I n t e r n al Me di c i n eCa r d i o v a s c u l a r Mn emo ni c s
Aortic stenosis characterist characteristics ics SAD: Syncope Angina Dyspnoea
MI: basic management BOOMAR : Bed rest Oxygen O piate Monitor Anticoagulate educe clot size R educe ECG: left vs. right bunle bloc! ""i##iaM MaRR o"": " pattern in V1-V2 and M pattern in V3-V6 is #eft bundle block. ight bundle block. M pattern in V1-V2 and " in V3-V6 is R ight !ote: consider bundle branch blocks hen #$% co&plex is ide. '(--)if (support*ine+ (support*ine+reak!e*ine,-- reak!e*ine,-- '(--)endif,--
$ericaritis: causes CARDIAC RI%D: $ericaritis: Collagen ascular disease Aortic aneurys& adiation R adiation Drugs /such as hydralazine0 Infections Acute renal failure Cardiac infarction heu&atic feer R heu&atic Inury %eoplas&s Dresslers syndro&e
Murmurs: s&stolic t&'es SA$S: Systolic Aortic $ul&onic Stenosis %ystolic &ur&urs include aortic and pul&onary stenosis. %i&ilarly %i&ilarly its co&&on sense that if it is aortic and pul&onary stenosis it could also be &itral and tricusp regurgitation,. '(--)if (support*ine+ (support*ine+reak!e*ine,-- reak!e*ine,-- '(--)endif,--
MI: signs an s&m'toms $(#SE: $ersistent chest pains ( pset sto&ach #ightheadedness Shortness of breath Excessie seating '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
)eart com'ensator& mechanisms that *save* organ bloo flo+ uring shoc! "4eart SA,ER ": Sy&phatoadrenal syste& Atrial natriuretic factor ,asopressin Endogenous digitalis-like factor R enin-angiotensin-aldosterone syste& 5n all syste& is actiated7factor is released '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
Murmurs: right vs. left louness "RI#E": R ight sided heart &ur&urs are louder on Inspiration. #eft sided heart &ur&urs are loudest on Expiration. '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
S- elevation causes in ECG E#E,A-IO% : Electrolytes #+++ Early repolarization ,entricular hypertrophy Aneurys& -reat&ent /eg pericardiocentesis0 Inury /895 contusion0 Osborne aes /hypother&ia0 %on-occlusie asospas& '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
Bec!*s tria cariac tam'onae/ 3 s: Distant heart sounds Distended ugular eins Decreased arterial pressure
'(--)if (support*ine+reak!e*ine,-- '(--)endif,-- MI: thera'eutic treatment ROAMBA#: R eassure Oxygen Aspirin Morphine /dia&orphine0
Beta blocker Arthroplasty #ignocaine
C)0: causes of e1acerbation 0AI#(RE: 0orgot &edication Arrhyth&ia7 Anae&ia Ische&ia7 Infarction7 Infection #ifestyle: taken too &uch salt ( pregulation of ;<: pregnancy hyperthyroidis& R enal failure E&bolis&: pul&onary '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
Murmurs: s&stolic vs. iastolic $ASS: $ul&onic = Aortic Stenosis>Systolic. $AID: $ul&onic = Aortic Insufficiency> Diastolic.
Murmurs: s&stolic vs. iastolic %ystolic &ur&urs: MR AS: "MR . ASner". iastolic &ur&urs: MS AR : "MS. AR den". ?he fa&ous people ith those surna&es are 9r. @d 8sner and 9s. Aane 8rden. '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
MI: thera'eutic treatment "O BA-MA%(": Oxygen Beta blocker A%8 -hro&bolytics /eg heparin0 Morphine Ace prn %itroglycerin '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
Mitral stenosis MS/ vs. regurgitation MR/: e'iemiolog& MS is a fe&ale title / Ms.0 and it is fe&ale predo&inant. MR is a &ale title / Mr.0 and it is &ale predo&inant. '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
$ericaritis: E2G "$ericarditi S": $$ depression in 'recordial leads. S? eleation. '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
3ugular venous 'ressure 3,$/ elevation: causes )O#-: Brab 4arold 4olt around the neck and thro hi& in the ocean: )eart failure O bstruction of enea caa #y&phatic enlarge&ent - supraclaicular 5ntra--horacic pressure increase
MI: thera'eutic treatment MO%A): Morphine Oxygen %itrogen Aspirin )eparin '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
De'resse S-4segment: causes DE$RESSED S- : Drooping ale /9VC0 Enlarge&ent of *V ith strain $otassiu& loss /hypokale&ia0 R eciprocal %?- depression /in 57D 8950 E&bolis& in lungs /pul&onary e&bolis&0 Subendocardial ische&ia Subendocardial infarct Encephalon hae&orrhage /intracranial hae&orrhage0 Dilated cardio&yopathy Shock -oxicity of digitalis Euinidine
