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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
Superior Vena Cava Syndrome on Physical Exam Prominent dilated collateral veins are seen bypassing the SVC obstruction #SVC
bypassing the SVC ... obstruction #SVC ... Cava #Syndrome #PhysicalExam
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 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
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