Aorta vs. vena cava: right vs. left

- (When looking at the patient from the anterior side.) Aorta and right each have 5 letters, so aorta is on the right. Vena and cava and left each have 4 letters, so vena cava is on the left

Aortic regurgitation: causes

Congenital Rheumatic damage Endocarditis Aortic dissection/ Aortic root dilatation Marfan’s

Aortic stenosis characteristics

Syncope Angina Dyspnoea SAD

Aortic to left Subclavian path

Aortic arch gives rise to: Brachiocephalic trunk left Common Carotid left Subclavian ABC'S

Apex beat: abnormalities found on palpation, causes of impalpable

Heaving Impalpable Laterally displaced Thrusting/ Tapping If it's impalpable, causes are COPD COPD

Atrial Arrhythmias

Beta blockers: To block the effects of certain hormones on the heart to slow the heart rate. Calcium Channel Blockers: Help slow the heart rate by blocking the number of electrical impulses that pass through the AV node into the lower heart chambers (ventricles). Digoxin: Helps slow the heart rate by blocking the number of electrical impulses that pass through the AV node into the lower heart chambers (ventricles). Electrocardioversion: A procedure in which electric currents are used to reset the heart's rhythm back to regular pattern. Anticoagulants: To prevent embolization.

Atrial Fibrillation causes

Pulmonary: PE, COPD Iatrogenic Rheumatic heart: mirtral regurgitation Atherosclerotic: MI, CAD Thyroid: hyperthyroid Endocarditis

Atrial fibrillation management

Anti-coagulate Beta-block to control rate Cardiovert Digoxin ABCD

Beck's triad (cardiac tamponade)

- 3 D's: Distant heart sounds Distended jugular veins Decreased arterial pressure

Betablockers: cardioselective betablockers

Betaxolol Acebutelol Esmolol Atenolol Metoprolol

CHF Treatment

Lasix Morphine Nitrites Oxygen VassoPressors

CHF: causes of exacerbation

Forgot medication Arrhythmia/ Anaemia Ischemia/ Infarction/ Infection Lifestyle: taken too much salt Upregulation of CO: pregnancy, hyperthyroidism Renal failure

Complications of Myocardial Infarction

Death Arrythmia Rupture(free ventricular wall/ ventricular septum/ papillary muscles) Tamponade Heart failure (acute or chronic) Valve disease

Coronary artery bypass graft: indications

Depressed ventricular function Unstable angina Stenosis of the left main stem Triple vessel disease DUST

ECG: left vs. right bundle block

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. WiLLiaM MaRRoW

Exercise ramp ECG: contraindications

Recent MI Aortic stenosis MI in the last 7 days Pulmonary hypertension RAMP

Heart blocks

Longer, longer, longer, drop! Then you have a Wenkebach. if some P's don't get through, then you have Mobitz II. If P's and Q's don't agree, then you have a Third Degree. If the R is far from P, then you have a First Degree.

Heart valve sequence

Tricuspid Pulmonary Mitral (bicuspid) Aorta Try Puling My Aorta

Infarctions

IV access Narcotic analgesics (e.g. morphine, pethidine) Facilities for defibrillation (DF) Aspirin/ Anticoagulant (heparin) Rest Converting enzyme inhibitor

JVP: wave form

Atrial contraction Systole (ventricular contraction) Klosure (closure) of tricusps, so atrial filling Maximal atrial filling Emptying of atrium

MI: basic management

Bed rest Oxygen Opiate Monitor Anticoagulate Reduce clot size

MI: signs and symptoms

Persistent chest pains Upset stomach Lightheadedness Shortness of breath Excessive sweating

MI: therapeutic treatment

Oxygen Beta blocker ASA Thrombolytics (e.g. heparin) Morphine Ace prn

MI: treatment of acute MI

Cyclomorph Oxygen Aspirin Glycerol trinitrate COAG

Murmur attributes

Intensity Location Pitch Quality Radiation Shape

Murmurs: innocent murmur features

Soft Systolic Short Sounds (S1 & S2) normal Symptomless Special tests normal (X-ray, EKG)

Murmurs: louder with inspiration vs expiration

RIght sided murmurs louder with Inspiration. LEft sided murmurs louder with Expiration

Murmurs: questions to ask

Site Character (e.g. harsh, soft, blowing) Radiation Intensity Pitch Timing

Murmurs: systolic vs. diastolic

- MS. PAID Mitral Stenosis Pulmonic or Aortic Insufficiency -> Diastolic.

Pericarditis: EKG

PR depression in precordial leads. ST elevation. PericarditiS

Pericarditis: causes

Collagen vascular disease Aortic aneurysm Radiation Drugs (such as hydralazine) Infections Acute renal failure

Peripheral vascular insufficiency: inspection criteria

Symmetry of leg musculature Integrity of skin Color of toenails Varicose veins Distribution of hair

Pulseless electrical activity: causes

Pulmonary embolus Acidosis Tension pneumothorax Cardiac tamponade Hypokalemia/ Hyperkalemia/ Hypoxia/ Hypothermia/ Hypovolemia Myocardial infarction

ST elevation causes in ECG

Electrolytes LBBB Early repolarization Ventricular hypertrophy Aneurysm Treatment (e.g. pericardiocentesis)

Supraventricular tachycardia: treatment

Adenosine Beta-blocker Calcium channel antagonist Digoxin Excitation (vagal stimulation)

Ventricular tachycardia: treatment

Lidocaine Amiodarone Mexiltene/ Magnesium Beta-blocker LAMB: