CARDIOVASCULAR SYSTEM MNEMONICS | INTERNAL MEDICINE

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Acute Coronary Syndrome initial treatment : "ABCD"
A - Aspirin
B - Beta blocker
C - Coagulation (anticoagulation with heparin/LMW Heparin)
D - Double product control (decrease heart rate and blood pressure)

Acute MI treatment : "COAG"
C - Cyclomorph
O - Oxygen
A - Aspirin
G - Glycerol trinitrate

Anti-arrythmics for AV nodes : "Dracula Blocked All Vampires"
Digoxin
B-blockers
Adenosine
Verapamil

Aortic dissection risk factors: "ABC"

A - Atherosclerosis/ Ageing/ Aortic aneurysm

B - Blood pressure high/ Baby (pregnancy)

C - Connective tissue disorders (eg Marfan's, Ehlers-Danlos)/ Cystic medial necrosis

Aortic Regurgitation Causes : "CREAM"
C - Congenital
R - Rheumatic damage
E - Endocarditis
A - Aortic dissection/ Aortic root dilatation
M - Marfan's

Causes Of Aortic Regurgitation : "MARRIS"
M - Marfans
A - Ankylosing spondylitis
R - Rheumatic fever
R - Rheumatoid arthritis
I - Infective endocarditis
S - Syphilis

Characteristics Of Aortic stenosis : "SAD"
S - Syncope
A - Angina
D - Dyspnoea

Apex Beat Differential for Impalpable Apex Beat: "DOPES"
D - Dextrocardia
O - Obesity
P - Pericarditis/ Pericardial tamponade/ Pneumothorax
E - Emphysema
S - Sinus inversus/Student incompetence/Scoliosis/Skeletal abnormalities (eg pectus excavatum)

Causes Of Atrial Fibrillation : "PIRATES"
P - Pulmonary : PE, COPD
I - Iatrogenic
R - Rheumatic heart : mirtral regurgitation
A - Atherosclerotic : MI, CAD
T - Thyroid : hyperthyroid
E - Endocarditis
S - Sick sinus syndrome

Atrial Fibrillation Management: "ABCD"
A - Anti-coagulant
B - Beta-block to control rate
C - Cardiovert
D - Digoxin

Beck's triad (cardiac tamponade): "3 Ds"
Distant heart sounds
Distended jugular veins
Decreased arterial pressure

Betablockers, Cardioselective Betablockers : "Betablockers Acting Exclusively At Myocardium"
Cardioselective Betablockers are
Betaxolol
Acebutelol
Esmolol
Atenolol
Metoprolol

Components Of CBC (Complete Blood Count) : "HELPR"
H - H/H (Hemoglobin/Hematocrit)
E - Erythrocytes (RBCs)
L - Leukocytes (WBCs)
P - Platelets
R - R/R (reticulocytes/RBC indices)

CHF Left-sided systolic failure signs and symptoms : "Honey!Please Leave Some Cold Dry Fruits On Hot Cakes"
High heart rate
Pink Sputum
Loss of hair on legs
Skin cold and clammy
Cyanosis
Dyspnea
Fatigue
Orthopnea
HTN
Crackles

CHF Causes of Exacerbation : "A SMITH PEAR"
Anemia
Salt/ Stress/ Stopping meds
MI
Infection/ Ischemia
Thyroid (high/low)
HTN
Pericarditis
Endocarditis (valve disease)
Arrhythmia
Rx (beta blocker, etc)

CHF causes of exacerbation : "FAILURE"
F - Forgot medication
A - Arrhythmia/ Anaemia
I - Ischemia/ Infarction/ Infection
L - Lifestyle: taken too much salt
U - Upregulation of CO: pregnancy, hyperthyroidism
R - Renal failure
E - Embolism: pulmonary

Categories Of Cardiomyopathy : "HARD"
H - Hypertrophic cardiomyopathy
A - Arrhythmogenic right ventricular cardiomyopathy
R - Restrictive cardiomyopathy
D - Dilated cardiomyopathy

Coronary Artery bypass Graft Indications: "DUST"
D - Depressed ventricular function
U - Unstable angina
S - Stenosis of the left main stem
T - Triple vessel disease

