Heart valvue disorders and murmurs

Sent by Fernanda Golzarri, mnemonic to remember the murmurs associates with valvulopathies:

REMEMBER: hARD ASS MRS. MSDoctor

hARD - Aortic Regurgitation is DIASTOLIC

ASS - Aortic Stenosis is SYSTOLIC

MRS - Mitral Regurgitation is SYSTOLIC

MSD - Mitral Stenosis is DIASTOLIC

Cardiology mindmaps free download

DOWNLOAD THE FOLLOWING MINDMAPS (.png format): 4.71MB

Angina
Bradyarrhythmias
CABG
Cardiac Arrest
Cardiac Failure
Cardiomyopathies
Cor Pulmonale
Dressler's Syndrome
DVT
Endocarditis
Malignant Hypertension

Myocardial Infarction

Pericarditis
Rheumatic Fever
Tachyarrhythmias

Download link: http://www.mediafire.com/?zgyyimmldny

Myocardial infarction

Many many thanks to Karun Kumar for sending his self made mnemonics on MI. Please note that he has included some hindi mnemonics in this post.

Definition (CAP)

• Evidence of myocardial necrosis with any 1 of the following:

1. Cardiac biomarkers (pref. Troponins) showing sudden rise or fall
2. Sudden unexpected cardiac death involving cardiac Arrest
3. Pathological findings of acute MI

Signs of MI (windows VISTA)

1. Vagal activation (vomiting, bradycardia)
2. Impaired myocard. Func. (s1,s2 soft; hypotension; inc. JVP; Oliguria; Cold, clammy skin)
3. Sympathetic activation (Pallor, sweating, tachycardia)
4. Tissue damage (Low grade fever)
5. A complication (MR / VSD producing pansystolic murmur

Enzymes elevated in MI (TALC - talcum powder)

1.  Troponin T/I
2.  AST
3.  LDH
4.  CK-MB

Complications of MI

• Immediate (RAILgaadi)

a) RV infarction
b) Arrythmias (VT, AF, VF) - may also be due to I.v. Xylocaine overdose
c) LHF

• Early (PSVT ka MELA laga hua hai !!)

a) Pericarditis

b) Sudden death

c) VSD

d) Thromboembolic complications (Pulmonary, Arterial)

e) MR (Papillary muscle dysfunction or rupture)

f)  LV free wall rupture (Pericardial tamponade)

g) Arterial compl. (same as mentioned in d) )

•  Late (PADS)

a) Psychological reaction (DADDA- Denial, Acceptance, Dependency, Depression, Adjustment - this is from earliest change to last)
b) Arrythmias (ventricular like VF, VT)
c) Dressler’s syndrome (Autoimmune phenomenon characterized by fever, pericarditis, pleuritis, pneumonitis)
d) Shoulder (Frozen shoulder) – Pain n stiffness of left shoulder

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Order of closure of heart valves

Remember " Heart is a Mighty TAP which closes in this order":
The order of closure of heart valves is Mitral - Tricuspid - Aortic - Pulmonary.

Fallot's tetrology

This video demonstrates the pathology in Tetrology of Fallot with open and closed Ductus arteriosus. Video animations are a great memory aid.

WPW Syndrome

Wolff-Pakinson-White Syndrome

is a

Wild Path Way (Wolf is a wild animal)

between

Atria and Ventricles.

Also Remember KENT's ART (Abnormal bundle is called Kent's. ART = Atrioventricular Re-entrant Tachycardia.)

EGG findings: Remember Dr. KENT wears SHORT Pants - ECG findings are 'Delta wave' and SHORT PR interval.

Symptom may be tachycardia, palpitation, syncope or may be asymptomatic- Remember you get palpitation on seeing a Wolf and your pulse goes up or you may faint; But if you are strong, you will be asymptomatic!

