Index
Module 11 • Cardiology
Cardiovascular Critical Care I
13%
Core Content
Cardiovascular Critical Care I
Sajni V. Patel ~2 min read Module 11 of 20
9
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Cardiovascular Critical Care I

Phase

Electrolyte movement

Conduction change

Na+ influx into cell

Depolarization

K+ and Cl- out of cell

Repolarization

Ca2+ into cell and K+ out of cell

Plateau

K+ out of cell

Repolarization

Resting Membrane Potential

ECG point

Representation

P

Sinoatrial (SA) node impulse generation/atrial depolarization

PR interval

Duration for conduction to occur from the SA node through the AV

node, bundle of His, bundle branches and Purkinje fibers

QRS

Concurrent atrial repolarization and ventricular depolarization

ST segment

Ventricular refractory period

T

Ventricular repolarization

QT interval

Duration for ventricular repolarization

RR interval

Duration between ventricular depolarizations (represents heart rate)

U

Further ventricular depolarizations not listed or commonly

visualized; may be more prominent in hypothermia, bradycardia, or

severe electrolyte depletions

12 — Lead Electrocardiogram (ECG)

Limb leads

Precordial Leads

I

Anterolateral (Circumflex)

aVR

V1

Anteroseptal (LAD)

V4

Anteroapical (Distal LAD)

II

Inferior (RCA)

aVL

Anterolateral (Circumflex)

V2

Anteroseptal (LAD)

Posterior (RCA)

V5

Anterolateral (Circumflex)

III

Inferior (RCA)

aVF

Inferior (RCA)

V3

Anteroapical (Distal LAD)

Posterior (RCA)

V6

Anterolateral (Circumflex)

adapted from ACLS instructor book

Figure 2. Cardiac Anatomy in relation to the ECG.
II.HEMODYNAMIC MANAGEMENT AND THE HEART
A.Hemodynamic Assessment Relies on the Clinician’s Ability to:
1

Understand cardiovascular circulation (Figure 3) and pathophysiology contributing to the hemodynamic

variables in isolation and in the context of other changes and conditions.

2Account for hemodynamic trends in view of end-organ function and use surrogates of oxygen delivery.
3

Understand the roles of hemodynamic tools, limitations of use, and interpretation of the devices/

technology.

4

Identify appropriate therapeutic targets (Figure 4), and apply the pharmacologic/pharmacodynamic

principles (Table 1) to initiate, modify, or discontinue therapy depending on clinical response.

B.Advantages and Disadvantages of Invasive Hemodynamic Monitoring for Assessing Cardiac Output and/

or Volume Status

1

Hemodynamic monitoring techniques facilitate diagnosis

2Therapy guided by clinical assessment and a pulmonary artery catheter compared with clinical

assessment alone for HF did not result in differences in overall mortality or hospitalizations. However,

more anticipated adverse events (i.e., infection, bleeding) were seen with pulmonary artery catheter-

guided care (JAMA 2005;294:1625-33).
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