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Memorising Medicine - Mnemonics > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Causes of aortic stenosis

A

CRABS (increasing age)

Congenital (congenital ring, HOCM, Williams syndrome)
Rheumatic fever (esp females and rheumatoid arthritis)
Atherosclerosis
Bicuspid AV calcification (40-60)
Senile calcific degeneration (60+)

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2
Q

Aortic stenosis - PC

A 
Angina
Arrhythmias
LVH
Exertional syncope
Emboli - TIA/ stroke
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3
Q

Aortic stenosis - Ix

A

ECG, CXR, Echo, Catheter

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4
Q

Aortic stenosis - Rx and contraindicated drugs

A

Medical - statins, antiplatelet
Contraindicated meds - nitrates, ACE inhib., Ca antagonists

SBE prophylaxis

Surgical - Valvuplasty, valve replacement, myomectomy

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5
Q

Causes of aortic regurgitation

A
  1. Ring dilation -
    a) pressure: hypertension, aortic dissection, trauma
    b) Weak connective tissue eg ehlos danlos or marfans, syphilis, cor bovium
  2. Cusp contraction -
    a) infection: Rheum fever, infective endocarditis
    b) autoimmune: seronegative arthropathies eg. ank spondylitis, Reiter’s
    c) toxins: cabergoline, pergolide
  3. Poor fitting
    a) biscupid aortic valve disease
    b) supracrital VSD
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6
Q

Aortic Regurgitation - PC

A
  1. Arrhythmias
  2. Emboli (from vegetation), TIA: amaurosis fugax, CVA
  3. Eccentric LVH, LVF, RVF
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7
Q

Aortic Regurgitation - Ix

A

ECG, CXR, Echo, Catheter

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8
Q

Aortic Regurgitation - Tx

A

Medical: Nifedipine (avoid in HF), ACE inhibitors

SBE prophylaxis

Surgical: valve replacement

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9
Q

Presentation of mitral stenosis

A
  1. Left atrial enlargement – AF, hoarseness, dysphasia, bronchiectasis
  2. emboli
  3. pulmonary oedema/recurrent respiratory tract infection
  4. pulmonary hypertension/RSH failure; ischaemia/cachexia
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10
Q

Mitral stenosis – investigations

A

ECG CXR echo catheter

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11
Q

Mitral stenosis – treatment

A
  1. Anticoagulate
  2. SBE prophylaxis
  3. surgical – closed valvotomy, open valvotomy, valve replacement
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12
Q

Causes of mitral regurgitation

A

a) Ring dilatation 1. LV dilatation (volume overload; AR, pressure overload; AS, HT)
2. Cardiomyopathy: HOCM, dilated, restrictive
3. Trauma/mechanical valve leak

b) Cusp contraction 1. infection e.g. rheumatic fever, SBE
2. Autoimmune e.g. RA, SLE, ankylosing spondylitis
3. ASD, primum
4. Senile calcification degeneration

c) subvalvular apparatus dysfunction e.g. MI, mitral valve prolapse (Marfan’s, VSD, polycystic kidney disease, straight back, ischaemic heart disease, neuroses/women)

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13
Q

Mitral regurgitation – PC

A
  1. AF
  2. pulmonary oedema/recurrent RTI
  3. pulmonary hypertension/RSH failure
  4. MVP PC – chest pain, palpitations, syncope, SOB, fatigue
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14
Q

Mitral regurgitation – Ix

A

ECG CXR echo catheter

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15
Q

Mitral regurgitation - Rx

A

Anticoagulate in AF, SBE prophylaxis, surgical valve replacement

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16
Q

Causes of atrial fibrillation

A

A.T.R.I.A.L S.W.I.T.C.H

Acute: PE, MRI, infection, post surgery
Thyrotoxicosis
Rheumatic heart disease
Ischaemic heart disease
ABP increased/alcohol/ASD/aortic regurgitation
Lung: bronchial carcinoma, PE
Sick sinus syndrome
Wolff Parkinson White syndrome
Inflammation: pericarditis, myocarditis, endocarditis
Toxin: digoxin toxicity
Cardiomyopathy e.g. sarcoid
Cancer: atrial myxoma
Hypokalaemia
17
Q

Pathophysiology of AF

A

Parts of the atria lose their refractoriness before the end of atrial systole enabling recurrent but unco-ordinated atrial contraction.

This may be due to atrial enlargement, conduction velocity decreased e.g. information, fibrosis, decreased refractory period e.g. ischaemia, T4, sympathetic tone increase

18
Q

Management of AF

A
  1. Underlying cause
  2. Rate control – beta-blocker, diltiazem, digoxin
  3. Rhythm control – amiodarone, flecainide if no ischaemic or structural heart disease, cardioversion
  4. Anticoagulation – CHADSVASC
19
Q

Causes of ventricular tachycardia

A

I.M. Q.V.I.C.K

Infarction
Myocarditis

QT interval increased
Valve abnormality: mitral valve prolapse, aortic stenosis.
Iatrogenic – Digoxin, antiarrhythmics, catheterisation, surgery.
Cardiomyopathy, especially dilated.
K+ low, Mg2+ low, O2 low, acidosis

20
Q

Causes of bradycardia

A

D.I.V.I.S.I.O.N.S.

Drugs - (ABCD) antiarrhythmic’s, beta-blockers.calcium antagonists, digoxin

Ischaemia/infarction – inferior or anteroseptal MI

Vagus hypotonia – athletes, vasovagal syncope, hypersensitive carotid sinus syndrome.

Infection

Sick sinus syndrome

Infiltration – restrictive or dilated cardiomyopathy e.g. sarcoid, haemochromatosis, amyloid, muscular dystrophy.

