Cardiology Mnemonics

 

 

Heart failure: causes HEART FAILED:HypertensionEndocrineAnemiaRheumatic heart diseaseToxinsFailure to take medsArrythmiaInfectionLung (PE, pneumonia)ElectrolytesDiet

EKG: 12 lead EKG quick interpretation of V1-V6 SSAALL:· Elevations matched with their classic location of MI:V1 SeptalV2 SeptalV3 AnteriorV4 AnteriorV5 LateralV6 Lateral

Aortic regurgitation: causes MARRIS:MarfansAnkylosing spondylitisRheumatic feverRheumatoid arthritisInfective endocarditisSyphilis

Cardiomyopathy: categories Cardiomyopathy is HARD:Hypertrophic cardiomyopathyArrhythmogenic right ventricular cardiomyopathyRestrictive cardiomyopathyDilated cardiomyopathy

Sinus tachycardia TACH FEVER:Tamponade/ ThyrotoxicosisAnemiaCHFHypotensionFeverExcrutiating painVolume depletionExerciseRx (Theo, Dopa, Epi, etc)

CHF: causes of exacerbation A SMITH PEAR:AnemiaSalt/ Stress/ Stopping medsMIInfection/ IschemiaThyroid (high/low)HTNPericarditisEndocarditis (valve disease)ArrhythmiaRx (beta blocker, etc)

Murmurs: louder with inspiration vs expiration LEftsided murmurs louder with ExpirationRIght sided murmurs louder with Inspiration.

Murmurs: questions to ask SCRIPT:SiteCharacter (eg harsh, soft, blowing)RadiationIntensityPitchTiming

Aortic regurgitation: causes CREAM:CongenitalRheumatic damageEndocarditisAortic dissection/ Aortic root dilatationMarfan's

Heart failure: signs TAPED TORCH:TachycardiaAscitesPulsus alternansElevated jugular venous pressureDisplaced apex beatThird heart soundOedemaRight ventricular heaveCrepitations or wheezeHepatomegaly (tender)

Pericarditis: causes PR DIP, ST UP:Post-pericardiectomyRheumatic fever

Drugs (eg isoniazid, hydralazine, procainalmide)Infection (eg TB, coxsackie, strep)PESLE/SclerodermaTumours/ Thyroid diseaseUraemiaPost MI (includes Dressler's)

Aortic dissection: risk factors ABC:Atherosclerosis/ Ageing/ Aortic aneurysmBlood pressure high/ Baby (pregnancy)Connective tissue disorders (eg Marfan's, Ehlers-Danlos)/ Cysticmedial necrosis

CHF: Left-sided systolic failure signs and symptoms "LeftSystolic Failure Can Have Dialated HeartCause Of Pulmpnary Backflow":Loss of hair on legsSkin cold and clammyFatigueCracklesHigh heart rateDyspneaHTNCyanosisOrthopneaPink Sputum

Acute Coronary Syndrome: initial treatment ABCD:AspirinBeta blockerCoagulation (anticoagulation with heparin/LMW Heparin)Double product control (decrease heart rate and blood pressure)

Exercise ramp ECG: contraindications RAMP:Recent MIAortic stenosisMI in the last 7 daysPulmonary hypertension

ECG: T wave inversion causes INVERT:IschemiaNormality [esp. young, black]Ventricular hypertrophyEctopic foci [eg calcified plaques]RBBB, LBBBTreatments [digoxin]

Rheumatic fever: Jones major criteria JONES:Joints (migrating polyarthritis)Obvious, the heart (carditis, pancarditis, pericarditis, endocarditis orvalvulits)Nodes (subcutaneous nodules)Erythema marginatumSydenham's chorea

Myocardial infarctions: treatment INFARCTIONS:IV accessNarcotic analgesics (eg morphine, pethidine)Facilities for defibrillation (DF)Aspirin/ Anticoagulant (heparin)RestConverting enzyme inhibitorThrombolysis

IV beta blockerOxygen 60%NitratesStool Softeners

Atrial fibrillation: causes PIRATES:Pulmonary: PE, COPDIatrogenicRheumatic heart: mirtral regurgitationAtherosclerotic: MI, CADThyroid: hyperthyroidEndocarditisSick sinus syndrome

Atrial fibrillation: management ABCD:Anti-coagulateBeta-block to control rateCardiovertDigoxin

Anti-arrythmics: for AV nodes "Do Block AV":DigoxinB-blockersAdenosineVerapamil

Murmurs: systolic MR PV TRAPS:MitralRegurgitation andProlaspe

VSDTricupsidRegurgitationAortic andPulmonaryStenosis

Apex beat: differential for impalpable apex beat DOPES:DextrocardiaObesityPericarditis/ Pericardial tamponade/ PneumothoraxEmphysemaSinus inversus/ Student incompetence/ Scoliosis/ Skeletalabnormalities (eg pectus excavatum)

Rheumatic fever: Jones 5 major criteria STREP:Sydenhams choreaTransient migratory arthritisRheumatic subcutaneous nodulesErythema marginatumPancarditis (endocarditis, myocarditis, pericarditis)· STREP, since Rheumatic fever is caused by group A strep.

Mitral regurgitation When you hear holosystolic murmurs,think "MR-THEM ARE holosystolic murmurs".

Sino-atrial node: innervation Sympathetic acts on Sodium channels (SS).Parasympathetic acts on Potassium channels (PS).

Supraventricular tachycardia: treatment ABCDE:AdenosineBeta-blockerCalcium channel antagonistDigoxinExcitation (vagal stimulation)

Ventricular tachycardia: treatment LAMB:LidocaineAmiodaroneMexiltene/ MagnesiumBeta-blocker

Rheumatic fever: Revised Jones criteria JONES PEACE:· Major criteria:Joints: migratoryO (heart shaped) Carditis: new onset murmurNodules, subcutaneous: extensor surfacesErythema marginatumSydenham's chorea· Minor criteria:PR interval, prolongedESR elevatedArthralgiasCRP elevatedElevated temperature (fever)· Need 2 major or 1 major and 2 minor criteria, plus evidence of recent GASinfection (throat cx, rapid antigen test, or rising strep antibody titer).

Pulseless electrical activity: causes PATCH MED:Pulmonary embolusAcidosisTension pneumothoraxCardiac tamponadeHypokalemia/ Hyperkalemia/ Hypoxia/ Hypothermia/ HypovolemiaMyocardial infarctionElectrolyte derangementsDrugs

Sinus bradycardia: aetiology "SINUS BRADICARDIA"(sinus bradycardia):SleepInfections (myocarditis)Neap thyroid (hypothyroid)Unconsciousness (vasovagal syncope)Subnormal temperatures (hypothermia)Biliary obstructionRaised CO2 (hypercapnia)AcidosisDeficient blood sugar (hypoglycemia)Imbalance of electrolytesCushing's reflex (raised ICP)AgingRx (drugs, such as high-dose atropine)Deep anaesthesiaIschemic heart diseaseAthletes

Rheumatic fever: Jones criteria · Major criteria: CANCER:CarditisArthritisNodulesChoreaErythemaRheumatic anamnesis· Minor criteria: CAFE PAL:

CRP increasedArthralgiaFeverElevated ESRProlonged PR intervalAnamnesis of rheumatismLeucocytosis

JVP: wave form ASK ME:Atrial contractionSystole (ventricular contraction)Klosure (closure) of tricusps, so atrial fillingMaximal atrial fillingEmptying of atrium

Coronary artery bypass graft: indications DUST:Depressed ventricular functionUnstable anginaStenosis of the left main stemTriple vessel disease

Murmurs: innocent murmur features 8 S's:SoftSystolicShortSounds (S1 & S2) normalSymptomlessSpecial tests normal (X-ray, EKG)Standing/ Sitting (vary with position)Sternal depression

Murmur attributes "IL PQRST" (person has ill PQRSTheart waves):IntensityLocationPitchQualityRadiationShapeTiming

Murmurs: locations and descriptions "MRS A$$":MRS: Mitral Regurgitation--SystolicA$$: Aortic Stenosis--Systolic· The other two murmurs, Mitral stenosis and Aortic regurgitation, are obviouslydiastolic.