Causes Of Depressed ST-Segment: "DEPRESSED ST"
D - Drooping valve (MVP)
E - Enlargement of LV with strain
P - Potassium loss (hypokalemia)
R - Reciprocal ST- depression (in I/W AMI)
E - Embolism in lungs (pulmonary embolism)
S - Subendocardial ischemia
S - Subendocardial infarct
E - Encephalon haemorrhage (intracranial haemorrhage)
D - Dilated cardiomyopathy
S - Shock
T - Toxicity of digitalis, quinidine

Causes of ECG T wave Inversion: "INVERT"
I - Ischemia
N - Normality [esp. young, black]
V - Ventricular hypertrophy
E - Ectopic foci [eg calcified plaques]
R - RBBB, LBBB
T - Treatments [digoxin]

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.

EKG 12 lead EKG quick interpretation of V1-V6 : "SSAALL"
Elevations matched with their classic location of MI
V1 Septal
V2 Septal
V3 Anterior
V4 Anterior
V5 Lateral
V6 Lateral

Exercise ramp ECG Contraindications: "RAMP"
R - Recent MI
A - Aortic stenosis
M - MI in the last 7 days
P - Pulmonary hypertension

Heart compensatory mechanisms that Save organ blood flow during shock : "SAVER"
S - Symphatoadrenal system
A - Atrial natriuretic factor
V - Vasopressin
E - Endogenous digitalis-like factor
R - Renin-angiotensin-aldosterone system
In all 5, system is activated/factor is released

Causes of Heart failure : "HEART FAILED"
H - Hypertension
E - Endocrine
A - Anemia
R - Rheumatic heart disease
T - Toxins
F - Failure to take meds
A - Arrythmia
I - Infection
L - Lung (PE, pneumonia)
E - Electrolytes
D - Diet

Signs of Heart failure: "TAPED TORCH"
T - Tachycardia
A - Ascites
P - Pulsus alternans
E - Elevated jugular venous pressure
D - Displaced apex beat
T - Third heart sound
O - Oedema
R - Right ventricular heave
C - Crepitations or wheeze
H - Hepatomegaly (tender)

Heart Murmurs: "hARD ASS MRS. MSD"
hARD : Aortic Regurg = Diastolic
ASS : Aortic Stenosis = Systolic
MRS : Mitral Regurg = Systolic
MSD : Mitral Stenosis = Diastolic

JVP wave Form : "ASK ME"
A - Atrial contraction
S - Systole (ventricular contraction)
K - Klosure (closure) of tricusps, so atrial filling
M - Maximal atrial filling
E - Emptying of atrium

Causes of Jugular Venous Pressure (JVP) Elevation : "Lies Of The Heart"
Lymphatic enlargement , supraclavicular
Obstruction of venea cava
intraThoracic pressure increase
Heart failure

Basic Management Of Myocardial Infarction : "BOOMAR"
B - Bed rest
O - Oxygen
O - Opiate
M - Monitor
A - Anticoagulant
R - Reduce clot size

Signs and Symptoms of Myocardial Infarction: "PULSE"
P - Persistent chest pains
U - Upset stomach
L - Lightheadedness
S - Shortness of breath
E - Excessive sweating

Therapeutic Treatment of Myocardial Infarction : "ROAMBAL"
R - Reassure
O - Oxygen
A - Aspirin
M - Morphine (diamorphine)
B - Beta blocker
A - Arthroplasty
L - Lignocaine

Attributes of Heart Murmurs : "I Like PQRST"
Intensity
Location
Pitch
Quality
Radiation
Shape
Timing

Features of Innocent Heart Murmur: "8 Ss"
Soft
Systolic
Short
Sounds (S1 & S2) normal
Symptomless
Special tests normal (X-ray, EKG)
Standing/ Sitting (vary with position)
Sternal depression

Locations and Descriptions of Heart Murmurs : "MRS ASS"
MRS : Mitral Regurgitation-Systolic
ASS : Aortic Stenosis-Systolic
The other two murmurs, Mitral stenosis and Aortic regurgitation, are obviously Diastolic.

Murmurs questions to ask : "SCRIPT"
S - Site
C - Character (eg harsh, soft, blowing)
R - Radiation
I - Intensity
P - Pitch
T - Timing

Murmurs right vs. left loudness : "RILE"

Right sided heart murmurs are louder on Inspiration.

Left sided heart murmurs are loudest on Expiration.