JVP

Jugular Venous Pulse waves:

a - wave : due to Atrial contraction
x - descent : due to atrial relaXation
c - wave : Bulging (Closure ) of Tricuspid valve into right atrium
v - wave : Venacaval blood Volume increased when Tricuspid valve is closed
y - descent: Tricuspid valve opening and inflow of blood into right ventricle ( Yahooooo ! - Tricuspid valve open! )

Note that first 2 waves are described in relation to Atrium and the next 3 waves in relation to Tricuspid.

Auscultatory areas

Thanks to anonymous reader for correcting a major error in this post.
Auscultatory areas starting from left 2nd intercostal space:
Remember: All Patients Take Medicines
Aortic - Pulmonary - Tricuspid - Mitral
Note:

• Only Aortic area is on right ; Remember that All stands for aortic area - read as Aortic ll (Second) ; Because it's in 2nd IC space !
• If you want to remember the other intercostal spaces where the auscultatory areas on left are situated just remember " Lot no.245 " - Left 2, 4, 5 IC spaces in that order for Pulmonary, Tricuspid, Mitral in that order of All Patients Take Medicine.
• Confusion buster: Please note that Aorta arises from left ventricle, but auscultatory area is on right side. Note the same problem with Pulmonary artery.
• Also check our older posts - Aorta and IVC : left or right ? 

Mnemonics and shortcuts to learn ECG

ECG or EKG simplified in this book packed with illustration and mnemonics. Get a preview of the book "EKG made incredibly simple" below, again a big hit from incredibly simple series.

Atrioventricular Valves

tRIcuspid valve is in RIght atrium
Bicuspid valve in Left atrium ( Remember BiLe)
Bicuspid valve is also called MitraL valve. So mitraL is on Left
If you know what is a "mitre", then you can easily remember that bicuspid valve is mitral. "Mitre" is the hat that you see often worn by bishops. It has 2 leafs resembling the cusps. See picture below.

               

• Alternatively, imagine a RAT in LAB; Right Atrium Tricuspid, Left Atrium Bicuspid.

• If you know Hindi, remember DoMitr (Two friends) Bicuspid valve = Mitral valve by  

Aortic regurgitation : Peripheral signs

This is a picture mnemonic which will help you remember the peripheral signs of Aortic regurgitation (AR) which is much talked about in the clinics.

Download free Cardiology mnemonics

FREE .doc file of cardiology mnemonics collection. Download it here.

Fallot's Triad, Tetrad and Pentad

To remember the Fallots, read this story along with the picture mnemonic :

Characters in the story and what they represent:

Ant - ASD

Parrot - Pulmonary stenosis

Rabbit - Right Ventricular Hypertrophy ( RVH )

Owl - Overriding of Aorta

Vulture - VSD

'3' represents Fallot's Triad, '4' - Tetrology of Fallot, '5' - Fallot's Pentad

The story: The Ant, Parrot and Rabbit ( 3 ) were living happily. Vulture and Owl are coming at 4 o'clock - an announcement informed them. The Ant was afraid that it would be eaten and went away in fear. At 4 o'clock the Vulture and Owl came. So there was the Owl, Vulture, Parrot and Rabbit ( 4 ) living together now. The newcomers came to know about the Ant. They promised that they won't eat the ant. So the Ant came back and all the 5 (Owl, Ant, Vulture, Parrot and Rabbit ) lived happily ever after.

Now, just substitute what the animals / insects / birds originally represent and you will remember the Fallots.

If it's not clear, watch this video below :

Congenital heart disease producing cyanosis

They all begin with 'T' :

Tetrology of Fallot

Transposition of great vessels

Truncus arteriosis

Tricuspid atresia

Total pulmonary anomalous venous return

Cole - Cecil Murmur

COLe-Cecil murmur is heard in Aortic Incompetence in AxIlla.
Remember AIshwarya RAI ( Miss world, 1994 ) likes Coco-COLa

Austin flint murmur

Austin FlInt murmur is heard in Aortic Incompetence