Betablockers: cardioselective betablockers "BetablockersActing Exclusively At Myocardium"· Cardioselective betablockers are:BetaxololAcebutelolEsmololAtenololMetoprolol

Apex beat: abnormalities found on palpation, causes of impalpableHILT:HeavingImpalpableLaterally displacedThrusting/ Tapping· If it is impalpable, causes are COPD:COPDObesity

Pleural, Pericardial effusionDextrocardia

MI: treatment of acute MI COAG:CyclomorphOxygenAspirinGlycerol trinitrate

Coronary artery bypass graft: indications DUST:Depressed ventricular functionUnstable anginaStenosis of the left main stemTriple vessel disease

Peripheral vascular insufficiency: inspection criteria SICVD:Symmetry of leg musculatureIntegrity of skinColor of toenailsVaricose veinsDistribution of hair

Rheumatic fever: Revised Jones' criteria JONES crITERIA:· Major criteria:Joint (arthritis)Obvious (Cardiac)Nodule (Rheumatic)Erythema marginatumSydenham chorea

· Minor criteria:Inflammatory cells (leukocytosis)Temperature (fever)ESR/CRP elevatedRaised PR intervalItself (previous Hx of Rheumatic fever)Arthralgia

Heart murmurs "hARD ASS MRS. MSD":hARD: Aortic Regurg = DiastolicASS: Aortic Stenosis = SystolicMRS: Mitral Regurg = SystolicMSD: Mitral Stenosis = Diastolic

MI: therapeutic treatment ROAMBAL:ReassureOxygenAspirinMorphine (diamorphine)Beta blockerArthroplastyLignocaine

CHF: causes of exacerbation FAILURE:Forgot medicationArrhythmia/ AnaemiaIschemia/ Infarction/ InfectionLifestyle: taken too much saltUpregulation of CO: pregnancy, hyperthyroidismRenal failureEmbolism: pulmonary

Murmurs: systolic vs. diastolic PASS: Pulmonic& Aortic Stenosis=Systolic.PAID: Pulmonic & Aortic Insufficiency=Diastolic.

Murmurs: systolic vs. diastolic Systolic murmurs: MR AS:"MR. ASner".Diastolic murmurs: MS AR: "MS. ARden".· The famous people with those surnames are Mr. Ed Asner and Ms. Jane Arden.

MI: therapeutic treatment "O BATMAN!":OxygenBeta blockerASAThrombolytics (eg heparin)MorphineAce prnNitroglycerin

Mitral stenosis (MS) vs. regurgitation (MR): epidemiology MS is a female title (Ms.) and it is female predominant.MR is a male title (Mr.) and it is male predominant.

Pericarditis: EKG "PericarditiS":PR depression in precordial leads.ST elevation.

Jugular venous pressure (JVP) elevation: causes HOLT:Grab Harold Holt around the neck and throw him in the ocean:Heart failureObstruction of venea cavaLymphatic enlargement - supraclavicularIntra-Thoracic pressure increase

MI: therapeutic treatment MONAH:MorphineOxygenNitrogenAspirinHeparin

Depressed ST-segment: causes DEPRESSED ST:Drooping valve (MVP)Enlargement of LV with strainPotassium loss (hypokalemia)Reciprocal ST- depression (in I/W AMI)Embolism in lungs (pulmonary embolism)Subendocardial ischemiaSubendocardial infarctEncephalon haemorrhage (intracranial haemorrhage)Dilated cardiomyopathyShockToxicity of digitalis, quinidine

Aortic stenosis characteristics SAD:SyncopeAnginaDyspnoea

MI: basic management BOOMAR:Bed restOxygenOpiateMonitorAnticoagulateReduce clot size

ECG: left vs. right bundle block "WiLLiaMMaRRoW":W pattern in V1-V2 and M pattern in V3-V6 is Left bundleblock.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 RIND:Collagen vascular diseaseAortic aneurysmRadiationDrugs (such as hydralazine)InfectionsAcute renal failureCardiac infarctionRheumatic feverInjuryNeoplasmsDressler's syndrome

Murmurs: systolic types SAPS:Systolic

AorticPulmonicStenosis· Systolic murmurs include aortic and pulmonary stenosis.· Similarly, it's common sense that if it is aortic and pulmonary stenosis itcould also be mitral and tricusp regurgitation].

MI: signs and symptoms PULSE:Persistent chest painsUpset stomachLightheadednessShortness of breathExcessive sweating

Heart compensatory mechanisms that 'save' organ blood flow duringshock "Heart SAVER":Symphatoadrenal systemAtrial natriuretic factorVasopressinEndogenous digitalis-like factorRenin-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:ElectrolytesLBBB

Early repolarizationVentricular hypertrophyAneurysmTreatment (eg pericardiocentesis)Injury (AMI, contusion)Osborne waves (hypothermia)Non-occlusive vasospasm

Beck's triad (cardiac tamponade) 3 D's:Distant heart soundsDistended jugular veinsDecreased arterial pressure