Cardiovascular System & Clinical Cardiology –
4th Year Medical Student Exam Notes
(Complete Guide with Anatomy, Pathology &
Pharmacology)
1. CARDIAC ANATOMY & PHYSIOLOGY
Heart Structure
Chambers:
Right atrium: receives deoxygenated blood from systemic circulation
Right ventricle: pumps blood to pulmonary circulation (lower pressure system)
Left atrium: receives oxygenated blood from pulmonary veins
Left ventricle: pumps blood to systemic circulation (higher pressure system)
Valves:
Tricuspid: between RA and RV (3 leaflets)
Pulmonary: between RV and pulmonary artery
Mitral/Bicuspid: between LA and LV (2 leaflets)
Aortic: between LV and aorta
Coronary Circulation:
Right coronary artery (RCA): supplies inferior wall, right ventricle
Left anterior descending (LAD): supplies anterior wall, septum
Left circumflex (LCX): supplies lateral and posterior walls
Venous drainage via coronary sinus into right atrium
Cardiac Cycle
Systole (contraction):
Isovolumetric contraction: all valves closed, pressure rises
, Ejection phase: semilunar valves open, blood ejected
Diastole (relaxation):
Isovolumetric relaxation: all valves closed, pressure falls
Filling phase: AV valves open, ventricular filling
Key Pressures:
Normal LV systolic: 100-140 mmHg
Normal LV diastolic: 5-12 mmHg
Normal RV systolic: 15-30 mmHg
Normal RV diastolic: 0-8 mmHg
Electrical Conduction System
Pathway:
1. Sinoatrial (SA) node (pacemaker, 60-100 bpm)
2. Atrioventricular (AV) node (backup pacemaker, 40-60 bpm)
3. Bundle of His
4. Left and right bundle branches
5. Purkinje fibers
Action Potential Phases:
Phase 0: Rapid depolarization (Na+ influx)
Phase 1: Early repolarization (K+ efflux)
Phase 2: Plateau (Ca2+ influx, K+ efflux)
Phase 3: Repolarization (K+ efflux)
Phase 4: Resting potential
2. CLINICAL EXAMINATION
History Taking
Key Symptoms:
4th Year Medical Student Exam Notes
(Complete Guide with Anatomy, Pathology &
Pharmacology)
1. CARDIAC ANATOMY & PHYSIOLOGY
Heart Structure
Chambers:
Right atrium: receives deoxygenated blood from systemic circulation
Right ventricle: pumps blood to pulmonary circulation (lower pressure system)
Left atrium: receives oxygenated blood from pulmonary veins
Left ventricle: pumps blood to systemic circulation (higher pressure system)
Valves:
Tricuspid: between RA and RV (3 leaflets)
Pulmonary: between RV and pulmonary artery
Mitral/Bicuspid: between LA and LV (2 leaflets)
Aortic: between LV and aorta
Coronary Circulation:
Right coronary artery (RCA): supplies inferior wall, right ventricle
Left anterior descending (LAD): supplies anterior wall, septum
Left circumflex (LCX): supplies lateral and posterior walls
Venous drainage via coronary sinus into right atrium
Cardiac Cycle
Systole (contraction):
Isovolumetric contraction: all valves closed, pressure rises
, Ejection phase: semilunar valves open, blood ejected
Diastole (relaxation):
Isovolumetric relaxation: all valves closed, pressure falls
Filling phase: AV valves open, ventricular filling
Key Pressures:
Normal LV systolic: 100-140 mmHg
Normal LV diastolic: 5-12 mmHg
Normal RV systolic: 15-30 mmHg
Normal RV diastolic: 0-8 mmHg
Electrical Conduction System
Pathway:
1. Sinoatrial (SA) node (pacemaker, 60-100 bpm)
2. Atrioventricular (AV) node (backup pacemaker, 40-60 bpm)
3. Bundle of His
4. Left and right bundle branches
5. Purkinje fibers
Action Potential Phases:
Phase 0: Rapid depolarization (Na+ influx)
Phase 1: Early repolarization (K+ efflux)
Phase 2: Plateau (Ca2+ influx, K+ efflux)
Phase 3: Repolarization (K+ efflux)
Phase 4: Resting potential
2. CLINICAL EXAMINATION
History Taking
Key Symptoms:
