Aortic stenosis characteristics SAD: Syncope Angina Dyspnoea MI: basic management BOOMAR: Bed rest Oxygen Opiate

Monitor Anticoagulate Reduce clot size ECG: left vs. right bun le bloc! ""i##iaM MaRRo"": " pattern in V1-V2 and M pattern in V3-V6 is #eft bundle block. M pattern in V1-V2 and " in V3-V6 is Right bundle block. !ote: consider bundle branch blocks "hen #$% co&plex is "ide. $ericar itis: causes CARDIAC RI%D: Collagen 'ascular disease Aortic aneurys& Radiation Drugs (such as hydralazine) Infections Acute renal failure Cardiac infarction Rheu&atic fe'er In*ury %eoplas&s Dressler+s syndro&e Murmurs: s&stolic t&'es SA$S:

Systolic Aortic $ul&onic Stenosis %ystolic &ur&urs include aortic and pul&onary stenosis. %i&ilarly, it+s co&&on sense that if it is aortic and pul&onary stenosis it could also be &itral and tricusp regurgitation-. MI: signs an s&m'toms $(#SE: $ersistent chest pains (pset sto&ach #ightheadedness Shortness of breath Excessi'e s"eating )eart com'ensator& mechanisms that *save* organ bloo flo+ uring shoc! ".eart SA,ER": Sy&phatoadrenal syste& Atrial natriuretic factor ,asopressin Endogenous digitalis-like factor Renin-angiotensin-aldosterone syste& /n all 0, syste& is acti'ated1factor is released Murmurs: right vs. left lou ness "RI#E": Right sided heart &ur&urs are louder on Inspiration. #eft sided heart &ur&urs are loudest on Expiration. /f get confused about "hich is "hich, re&e&ber #IRE2liar "hich "ill be inherently false. S- elevation causes in ECG. E#E,A-IO%: Electrolytes

#333 Early repolarization ,entricular hypertrophy Aneurys& -reat&ent (eg pericardiocentesis) In*ury (45/, contusion) Osborne "a'es (hypother&ia) %on-occlusi'e 'asospas& Bec!*s tria /car iac tam'ona e0 3 6+s: Distant heart sounds Distended *ugular 'eins Decreased arterial pressure 11 MI: thera'eutic treatment ROAMBA#: Reassure Oxygen Aspirin Morphine (dia&orphine) Beta blocker Arthroplasty #ignocaine C)1: causes of e2acerbation 1AI#(RE: 1orgot &edication Arrhyth&ia1 Anae&ia Ische&ia1 Infarction1 Infection #ifestyle: taken too &uch salt (pregulation of 78: pregnancy, hyperthyroidis& Renal failure E&bolis&: pul&onary

Murmurs: s&stolic vs. iastolic $ASS: $ul&onic 9 Aortic Stenosis2Systolic. $AID: $ul&onic 9 Aortic Insufficiency2Diastolic. Murmurs: s&stolic vs. iastolic %ystolic &ur&urs: MR AS: "MR. ASner". 6iastolic &ur&urs: MS AR: "MS. ARden". :he fa&ous people "ith those surna&es are 5r. ;d 4sner and 5s. <ane 4rden. Mitral stenosis /MS0 vs. regurgitation /MR0: e'i emiolog& MS is a fe&ale title (Ms.) and it is fe&ale predo&inant. MR is a &ale title (Mr.) and it is &ale predo&inant. $ericar itis: E3G "$ericarditiS": $$ depression in 'recordial leads. S: ele'ation. 4ugular venous 'ressure /4,$0 elevation: causes )O#-: =rab .arold .olt around the neck and thro" hi& in the ocean: )eart failure Obstruction of 'enea ca'a #y&phatic enlarge&ent - supracla'icular /ntra--horacic pressure increase De'resse S-5segment: causes DE$RESSED S-: Drooping 'al'e (5V>) Enlarge&ent of ?V "ith strain $otassiu& loss (hypokale&ia) Reciprocal %:- depression (in /1@ 45/)

E&bolis& in lungs (pul&onary e&bolis&) Subendocardial ische&ia Subendocardial infarct Encephalon hae&orrhage (intracranial hae&orrhage) Dilated cardio&yopathy Shock -oxicity of digitalis, Auinidine 22 Murmurs: innocent murmur features B %+s: Soft Systolic Short Sounds (%1 9 %2) nor&al Sy&pto&less Special tests nor&al (C-ray, ;D=) Standing1 Sitting ('ary "ith position) Sternal depression Murmur attributes "I# $6RS-" (person has ill >#$%: heart "a'es): Intensity #ocation $itch 6uality Radiation Shape -i&ing Murmurs: locations an escri'tions "MRS A77": MRS: Mitral Regurgitation--Systolic A77: Aortic Stenosis--Systolic :he other t"o &ur&urs, 5itral stenosis and 4ortic regurgitation, are

ob'iously diastolic. Betabloc!ers: car ioselective betabloc!ers "Betablockers Acting Exclusi'ely At Myocardiu&" 7ardioselecti'e betablockers are: Betaxolol Acebutelol Es&olol Atenolol Metoprolol A'e2 beat: abnormalities foun on 'al'ation. causes of im'al'able )I#-: )ea'ing I&palpable #aterally displaced -hrusting1 -apping /f it is i&palpable, causes are CO$D: C8>6 Obesity $leural, $ericardial effusion Dextrocardia MI: treatment of acute MI COAG: Cyclo&orph Oxygen Aspirin Glycerol trinitrate Coronar& arter& b&'ass graft: in ications D(S-: Depressed 'entricular function

(nstable angina Stenosis of the left &ain ste& -riple 'essel disease $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 )eart murmurs "hARD ASS MRS. MSD": h4$6: Aortic Regurg 2 Diastolic 4%%: Aortic Stenosis 2 Systolic 5$%: Mitral Regurg 2 Systolic 5%6: Mitral Stenosis 2 Diastolic 33 Mitral regurgitation @hen you hear holosystolic &ur&urs, think "5$:.;5 4$; holosystolic &ur&urs". Sino5atrial no e: innervation Sy&pathetic acts on Sodiu& channels (%%). $arasy&pathetic acts on $otassiu& channels (>%). Su'raventricular tach&car ia: treatment ABCDE: Adenosine Beta-blocker Calciu& channel antagonist

Digoxin Excitation ('agal sti&ulation) ,entricular tach&car ia: treatment #AMB: #idocaine A&iodarone Mexiltene1 Magnesiu& Beta-blocker $ulseless electrical activit&: causes $A-C) MED: $ul&onary e&bolus Acidosis -ension pneu&othorax Cardiac ta&ponade )ypokale&ia1 )yperkale&ia1 )ypoxia1 )ypother&ia1 )ypo'ole&ia Myocardial infarction Electrolyte derange&ents Drugs Sinus bra &car ia: aetiolog& "SI%(S BRADICARDIA" (sinus bradycardia): Sleep Infections (&yocarditis) %eap thyroid (hypothyroid) (nconsciousness ('aso'agal syncope) Subnor&al te&peratures (hypother&ia) Biliary obstruction Raised 782 (hypercapnia) Acidosis Deficient blood sugar (hypoglyce&ia) I&balance of electrolytes Cushing+s reflex (raised /7>)

Aging Rx (drugs, such as high-dose atropine) Deep anaesthesia Ische&ic heart disease Athletes Rheumatic fever: 4ones criteria 5a*or criteria: CA%CER: Carditis Arthritis %odules Chorea Erythe&a Rheu&atic ana&nesis 5inor criteria: CA1E $A#: C$> increased Arthralgia 1e'er Ele'ated ;%$ $rolonged >$ inter'al Ana&nesis of rheu&atis& #eucocytosis 4,$: +ave form AS3 ME: Atrial contraction Systole ('entricular contraction) 3losure (closure) of tricusps, so atrial filling Maxi&al atrial filling E&ptying of atriu& %ee diagra&. Coronar& arter& b&'ass graft: in ications D(S-: Depressed 'entricular function (nstable angina Stenosis of the left &ain ste&

-riple 'essel disease E1 E2ercise ram' ECG: contrain ications RAM$: Recent 5/ Aortic stenosis M/ in the last F days $ul&onary hypertension ECG: - +ave inversion causes I%,ER-: Ische&ia %or&ality Gesp. young, black,entricular hypertrophy Ectopic foci Geg calcified plaAuesR333, ?333 -reat&ents GdigoxinRheumatic fever: 4ones ma8or criteria 4O%ES: 4oints (&igrating polyarthritis) Ob'ious, the heart (carditis, pancarditis, pericarditis, endocarditis or 'al'ulits) %odes (subcutaneous nodules) Erythe&a &arginatu& Sydenha&+s chorea M&ocar ial infarctions: treatment I%1ARC-IO%S: IV access %arcotic analgesics (eg &orphine, pethidine) 1acilities for defibrillation (6H) Aspirin1 Anticoagulant (heparin) Rest

Con'erting enzy&e inhibitor -hro&bolysis IV beta blocker Oxygen 6IJ %itrates Stool %ofteners Atrial fibrillation: causes $IRA-ES: $ul&onary: >;, 78>6 Iatrogenic Rheu&atic heart: &irtral regurgitation Atherosclerotic: 5/, 746 -hyroid: hyperthyroid Endocarditis Sick sinus syndro&e Atrial fibrillation: management ABCD: Anti-coagulate Beta-block to control rate Cardio'ert Digoxin Anti5arr&thmics: for A, no es "Do Block A,": Digoxin B-blockers Adenosine ,erapa&il Murmurs: s&stolic MR $, -RA$S: Mitral Regurgitation and

$rolaspe ,%6 -ricupsid Regurgitation Aortic and $ul&onary Stenosis A'e2 beat: ifferential for im'al'able a'e2 beat DO$ES: Dextrocardia Obesity $ericarditis or pericardial ta&ponade E&physe&a Sinus in'ersus1 Student inco&petence