O – hypOthyroidism, hypOkalaemia, hypOthermia, obstructive jaundice

Neuro: raised intracranial pressure

Septal defect: ASD; Surgery or catheterisation

21
Q

MI – Complications

A 
S  -  Sudden death 
P  -  Pump failure / Pericarditis 
R  -  Rupture papillary muscles or septum 
E  -  Embolism 
A  -  Aneurysm / Arrhythmias 
D  -  Dressler’s syndrome
22
Q

Causes of shock

A

S.H.O.C.K.I.N.G.

Septic

Hypovolaemia

Organ failure

Cardiogenic

K anaphylaxis

Iatrogenic – blood transfusion: haemolytic reaction, anaesthesia, drugs

Neurogenic – pain, stroke, seizure, autonomic neuropathy

Glands – diabetes mellitus, diabetes insipidus, Addison’s disease, hypothyroidism

23
Q

Causes of hypertension

A

P.R.E.D.I.C.T.I.O.N

Primary – essential or isolated systolic

Renal – vascular, glomerulonephritis or tubular nephritis, structural (APKD, tumour)

Endocrine - stress hormones (epinephrine, cortisol, GH, T4); hypermineralocorticoidism (hyper/hypo aldosteronism), other (somatostatinoma, hyperPTHism, ACP)

Drugs

Intracranial pressure

Co-optation of aorta

Toxaemia of pregnancy

Increased viscosity

Overloaded with fluid

Neurogenic

24
Q

End organ damage of hypertension

A

C.A.R.N.A.G.E

Cardiac – IHD, LVH, CCF, AR, MR

Aortic – aneurism comedy section

Renal – proteinuria, chronic renal failure

Neurological – CVA, headache, dizzy, syncope

Anaemia

GIT – N and V

Eyes – retinopathy

25
Q

Causes of heart failure

A

Fluid overload – iatrogenic, renal failure

High-output – hyperdynamic circulation (ATPmoleculeS)
anaemia, alcohol, AVM, aortic regurgitation
thyrotoxicosis, temperature, toxins
pregnancy, proliferative,
severe obesity, systemic e.g. CO2 retention, cirrhosis

Low output – LVH or RVH

26
Q

Causes of cardiogenic shock

A

T.H.E. C.H.O.P. M.E.A.T

Tension pneumothorax

Hypovolaemia

Electrolytes (increased calcium, decreased potassium, acidosis)

Cardiac tamponade

Hypothermia

Overdose/hypOxaemia

Pulmonary embolism

Myocardial infarction

Endocarditis, myocarditis, septicaemia

Arrhythmia

Toxins e.g. beta-blockers, verapamil

27
Q

Rheumatic fever – PC

A

Revised Jones criteria

P.A.S.S.E.S

Pancarditis

Arthritis

Subcutaneous nodules

Sydenham’s chorea

Erythaema marginatum

Streptococcal infection in recent past

Extra symptoms: fever, arthralgia
ESR increased (or WCC, CRP), increased PR interval
Ever had rheumatic fever before

28
Q

Causes of pericardial disease

A

I.A.M.H.U.R.T.I.N

Infection

Autoimmune

Myocardial infarction

Haemorrhage

Uraemia

Radiotherapy

Thyroid decreased/cholesterol increased

Iatrogenic: hydralazine

Neoplasia

29
Q

Pericardial effusion types

A

Transudative (congestive heart failure, myxoedema, Nephrotic syndrome),

Exudative (tuberculosis, spread from empyema)

Hemorrhagic (trauma, rupture of aneurysms, malignant effusion).

Chyle

Malignant (due to fluid accumulation caused by metastasis)

30
Q

Myxoma – PC

A

F.L.E.C.K.S.fall off

Failure, cardiac

Loss of consciousness or sudden death

Emboli: CVA, PVD, MRI

Clubbing

Koagulation: polycythaemia, thrombocytosis – DVT, PE

Systemic: fever, loss of weight, myalgia

31
Q

Pathology and causes of hypertrophic cardiomyopathy

A

H.O.C.M

Hypertrophy: asymmetric septal hypertrophy or concentric LVH

Obstruction: systolic anterior motion of anterior leaflet mitral valve

Catecholamine (neural crest cell disorder: associated hypertension, phaeochromocytoma) and calcium excess (impaired relaxation and diastolic failure)

Myosin: beta myosin heavy chain mutation

32
Q

Causes of dilated cardiomyopathy

A

DILATED

Dystrophy: primary, muscular dystrophy, myotonic dystrophy, glycogen storage disease

Infection: myocarditis

Late pregnancy: third trimester to 6 months postpartum

Autoimmune: SLE

Toxin: alcohol, cocaine, cyclophosphosamide and radiotherapy

Endocrine: dysthyroidism, acromegaly, Addison’s, diabetes

Diet: osteomalacia, selenium deficiency

33
Q

Causes of restrictive cardiomyopathy

A

SHAPEN

Sarcoidosis/systemic sclerosis

Haemochromatosis

Amyloidosus

Primary: endomyocardial fibrosis

Eosinophilia

Neoplasia: carcinoid, carcinoma,, lymphoma

34
Q

Pathophysiology of Fallot’s tetralogy

A

Failure of bulbis cordis to rotate

Pulmonary stenosis

Ventriculoseptal defects

Right ventricular hypertrophy

Overriding aorta

35
Q

Describe the murmur/cyanosis variability in fallots tetralogy

A

Through the pulmonary artery, so that: louder the murmur the less cyanosis

36
Q

CXR – radiological signs of heart failure

A

ABCD E

Airspace shadowing

kerley B lines

Cardiomegaly

Diversion blood to off load

Efusions

Memorising Medicine - Mnemonics (23 decks)

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