Chapter 249 - Cardiac Catheterization Complete indications table (Table 249-1) Access sites: radial vs femoral with advantages/disadvantages Radial artery cocktail (verapamil + NTG doses) Normal hemodynamic values reference table Hemodynamic patterns in tamponade, constriction, restriction, MR, AS, PAH Constriction vs restriction hemodynamic differentiation Gorlin formula for AVA and MVA calculations PVR/SVR calculation formulas Shunt quantification (Qp:Qs) Coronary anatomy with dominance percentages Angiographic projections table FFR and iFR: cut-offs, adenosine dosing, landmark trials (FAME, DEFER) IVUS and OCT: indications, LM MLA cut-offs AR and MR Sellers grading TIMI flow grading Contrast nephropathy prevention protocol Anticoagulation during cath (heparin, bivalirudin doses) Make harrison base notes
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Indications Table (Table 249-1) - All 8 categories: CAD, AMI, valvular, CHF, congenital, pericardial, transplant, other conditions - with exact Harrison's language
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Access Sites - Radial (preferred) vs femoral with full advantage/disadvantage tables; femoral needle placement zone; post-procedure care
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Radial Cocktail - Verapamil 2.5-5 mg IA + NTG 100-200 mcg IA + heparin (all intraarterial)
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Normal Hemodynamics (Table 249-2) - Every pressure, resistance, and flow value verbatim from Harrison's
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Hemodynamic Patterns - Tamponade, constriction, restriction, MR (v waves), AS (LV-Ao gradient), PAH - with a dedicated constriction vs restriction differentiation table
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Gorlin Formula - AVA (constant 44.3) and MVA (constant 37.7) with the limitation in mixed disease; Hakki simplified formula
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PVR/SVR formulas - With Wood units conversion; Fick CO formula
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Qp:Qs - Full formula, step-up method (>8% = shunt), interpretation table
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Coronary Anatomy - Dominance percentages (R 70%, L 10%, co 20%), key segments, territories
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Angiographic Projections - Table of views with optimal anatomy visualized
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FFR & iFR - Cut-offs (0.80 / 0.89), adenosine dosing (IV 140 mcg/kg/min; IC 60-80 mcg LCA), DEFER + FAME + FAME-2 + DEFINE-FLAIR trials
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IVUS & OCT - Indications, LM MLA cut-offs (IVUS ≤6.0 mm²; non-LM ≤4.0 mm²; OCT non-LM ≤2.5 mm²), comparison table
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Sellers Grading - AR and MR grades 1-4 with exact descriptions
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TIMI Flow - Grades 0-3 with full descriptions; frame count reference
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CIN Prevention - Full protocol (hydration cornerstone, contrast minimization, NAC, bicarb, hold nephrotoxins); PRESERVE trial note
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Anticoagulation - Exact Harrison's doses: bivalirudin 0.75 mg/kg bolus + 1.75 mg/kg/hr; argatroban 350 mcg/kg + 15 mcg/kg/min; UFH targets
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Quick Reference Card - All formulas and cut-offs in one scannable block
Create a printable PDF study guide of these notes for exam prep
Harrison Ch249 CardiacCath StudyGuide
PDF Document · PDF
| Page | Content |
|---|---|
| 1 | Cover page + Table of Contents |
| 2 | Indications table + Procedural risks + Access sites (Radial vs Femoral) |
| 3 | Radial cocktail + Normal hemodynamic values (Table 249-2) |
| 4 | Hemodynamic patterns (Tamponade, Constriction, Restriction, MR, AS, PAH) |
| 5 | Constriction vs Restriction differentiator + Gorlin formula |
| 6 | PVR/SVR formulas + Shunt quantification (Qp:Qs) |
| 7 | Coronary anatomy/dominance + Angiographic projections |
| 8 | FFR & iFR (doses, cut-offs, FAME/DEFER/DEFINE-FLAIR trials) |
| 9 | IVUS vs OCT + MLA cut-offs + Sellers AR/MR grading |
| 10 | TIMI flow + CIN prevention protocol |
| 11 | Anticoagulation doses (exact Harrison's values) |
| 12 | Dark-background Quick Reference Card (all formulas + cut-offs at a glance) |