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MNEMONICS - Cardiovascular

Terms in this set (53)

Mitral Stenosis, Complications
PASTRI

Pulm ↑BP, A fib, Systemic embolism, Tricuspid regurg, Right heart failure, Infective
endocarditis
Myocardial infarct, complications
ABCDE x2

Arrhythmias / Aneurysm
Bradycardia / ↓BP
Cardiac failure / cardiac tamponade
Dresslers / Death!
Embolism / Extra (VSD, pap muscle rupture)
Postural Hypotension
HANDI

Hypovolaemia / hypopituitarism, Addisons, Neuropathy (autonomic), Drugs (vasodilators /
TCADs, diuretics, antipsychotics), Idiopathic
Splinter haemorrhages
TRIP SAM

Trauma, RA, Infective Endo, PAN
SLE / Sepsis, Anaemia (profound), Malignancy (haematological)
ST elevation
ELEVATION

Electrolytes, LBBB, Early Repolarization, Ventricular hypertrophy, Aneurysm, Treatment (eg
pericardiocentesis), Injury (AMI, contusion), Osborne waves (hypothermia), Non-occlusive
vasospasm (prinzmetal's)
Symptoms of aortic stenosis
ASD
Angina 2 years }
Syncope 1 year } prognosis
Dyspnoea 6/12 }
No apex beat
DOPES
Dextrocardia (don't say this first!), Obesity, Pleural/Pericardial effusion, Emphysema, Shoc
3rd Heart Soun
d FIPPY
Failure, Incompetence (mitral/tricuspid), Pregnancy/Pill/PE/Pericarditis, Yout
4th Heart Sound
****
Stenosis (aortic/pulmonary), Hypertension/Heart Block, Ischaemic HD, Tamponade
Arrhythmias
ARHYTHMIAL 4PC
Atrial Myxoma, Rh heart dis, HYpertension, THyrotoxicosis, Mitral valve dis, IHD,
ALcohol
Pneumonia / PE / Pericardial eff, cardiomyopathy
Atrial Fibrillation
ARITHMATIC
Alcohol, Rh fever, IHD, Thyrotoxicosis, Hypertension, Mitral stenosis / MI / Myxoma
(atrial)
ASD, Toxins, Idiopathic/Infective endocarditis Cardiomyopathy/Constrictive pericarditis
Shock
HEN SCAM
Hypovolaemia, Endocrine (adrenal, thyroid), Neuropathic (autonomic)
Spinal cord injury/ Sepsis, Cardiac, anapyhlaxis/ anaesthesia, anti HPT, Massive PE
Treatment of Heart Failure
ABCDE
ACE inhibitors; Beta-blockers; Calcium channel blockers; Diuretics; Endothelin-converting enzyme inhibitors
Basic MI Management
BOOMAR
Bed rest, Oxygen, Opiate, Monitoring, Anticoagulation, Reduce clot size
Treatment for Acute MI
M.O.N.A
Morphine, Oxygen, Nitrate, Aspirin
JVP Wave form
ASK ME:
Atrial contraction
Systole (ventricular contraction)
Klosure (closure) of tricusps, so atrial filling
Maximal atrial filling
Emptying of atrium
Heart Failure Signs
TAPED TORCH:
Tachycardia
Ascites
Pulsus alternans
Elevated jugular venous pressure
Displaced apex beat
Third heart sound
Oedema
Right ventricular heave
Crepitations or wheeze
Hepatomegaly (tender)
Heart Failure
causes HEART FAILED:
Hypertension
Endocrine
Anemia
Rheumatic heart disease
Toxins
Failure to take meds
Arrythmia
Infection
Lung (PE, pneumonia)
Electrolytes
Diet
EKG 12 lead quick interpretation of v1-v6 MI
V1-V6 SSAALL:
· Elevations matched with their classic location of MI:
V1 Septal
V2 Septal
V3 Anterior
V4 Anterior
V5 Lateral
V6 Lateral
MI: Signs and symptoms
PULSE:
Persistent chest pains
Upset stomach
Lightheadedness
Shortness of breath
Excessive sweating
Right to Left Shunt
5 T's

Truncus arteriosus (1 vessel)
Transposition of great arteries (2 vessels transposed)
Tricuspid atresia (3 =Tri)
Tetralogy of fallot (4 =Tetra)
Total anomalous pulmonary venous return (5 =5 words)
Tetrology of Fallot
PROVe you're TOF