Systolic Murmurs : "MR. PV TRAPS"
M - Mitral
R - Regurgitation and
P - Prolaspe
V - VSD
T - Tricupsid
R - Regurgitation
A - Aortic and
P - Pulmonary
S - Stenosis

Types of Systolic Murmurs: "SAPS"
Systolic
Aortic
Pulmonic
Stenosis
Systolic murmurs include Aortic and Pulmonary stenosis.

Similarly, its common sense that if it is Aortic and Pulmonary Stenosis it could also be Mitral and Tricusp Regurgitation

Murmurs Systolic vs. Diastolic: "PASS"

Pulmonic & Aortic Stenosis = Systolic.

"PAID"

Pulmonic & Aortic Insufficiency = Diastolic.

Myocardial Infarction Treatment: "MONA"
M : Morphine
O : Oxygen
N : Nitroglycerin
A : Aspirin

Myocardial Infarctions Treatment : "INFARCTIONS"
I - IV access
N - Narcotic analgesics (eg morphine, pethidine)
F - Facilities for defibrillation (DF)
A - Aspirin/ Anticoagulant (heparin)
R - Rest
C - Converting enzyme inhibitor
T - Thrombolysis
I - IV beta blocker
O - Oxygen 60%
N - Nitrates
S - Stool Softeners

Pericarditis EKG : "PericarditiS"

PR depression in precordial leads to ST elevation

Causes of Pericarditis : "CARDIAC RIND"
C - Collagen vascular disease
A - Aortic aneurysm
R - Radiation
D - Drugs (such as hydralazine)
I - Infections
A - Acute renal failure
C - Cardiac infarction
R - Rheumatic fever
I - Injury
N - Neoplasms
D - Dressler's syndrome

Peripheral vascular insufficiency inspection criteria : "SICVD"
Symmetry of leg musculature
Integrity of skin
Color of toenails
Varicose veins
Distribution of hair

Causes of Pulseless Electrical activity : "MATCH PED"
M - Myocardial infarction
A - Acidosis
T - Tension pneumothorax
C - Cardiac tamponade

H - Hypokalemia/ Hyperkalemia/ H - Hypoxia/ Hypothermia/ H - Hypovolemia

P - Pulmonary embolus
E - Electrolyte derangements
D - Drugs

Right to Left shunt : "4 Ts"
T : Tetrology of fallot
T : Tricuspid atresia
T : Truncus Arteriosus
T : Transposition of great vessels

ST elevation Causes : ECG "ELEVATION"
E - Electrolytes
L - LBBB
E - Early repolarization
V - Ventricular hypertrophy
T - Aneurysm
T - Treatment (eg pericardiocentesis)
I - Injury (AMI, contusion)
O - Osborne waves (hypothermia)
N - Non-occlusive vasospasm

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

Sinus bradycardia aetiology : "SINUS BRADICARDIA"
S - Sleep
I - Infections (myocarditis)
N - Neap thyroid (hypothyroid)
U - Unconsciousness (vasovagal syncope)
S - Subnormal temperatures (hypothermia)
B - Biliary obstruction
R - Raised CO2 (hypercapnia)
A - Acidosis
D - Deficient blood sugar (hypoglycemia)
I - Imbalance of electrolytes
C - Cushing's reflex (raised ICP)
A - Aging
R - Rx (drugs, such as high-dose atropine)
D - Deep anaesthesia
I - Ischemic heart disease
A - Athletes

Sinus tachycardia : "TACH FEVER"
T - Tamponade/ Thyrotoxicosis
A - Anemia
C - CHF
H - Hypotension
F - Fever
E - Excrutiating pain
V - Volume depletion
E - Exercise
R - Rx (Theo, Dopa, Epi, etc)

Supraventricular tachycardia treatment : "ABCDE"
A - Adenosine
B - Beta-blocker
C - Calcium channel antagonist
D - Digoxin
E - Excitation (vagal stimulation)

Tetrology of Fallot : "PROVe"
P : Pulmonary stenosis
R : Right ventricular hypertrophy
O : Overriding aorta
Ve : Ventricular septal defect

Ventricular tachycardia treatment : "LAMB"
L - Lidocaine
A - Amiodarone
M - Mexiltene/ Magnesium
B - Beta-blocker

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