Arrhythmias Mnemonics

By : Dr. Subrahmanyam Karuturi

> SVT Causes SNAP
Sinus tachy, nodal tachy, a fib, paroxysmal atrial tachy

> Arrhythmias ARHYTHMIAL 4PC
Atrial Myxoma, Rh heart dis, HYpertension, THyrotoxicosis, Mitral valve dis, IHD,
ALcohol
Pneumonia / PE / Pericardial eff, cardiomyopathy

 > Atrial Fibrillation ARITHMATIC
Alcohol, Rh fever, IHD, Thyrotoxicosis, Hypertension, Mitral stenosis / MI / Myxoma
(atrial)
ASD, Toxins, Idiopathic/Infective endocarditis Cardiomyopathy/Constrictive pericarditis

 > Bradycardia, regular PAD HIM
Physiological (athlete, sleep) / paroxysmal, AV block (2°II, 3°), Drugs (β, dig, amiodarone)
Hypothyroid / hypothermia, Icteric (severe), MI

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

  > Supraventricular tachycardia: treatment ABCDE:
Adenosine
Beta-blocker
Calcium channel antagonist
Digoxin
Excitation (vagal stimulation)

  > Ventricular tachycardia: treatment LAMB:
Lidocaine
Amiodarone
Mexiltene/ Magnesium
Beta-blocker

> Pulseless electrical activity: causes PATCH MED:
Pulmonary embolus
Acidosis
Tension pneumothorax
Cardiac tamponade
Hypokalemia/ Hyperkalemia/ Hypoxia/ Hypothermia/ Hypovolemia
Myocardial infarction
Electrolyte derangements
Drugs

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

> Atrial fibrillation: causes PIRATES:
Pulmonary: PE, COPD
Iatrogenic
Rheumatic heart: mirtral regurgitation
Atherosclerotic: MI, CAD
Thyroid: hyperthyroid
Endocarditis
Sick sinus syndrome

  > Atrial fibrillation: management ABCD:
Anti-coagulate
Beta-block to control rate
Cardiovert
Digoxin

  > Anti-arrythmics: for AV nodes "Do Block AV":
Digoxin
B-blockers
Adenosine
Verapamil

> Sinus tachycardia TACH FEVER:
Tamponade/ Thyrotoxicosis
Anemia
CHF
Hypotension
Fever
Excrutiating pain
Volume depletion
Exercise
Rx (Theo, Dopa, Epi, etc)

> Heart electrical conduction pathway "If patient's family are all having Heart attacks, you must SAVe HIS KIN!"
SA node --->
AV node --->
His (bundle of) -->
PurKINje fibers

> Vfib/Vtach drugs used according to ACLS "Every Little Boy Must Pray":
Epinephrine
Lidocaine
Bretylium
Magsulfate
Procainamide

> Ventricular fibrillation: treatment "Shock, Shock, Shock, Everybody Shock, Little Shock, Big Shock, Momma Shock, Poppa Shock":
Shock= Defibrillate
Everybody= Epinephine
Little= Lidocaine
Big= Bretylium
Momma= MgSO4
Poppa= Pocainamide

> Syncope causes, by system HEAD HEART VESSELS:
· CNS causes include HEAD:
Hypoxia/ Hypoglycemia
Epilepsy
Anxiety
Dysfunctional brain stem (basivertebral TIA)
· Cardiac causes are HEART:
Heart attack
Embolism (PE)
Aortic obstruction (IHSS, AS or myxoma)
Rhythm disturbance, ventricular
Tachycardia
· Vascular causes are VESSELS:
Vasovagal
Ectopic (reminds one of hypovolemia)
Situational
Subclavian steal
ENT (glossopharyngeal neuralgia)
Low systemic vascular resistance (Addison's, diabetic vascular neuropathy)
Sensitive carotid sinus

> Syncope (fainting) treatment If the face is red, raise the head.
If the face is pale, raise the tail.

> Atrial fibrillation: causes of new onset THE ATRIAL FIBS:
Thyroid
Hypothermia
Embolism (P.E.)
Alcohol
Trauma (cardiac contusion)
Recent surgery (post CABG)
Ischemia
Atrial enlargement
Lone or idiopathic
Fever, anemia, high-output states
Infarct
Bad valves (mitral stenosis)
Stimulants (cocaine, theo, amphet, caffeine)

> Pulseless Electrical Activity (PEA): checklist PEA:
Pulses check
Epinepherine
Atropine
 

  > PEA/Asystole (ACLS): etiology ITCHPAD:
Infarction
Tension pneumothorax
Cardiac tamponade
Hypovolemia/ Hypothermia/ Hypo-, Hyperkalemia/ Hypomagnesmia/ Hypoxemia
Pulmonary embolism
Acidosis
Drug overdose

  > V-fib/pulseless v-tach (new ACLS as of 2001) "EVAL My Pumper":
Epinephrine
Vasopressin
Amiodarone (class IIb--better for heart failure)
Lidocaine (indeterminate - better for young, healthy or persistent)
MgSO4 (IIb for hypomagnesemic state or torsades)
Procainamide (IIb for intermittent/recurrent VF/VT)

> Asystole: treatment "Have some asystole "TEA":
Transcutaneous pacing
Epi
Atropine

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