Pulmonary stenosis
Right ventricular hypertrophy
Overriding aorta
Ventricular septal defect
Whas is the mechanism oof Arrhythmias?
HARD heart

Heart Block -- no AV node conduction --> prolonged PR interval, more P than QRS waves, indepent action of Atria and Ventricles

Abnormal Pacemaker Activity: normal pace maker activity in phase 4; during ischemia/catecholamine activation, APs else where inthe heart become more likely

Re-entry: circular (circus) movement of a wave of depolarization; in order for APs to maintain a circular movement, the refractory period must be short enough for the action potential to continue to propagate without running into the back of itself and extinguish, e.g. if there's a dilated ventricle: lengthens path geometrically, slow conduction: lengths path Time

Delayed after depolarizing: increased intracellular Ca2+ --> increased resting potential --> spontaneous rhythm, prominent mechanism for severe ischemia
Factors Favoring or predispoint to Thrombus
Virchow's or VirCHIs Triad

Changes in Blood flow: stasis/turbulence
Hypercoagulability: primary (genetic), secondary (acquired changes in coagulent or anticoagulent factors
Injury to Endothelium: atherosclerosis, hypertensive drugs, cigarette smoking, hypercholesteremia
Atherosclerosis Risk Factors
SHIFT MAID:
Smoking
Hypertension
(N)IDDM
Family history
Triglycerdides & fats
Male
Age
Inactivity
Diet / Drink
Heart Failure Causes
"HEART MAy DIE":
Hypertension
Embolism
Anemia
Rheumatic heart disease
Thyrotoxicosis (incl. pregnancy)
Myocardial infarct
Arrythmia
Y
Diet & lifestyle
Infection
Endocarditis
MI emergency treatment drugs
MOAN:
Morphine: analgesia for severe pain
Oxygen: not harmful adn may help if V/Q mismatch
Asprin: inhibit furtherplatelet aggregation
Nitrates: peripheral vasodilation --> reduced preload --> reduced workload (o2 demand) of thee heart
Myocardial Infarct Complications
ABCDE x2
Arrhythmias / Aneurysm
Bradycardia / ↓BP
Cardiac failure / cardiac tamponade
Dresslers / Death!
Embolism / Extra (VSD, pap muscle rupture)
MI: basic management
BOOMAR:
Bed rest
Oxygen
Opiate
Monitor
Anticoagulate
Reduce clot size
ECG: left vs. right bundle block
"WiLLiaM MaRRoW":
W pattern in V1-V2 and M pattern in V3-V6 is Left bundle block.
M pattern in V1-V2 and W in V3-V6 is Right bundle block.
· Note: consider bundle branch blocks when QRS complex is wide
Pericarditis: causes
CARDIAC RINDS:
Collagen vascular disease
Aortic aneurysm
Radiation
Drugs (such as Isoniazid, procainamide, hydralazine)
Infections
Acute renal failure (uremia)
Cardiac infarction
Rheumatic fever
Injury/Invasion (amyloid/sarcoidosis)
Neoplasms
Dressler's syndrome
SLE/Scleroderma
MI: signs and symptoms
PULSE:
Persistent chest pains
Upset stomach
Lightheadedness
Shortness of breath
Excessive sweating
Heart compensatory mechanisms that 'save' organ blood flow during shock
"Heart SAVER":
Symphatoadrenal system
Atrial natriuretic factor
Vasopressin
Endogenous digitalis-like factor
Renin-angiotensin-aldosterone system
· In all 5, system is activated/factor is released
Murmurs: right vs. left loudness
"RILE":
Right sided heart murmurs are louder on Inspiration.
Left sided heart murmurs are loudest on Expiration
ST elevation causes in ECG
ELEVATION:
Electrolytes
LBBB
Early repolarization
Ventricular hypertrophy
Aneurysm
Treatment (eg pericardiocentesis)
Injury (AMI, contusion)
Osborne waves (hypothermia)
Non-occlusive vasospasm
Beck's triad (cardiac tamponade)
3 D's:
Distant heart sounds
Distended jugular veins
Decreased arterial pressure
MI: therapeutic treatment
"O BATMAN!": or MONAH
Oxygen
Beta blocker
ASA
Thrombolytics (eg heparin)
Morphine
ACE prn
Nitroglycerin
CHF: causes of exacerbation
FAILURE:
Forgot medication
Arrhythmia/ Anaemia
Ischemia/ Infarction/ Infection
Lifestyle: taken too much salt
