In this episode, we review the presentation of acute coronary syndromes (ACS) and the Fourth Universal Definition of Myocardial Infarction (MI). What is the difference between myocardial injury, ischemia, and infarction? Why is the term "Type 2 NSTEMI" no longer appropriate? Why is the term "atypical angina" deprecated? What does the GRACE score and TIMI score contain? Tune in for answers to these questions.

Difficulty Level: Easy

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we review ECG changes in acute coronary syndromes (ACS). What constitutes a significant vs a non-significant Q wave? Can the shape of the curve of the ST elevation or depression offer clues about whether the ST change is ischemic or non-ischemic? What types of infarctions would you not see reciprocal changes on in the standard ECG? How do you define Sgarbossa's criteria, Wellen's syndrome, and De Winter's syndrome? Tune in for answers to these questions.

Difficulty Level: Easy

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we review apolipoproteins, Lp(a), and familial dyslipidemias. What roles do apolipoproteins like ApoB48, ApoB100 and ApoA-I play in lipid transport and cardiovascular risk? Why is measuring Lp(a) in nmol/L more informative than mg/dL? Who should ApoB and Lp(a) level testing be sent on? How do conditions like familial hypercholesterolemia differ from dysbetalipoproteinemia or familial hypertriglyceridemia? Tune in for answers to these questions.

Difficulty Level: Intermediate

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we review ASCVD risk estimation and lipid-lowering therapies. What low-density lipoprotein cholesterol (LDL-C) level should be targeted for patients who have had an ASCVD event versus those who have not, and how do these target LDL-C levels vary based on the presence of risk factors, diabetes status, and estimated 10-year ASCVD risk? What equation recently replaced the pooled cohort equations for estimating 10-year risk of ASCVD, and what new variables are introduced in the updated equation? What does high, moderate, and low intensity statin mean? In which two populations do you bypass the classic ASCVD risk chart for statin initiation and go straight for a high-intensity statin? What events and conditions comprise the definition of secondary prevention patients who are at "very high risk" of additional ASCVD events? How do these differ from the primary prevention risk enhancing factors? Furthermore, how do these differ from the diabetes-specific risk enhancing factors? In what situations is it appropriate to obtain a coronary artery calcium (CAC) score? What are the implications of a CAC score of 0, 1-99, and 100+? What is the definition of statin intolerance? Which statins are hydrophilic and which are lipophilic? Which statins are metabolized by CYP3A and which are metabolized by CYP2C9? What non-statin therapies are available for additional lipid lowering? What is the difference between the Friedewald equation and the Martin-Hopkins equation? How often do you need to be checking a lipid panel? Tune in for answers to these questions.

Difficulty Level: Easy

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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More MedEd resources available at ⁠⁠⁠www.rueyhu.com⁠⁠⁠

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In this episode, we discuss common complications of pacemaker (PPM) and implantable cardioverter-defibrillator (ICD) implantation, along with considerations at the end of life. What are the risks of pacemaker pocket hematoma, pneumothorax, lead dislodgement, diaphragmatic stimulation, and muscular stimulation post-implantation, and how are these managed? What is twiddler's syndrome? What is the difference between pacemaker syndrome and pacemaker-mediated tachycardia, and how do they occur? When is it appropriate and necessary to deactivate an ICD at the end of life? Do PPMs need to be deactivated at the end of life? Tune in for answers to these questions.

Difficulty Level: Easy

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we clarify key terms related to pacemakers (PPMs) and implantable cardioverter-defibrillators (ICDs). What do the common two-letter labels AR, VR, AS, VS, AP, VP, FD, TD, TP, CD, RV, and RT mean on EGM of an ICD? What is the relationship between the lower rate limit and the lower rate interval? What is the relationship between the post-ventricular atrial refractory period (PVARP) and the total atrial refractory period (TARP)? What is hysteresis? What is a typical upper tracking rate? What is fusion and pseudofusion? Tune in for answers to these questions.

Difficulty Level: Advanced

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we explore the concept of ventricular dyssynchrony and cardiac resynchronization therapy (CRT). What are the eleven scenarios in which CRT is recommended, according to the 2022 heart failure guidelines? What benefits to patients receive when CRT is appropriately used? What factors could contribute to nonresponse to CRT? How can echocardiography be used to find the atrioventricular delay to optimize LV filling? Tune in for answers to these questions.

Difficulty Level: Intermediate

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we review the key aspects of ICD therapies. What are typical thresholds for a VT monitor zone, regular VT zone, fast VT zone, and VF zone? How is the number of intervals to detect (NID) defined deterministically vs probabilistically for VT vs VF detection? What is a typical rate and interval decrement for anti-tachycardia pacing (ATP)? What is the difference between a burst and a ramp of ATP? What do the B>AX, B>X, and B>A vectors for ICD shock describe? What are strategies for reducing inappropriate shocks? When is it appropriate to use a subcutaneous ICD or a wearable ICD? Tune in for answers to these questions.

Difficulty Level: Advanced

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we explore the fundamentals of permanent pacemaker (PPM) and implantable cardioverter-defibrillator (ICD) interrogation. What are the most common pacing modes, and when are they used? What is rate-adaptive pacing, mode switching, and managed ventricular pacing? What mode do you induce when you place a magnet? How do you perform a sensing test and a threshold test? What are the timing cycles in single-chamber pacing and dual-chamber pacing? What mode is induced when the device reaches the recommended replacement time (RRT), and how many months are left when RRT is reached? Tune in for answers to these questions.

Difficulty Level: Advanced

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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In this episode, we review QT prolongation and QT shortening. What is the QT interval, and how is it corrected (QTc) for heart rate variations? Which arrhythmogenic syndromes are associated with mutations in KCNQ1, KCNH2, and SCN5A? How do the T waves of long QT syndrome types 1, 2, and 3 differ? Which long QT syndrome is suggested by arrhythmia triggered from swimming? Which long QT syndrome is suggested by arrhythmia from noises and auditory triggers? Which long QT syndrome will need addition of mexiletine (on top of nadolol) sooner? What are the QT and QRS effects of hypocalcemia, hypomagnesemia, and hypokalemia? What is the definition of a prominent U wave? What is the criteria for short QT syndrome? Tune in for answers to these questions.

Difficulty Level: Intermediate

You are listening to Hu Said: Cardiology Board Review Series (2024-2025 Season)

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More MedEd resources available at ⁠⁠www.rueyhu.com⁠⁠

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