressors and Inotropes - Pharmacology Summary Vasopressors Phenylephrine (alpha-1) • Increases BP, SVR • Risk of reflex bradycardia
Increases BP, SVR ... Increases BP, SVR ... Increases HR, SVR ... Increases BP, SVR ... vasoconstriction, SVR
Lead AVR on ECG 1. Acute myocardial infarction: ST elevation > 1.5 mm in aVR, indicative of
Lead AVR on ECG ... elevation > 1.5 mm in aVR ... PR elevation in aVR ... PR elevation in aVR ... - R/S ratio in aVR
Calcium Channel Blockers - Dihydropyridines vs Non-Dihydropyridines Dihydropyridines (amlodipine, felodipine, nifedipine, nicardipine) • SVR: Decrease • Inotropy:
nicardipine) • SVR ... verapamil) • SVR
Syncope in 3 Steps 1. Consider the 3 "S" Mimics: Seizure, low Sugar, Stroke (TIA) 2. Heart vs
Heart vs SVR Heart ... > fast or slow SVR
Simplified Vasopressors and Inotropes Comparison Chart MAP = CO x SVR Dobutamine - Norepinephrine - Epinephrine - Phenylephrine
Chart MAP = CO x SVR
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