Atherosclerotic Cardiovascular Disease Mnemonics
By : Dr. Subrahmanyam Karuturi
> Myocardial infarct, complications ABCDE x2
Arrhythmias / Aneurysm
Bradycardia / ↓BP
Cardiac failure / cardiac tamponade
Dresslers / Death!
Embolism / Extra (VSD, pap muscle rupture)
> Occlusive arterial disease 6Ps
Pain, pallor, pulseless, parasthesia, paralysis, perishing with cold
> BOOMAR
Basic MI management – Bed rest, Oxygen, Opiate, Monitoring, Anticoagulation, Reduce clot size
> DOLMA
Lines of treatment of pulmonary oedema:
Digoxin, Oxygen, Lasix, Morfine, Aminophylline. (Dolma is a very famous food in the middle east.)
> M.O.N.A
“MONA” treatment for acute MI.
Morphine, Oxygen, Nitrate, Aspirin
> Coronary artery bypass graft: indications DUST:
Depressed ventricular function
Unstable angina
Stenosis of the left main stem
Triple vessel disease
> Myocardial infarctions: treatment INFARCTIONS:
IV access
Narcotic analgesics (eg morphine, pethidine)
Facilities for defibrillation (DF)
Aspirin/ Anticoagulant (heparin)
Rest
Converting enzyme inhibitor
Thrombolysis
IV beta blocker
Oxygen 60%
Nitrates
Stool Softeners
> Acute Coronary Syndrome: initial treatment ABCD:
Aspirin
Beta blocker
Coagulation (anticoagulation with heparin/LMW Heparin)
Double product control (decrease heart rate and blood pressure)
> MI: treatment of acute MI COAG:
Cyclomorph
Oxygen
Aspirin
Glycerol trinitrate
> Peripheral vascular insufficiency: inspection criteria SICVD:
Symmetry of leg musculature
Integrity of skin
Color of toenails
Varicose veins
Distribution of hair
> MI: therapeutic treatment ROAMBAL:
Reassure
Oxygen
Aspirin
Morphine (diamorphine)
Beta blocker
Arthroplasty
Lignocaine
> MI: therapeutic treatment "O BATMAN!":
Oxygen
Beta blocker
ASA
Thrombolytics (eg heparin)
Morphine
Ace prn
Nitroglycerin
> MI: therapeutic treatment MONAH:
Morphine
Oxygen
Nitrogen
Aspirin
Heparin
> MI: basic management BOOMAR:
Bed rest
Oxygen
Opiate
Monitor
Anticoagulate
Reduce clot size
> MI: signs and symptoms PULSE:
Persistent chest pains
Upset stomach
Lightheadedness
Shortness of breath
Excessive sweating
> White toe (arterial insufficiency toe) 5 P's:
Pale coloration
Pain (excruciating)
Paresthesia
Pulselessness
Warm compression and vasodilatory Patch to Proximal area
> Blue toe (microembolic toe) CAVEMAN:
Cholesterol embolizations
Atrial fib with electricity or digitoxin
Valvular problems
Endocarditis
Mural thrimbosis
Aneurysm/ AV fistula
Nothing
> Peripheral vascular diseases ABCDEF:
Atherosclerosis.
Buerger's disease (TAO)
Cyanosis/ Cold agglutinin/ Connective tissue disease (Raynaud's phenomenon)
Deep vein phlebothrombosis
Embolism
inFlammation of veins
> TIA: internal carotid vs. vertebrobasilar MD vs. DPM
· Internal carotid:
Monocular blindness (amaurox fugax)
Dominant hemisphere (apahsia)
· The weakness or numbness is still less in the legs.
· Vetebrobasilar:
Diplopia/ Double blindness
Paralysis (quadriplesia)
Motor weakness (ipsilateral)
· Ataxia is characteristic in veterbrobasilar lesions.
> Acute ischemia: signs [especially limbs] 6 P's:
Pain
Pallor
Pulselessness
Paralysis
Paraesthesia
Perishingly cold
> MI: sequence of elevated enzymes after MI "C-AST-Le" (castle):
CK-MB first
AST second
LDH third
· Also: can use the last 'E' for ESR.
> Atherosclerosis risk factors "You're a SAD BET with these risk factors":
Sex: male
Age: middle-aged, elderly
Diabetes mellitus
BP high: hypertension
Elevated cholesterol
Tobacco
> Atherosclerosis risk factors SHIFT MAID:
Smoking
Hypertension
(N)IDDM
Family history
Triglycerdides & fats
Male
Age
Inactivity
Diet / Drink
> Thrombus: possible fates DOPE:
Dissolution
Organization & repair
Propagation
Embolization
> MI: sequence of elevated enzymes after MI "Time to CALL 911":
· From first to appear to last:
Troponin
CK-MB
AST
LDH1
> Buerger's disease features "burger SCRAPS":
Segmenting thrombosing vasculitis
Claudication (intermittent)
Raynaud's phenomenon
Associated with smoking
Pain, even at rest
Superficial nodular phlebitis
· Alternatively, if hungry for more detail [sic], "CRISP PIG burgers":
Chronic ulceration
Raynaud's phenomenon
Intermittent claudication
Segmenting, thrombosing vasculitis
Pain, even at rest
Phlebitis (superficial nodular)
Idiopathic
Gangrene
> MI: complications "LEAP on the MAP":
LVF
Embolism (systemic)
Aneurysm (ventricular)
Progressive infarction
Myocardial rupture
Arrhythmia
Pericarditis
> MI: post-MI complications ACT RAPID:
Arrhythmias (SVT, VT, VF)
Congestive cardiac failure
Tamponade/ Thromboembolic disorders
Rupture (ventricle, septum, papillary muscle)
Aneurysm (ventricle)
Pericarditis
Infaction (a second one)
Death/ Dressler's syndrome
> Cardiovascular risk factors FLASH BODIES:
Family history
Lipids
Age
Sex
Homocystinaemia
Blood pressure
Obesity
Diabetes mellitus
Inflammation (raised CRP)/ Increased thrombosis
Exercise
Smoking
> Cardiovascular risk factors (Framingham) FRAMINGHAM:
Family history
Running (exercise)
Adiposity (obesity)
Marlboros (tobacco)
Insulin resistance (diabetes)
Non-regulated lipids (dyslipidaemia)
Georgie Pie (high fat diet)
Hypertension
Age
Male
> Stroke risk factors HEADS:
Hypertension/ Hyperlipidemia
Elderly
Atrial fib
Diabetes mellitus/ Drugs (cocaine)
Smoking/ Sex (male)
> Stroke: young patient's likely causes 7 C's:
Cocaine
Consanguinity [familial such as neurofibromatosis and von Hippel-Lindau]
Cancer
Cardiogenic embol
hyperCoagulation
CNS infection [eg: HIV conditions]
Congenital arterial lesion
> Stroke: basic work up The 3 P's:
Pump
Pipes
Plasma
> Chest pain treatment, for nurses "MOVE your patient!":
Monitor: put patient on cardiac monitor
Oxygen: put patient on O2
Venous: gain large bore venous access
EKG: 12 lead EKG
> MI: immediate treatment DOGASH:
Diamorphine
Oxygen
GTN spray
Asprin 300mg
Streptokinase
Heparin
> Myocardial infarction: some emergency treatment drugs ABCD:
Aspirin
Beta blockers
Clot busters (thromboytics)
Dynamite (nitrates)
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