Upregulation of CO: pregnancy, hyperthyroidism
Renal failure
Embolism: pulmonary
Pericarditis: EKG
"PericarditiS":
PR depression in precordial leads.
ST elevation
Depressed ST-segment: causes
DEPRESSED ST:
Drooping valve (MVP)
Enlargement of LV with strain
Potassium loss (hypokalemia)
Reciprocal ST- depression (in I/W AMI)
Embolism in lungs (pulmonary embolism)
Subendocardial ischemia
Subendocardial infarct
Encephalon haemorrhage (intracranial haemorrhage)
Dilated cardiomyopathy
Shock
Toxicity of digitalis, quinidine
Coronary artery bypass graft: indications
DUST:
Depressed ventricular function
Unstable angina
Stenosis of the left main stem
Triple vessel disease
Peripheral vascular insufficiency: inspection criteria
SICVD:
Symmetry of leg musculature
Integrity of skin
Color of toenails
Varicose veins
Distribution of hair
Rheumatic fever: Revised Jones criteria
JONES PEACE:
· Major criteria:
Joints: migratory
O (heart shaped) Carditis: new onset murmur
Nodules, subcutaneous: extensor surfaces
Erythema marginatum
Sydenham's chorea
· Minor criteria:
PR interval, prolonged
ESR elevated
Arthralgias
CRP elevated
Elevated temperature (fever)
· Need 2 major or 1 major and 2 minor criteria, plus evidence of recent GAS infection (throat cx, rapid antigen test, or rising strep antibody titer).
Pulseless electrical activity: causes
PATCH MED:
Pulmonary embolus
Acidosis
Tension pneumothorax
Cardiac tamponade
Hypokalemia/ Hyperkalemia/ Hypoxia/ Hypothermia/ Hypovolemia
Myocardial infarction
Electrolyte derangements
Drugs
Exercise ramp ECG: contraindications
RAMP:
Recent MI
Aortic stenosis
MI in the last 7 days
Pulmonary hypertension
ECG: T wave inversion causes
INVERT:
Ischemia
Normality [esp. young, black]
Ventricular hypertrophy
Ectopic foci [eg calcified plaques]
RBBB, LBBB
Treatments [digoxin]
Myocardial infarctions: treatment
INFARCTIONS:
IV access
Narcotic analgesics (eg morphine, pethidine)
Facilities for defibrillation (DF)
Aspirin/ Anticoagulant (heparin)
Rest
Converting enzyme inhibitor
Thrombolysis
IV beta blocker
Oxygen 60%
Nitrates
Stool Softeners
Atrial fibrillation: causes
PIRATES:
Pulmonary: PE, COPD
Iatrogenic
Rheumatic heart: mirtral regurgitation
Atherosclerotic: MI, CAD
Thyroid: hyperthyroid
Endocarditis
Sick sinus syndrome
Atrial fibrillation: management
ABCD:
Anti-coagulate
Beta-block to control rate
Cardiovert
Digoxin
Aortic dissection: risk factors
ABC:
Atherosclerosis/ Aging/ Aortic aneurysm
Blood pressure high/ Baby (pregnancy)
Connective tissue disorders (eg Marfan's, Ehlers-Danlos)/ Cystic medial necrosis
Heart failure: causes
HEART FAILED:
Hypertension
Endocrine
Anemia
Rheumatic heart disease
Toxins
Failure to take meds
Arrythmia
Infection
Lung (PE, pneumonia)
Electrolytes
Diet
Bacterial Endocarditis: Duke's criteria
Bacterial Endocarditis FIVE PM:
Major Criteria
B : Blood culture +ve x2
E : Endocardial involvement
+ve echocardiogram (vegetation, abscess or valve dehiscence) or
New valvular regurgitation

Minor criteria
Fever > 38 oC
Immunologic phenomena (glomerulonephritis, Osler's nodes, Roth's spots, Rheumatoid factor)
Vascular phenomena (major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjuntival hemorrhage, Janeway lesions)
Echocardiography findings (suggestive but not definitive)
Predisposition (heart condition or IV drug user)
Microbiologic evidence (Positive blood culture but not meeting major criteria)

Definitive Diagnosis requires 2 Major
or 3 Minor + 1 Major
or 5 Minor
Bacterial Endocarditis: features
F-Fever
R-Roth's spots (retinal hemmorrhages with white or pale centers)
O-Osler's Nodes (Painful palpable pads fingers/toes)
M-Murmur (usually regurg in mitral/aortic)
J-Janeway lesions (non-tender macular lesions palms/soles)
A-Anemia
N-Nail bed hemorrhage
E-emboli
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