Murmurs: innocent murmur features F %s: Soft Systolic Short Sounds /%1 = %20 nor&al Sy&pto&less S pecial tests nor&al /G-ray @HB0 Standing7 Sitting /ary ith position0 Sternal depression '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
Murmur attributes "I# $5RS-" /person has ill C#$%? heart aes0: Intensity #ocation $itch 5uality
R adiation Shape -i&ing '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
Murmurs: locations an escri'tions "MRS A66": MRS: Mitral R egurgitation-- Systolic A66: Aortic Stenosis--Systolic ?he other to &ur&urs 9itral stenosis and 8ortic regurgitation are obiously diastolic. '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
Betabloc!ers: carioselective betabloc!ers "Betablockers Acting Exclusiely At Myocardiu&" ;ardioselectie betablockers are: Betaxolol Acebutelol Es&olol Atenolol Metoprolol '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
A'e1 beat: abnormalities foun on 'al'ation7 causes of im'al'able )I#-: )eaing I&palpable #aterally displaced -hrusting7 -apping 5f it is i&palpable causes are CO$D: C
MI: treatment of acute MI COAG: Cyclo&orph Oxygen Aspirin Glycerol trinitrate '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
Coronar& arter& b&'ass graft: inications D(S-: Depressed entricular function (nstable angina Stenosis of the left &ain ste& -riple essel disease
'(--)if (support*ine+reak!e*ine,-- '(--)endif,--
$eri'heral vascular insufficienc&: ins'ection criteria SIC,D: Sy&&etry of leg &usculature Integrity of skin Color of toenails ,aricose eins Distribution of hair '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
Rheumatic fever: Revise 3ones* criteria 3O%ES cr I-ERIA: 9aor criteria: 3oint /arthritis0 O bious /;ardiac0 %odule /$heu&atic0 Erythe&a &arginatu& Sydenha& chorea 9inor criteria: Infla&&atory cells /leukocytosis0 -e&perature /feer0 E%$7;$C eleated R aised C$ interal Itself /preious 4x of $heu&atic feer0 Arthralgia '(--)if (support*ine+reak!e*ine,-- '(--)endif,--
)eart murmurs "hARD ASS MRS. MSD ": h8$: Aortic R egurg > Diastolic 8%%: Aortic Stenosis > Systolic 9$%: Mitral R egurg > Systolic 9%: Mitral Stenosis > Diastolic
Rheumatic fever: Revise 3ones criteria 3O%ES $EACE : 9aor criteria: 3oints: &igratory O /heart shaped0 ;arditis: ne onset &ur&ur %odules subcutaneous: extensor surfaces Erythe&a &arginatu& Sydenha&s chorea 9inor criteria: $$ interal prolonged E%$ eleated Arthralgias C$C eleated
Eleated te&perature /feer0 !eed 2 &aor or 1 &aor and 2 &inor criteria plus eidence of recent B8% infection /throat cx rapid antigen test or rising strep antibody titer0.
$ulseless electrical activit&: causes $A-C) MED: $ul&onary e&bolus Acidosis -ension pneu&othorax Cardiac ta&ponade )ypokale&ia7 )yperkale&ia7 )ypoxia7 )ypother&ia7 )ypoole&ia Myocardial infarction Electrolyte derange&ents Drugs
Coronar& arter& b&'ass graft: inications D(S-: Depressed entricular function (nstable angina Stenosis of the left &ain ste& -riple essel disease
E1ercise ram' ECG: contrainications RAM$: R ecent 95 Aortic stenosis M5 in the last I days $ul&onary hypertension
ECG: - +ave inversion causes I%,ER-: Ische&ia %or&ality )esp. young black, ,entricular hypertrophy Ectopic foci )eg calcified plaEues, R +++ *+++ -reat&ents )digoxin,
M&ocarial infarctions: treatment I%0ARC-IO%S: IV access %arcotic analgesics /eg &orphine pethidine0 0acilities for defibrillation /J0 Aspirin7 Anticoagulant /heparin0 R est Conerting enzy&e inhibitor
-hro&bolysis IV beta blocker Oxygen 6KL %itrates Stool %ofteners
Atrial fibrillation: causes $IRA-ES : $ul&onary: C@ ;
Atrial fibrillation: management ABCD: Anti-coagulate Beta-block to control rate Cardioert Digoxin
Murmurs: louer +ith ins'iration vs e1'iration *Eft sided &ur&urs louder ith Expiration $ Ight sided &ur&urs louder ith Inspiration.
Murmurs: 8uestions to as! SCRI$-: Site Character /eg harsh soft bloing0 R adiation Intensity $itch -i&ing
$ericaritis: causes $R DI$7 S- ($ : $ost-pericardiecto&y
R heu&atic feer Drugs /eg isoniazid hydralazine procainal&ide0 Infection /eg ?+ coxsackie strep0 $@ S*@7%cleroder&a -u&ours7 -hyroid disease (rae&ia $ost 95 /includes resslers0
Aortic issection: ris! factors ABC: Atherosclerosis7 Ageing7 Aortic aneurys& Blood pressure high7 Baby /pregnancy0 Connectie tissue disorders /eg 9arfans @hlers-anlos07 Cystic &edial necrosis
)eart failure: causes )EAR- 0AI#ED: )ypertension Endocrine Ane&ia R heu&atic heart disease -oxins 0ailure to take &eds Arryth&ia Infection #ung /C@ pneu&onia0 Electrolytes Diet
