Dilated cardiomyopathy (DCM) causes

Dilated Hearts End In Terrible Infiltration

• Dietary – beri-beri (thiamine deficiency)
• Hereditary – familial DCM, muscular dystrophies (Duchenne, myotonia, mitochondrial)
• Endocrine – hypothyroidism, thyrotoxicosis, phaeochromocytoma
• Infective – viruses (coxsackie), Chagas’ disease
• Toxins – alcohol, drugs (anthracyclines)
• Infiltrative – sarcoid, iron overload (haemochromatosis, excess blood transfusions)

Aneurysm typical causes

ATTIC

• Atheroma
• Trauma
• Takayasu’s aortitis (inflammation)
• Infection e.g. mycotic aneurysm in endocarditis, syphilis
• Connective tissue disorders e.g. Marfan’s syndrome, Ehlers-Danlos

Rheumatic fever

:
Major criteria CASES
Carditis, Arthritis (migratory), Subcut nodules, Erythema marginatum, Syndenhams chorea

Minor criteria 4PA
Pyrexia, prolonged PR, past Hx, positive (ie ↑)ESR/CRP, Arthralgia

Occlusive arterial disease 6Ps
Pain, pallor, pulseless, parasthesia. Paralysis, perishing with cold

Splinter haemorrhages TRIP SAM
Trauma, RA, Infective Endo, PAN
SLE / Sepsis, Anaemia (profound), Malignancy (haematological)

ST elevation ELEVATION
Electrolytes, LBBB, Early Repolarization, Ventricular hypertrophy, Aneurysm, Treatment (eg
pericardiocentesis), Injury (AMI, contusion), Osborne waves (hypothermia), Non-occlusive
vasospasm (prinzmetal’s)

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

Symptoms of aortic stenosis ASD
Angina 2 years }
Syncope 1 year } prognosis
Dyspnoea 6/12 }
Endocrinology

Cardiology 2

LVF, Management of
FOAM
Frusemide 40mg iv, Oxygen, Atrovent (& Ventolin) nebs, Morphine 2.5 - 5 mg

Mitral Stenosis, Complications
PASTRI
Pulm ↑BP, A fib, Systemic embolism, Tricuspid regurg, Right heart failure, Infective
endocarditis

Myocardial infarct, complications
ABCDE x2
Arrhythmias / Aneurysm
Bradycardia / ↓BP
Cardiac failure / cardiac tamponade
Dresslers / Death!
Embolism / Extra (VSD, pap muscle rupture)

Pericarditis
 DRUMSTICX
Dresslers, Rh fever / RA, Uraemia, MI, SLE, Trauma, Idiopathic, Coxsackie, X-ray

Postural Hypotension
 HANDI
Hypovolaemia / hypopituitarism, Addisons, Neuropathy (autonomic), Drugs (vasodilators /
TCADs, diuretics, antipsychotics), Idiopathic

Cardiology 1

No apex beat
DOPES
Dextrocardia (don’t say this first!), Obesity, Pleural/Pericardial effusion, Emphysema, Shock.

3rd Heart Sound
FIPPY
Failure, Incompetence (mitral/tricuspid), Pregnancy/Pill/PE/Pericarditis, Youth

4th Heart Sound
 SHIT
Stenosis (aortic/pulmonary), Hypertension/Heart Block, Ischaemic HD, Tamponade

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

Dominant R wave in
 V1 WORD
WPW, Old MI, RBBB, Dextrocardia

EMD Arrest
4Hs 4Ts
Hypothermia, Hypo & hyper-electrolytes, Hypovolaemia, Hypoxia
Toxic (including drugs), Trauma, Tamponade, Tension pneumothorax

JVP
 MOP HAIR
Multiple wave form, Occludable, Postural changes
Hepatojugular reflex, Above (fills from), Impalpable, Respiratory changes

Cardiovascular risk factors

FLASH BODIES:

Family history
Lipids
Age
Sex
Homocystinaemia
Blood pressure
Obesity
Diabetes mellitus
Inflammation (raised CRP)/ Increased thrombosis
Exercise
Smoking

CARDIAC MURMURS

PANSYSTOLIC ( M TV ) 
MR
TR
VSD

CRESCENDO MURMURS (C.M.S)
Mitral Stenosis

DECRESCENDO MURMURS (DARe)
Aortic Regurgitation

CRESCENDO-DECRESCENDO MURMURS (C.DAS)
Aortic Stenosis

THIRD HEART SOUND (CeMeNT)
C = CCF
e
M = MR
e
N = Normal upto 30yrs
T = TR

FOURTH HEART SOUND (4 H's)
Hypertension
Heart Block
Heart Failure
Hypertrophic Obstructive Cardiomyopathy

MID-DIASTOLIC MURMURS (M.FACT)
Mitral Stenosis
Flow Murmurs
Austin-Flint Murmurs
CAREY-COOMBS MURMUR
TRICUSPID STENOSIS

Heart failure: signs

TAPED TORCH:

T achycardia
A scites
P ulsus alternans
E levated jugular venous pressure
D isplaced apex beat

T hird heart sound
O edema
R ight ventricular heave
C repitations or wheeze
H epatomegaly (tender).

Peripheral signs of aortic regurgitation

ARathi Got Low Quality BCG, DPT & MMR from PHC

AR- Aortic Regurgitation

G=gerhard sign

L=landolfis sign, lighthouse sign

Q=quinckes sign

B=becker sign
C=corrigans neck sign
G=gerhard sign

D=de mussets sign, duroziez sign 
P=pistol shot femorals, pulse pressure wide

T=traubes sign
 

M=muller sign
M=mayne sign
R=rosenbch sign
 

P=pulsus bisferiens
H=hills sign
C=collapsing pulse(corrigans pulse)

Heart failure: signs & symptoms

Heart failure: signs

TAPED TORCH:

T achycardia
A scites
P ulsus alternans

E levated jugular venous pressure
D isplaced apex beat

T hird heart sound
O edema
R ight ventricular heave
C repitations or wheeze
H epatomegaly (tender).

Inferior vena cava tributaries

'' I Like To Rise So High''

I- Illiacs
L- Lumber
T- Testicular
R- Renel
S- Supra renel
H- hepatic vein

Internal jugular vein: tributaries

 ” Medical Schools Let Confident People In”:

• From inferior to superior:
Middle thyroid
Superior thyroid
Lingual
Common facial
Pharyngeal
Inferior petrosal sinus

CARDIAC MURMURS

PANSYSTOLIC ( M TV )
1. MR
2. TR

...3. VSD

CRESCENDO MURMURS (C.M.S)
* Mitral Stenosis

DECRESCENDO MURMURS (DARe)
* Aortic Regurgitation

CRESCENDO-DECRESCENDO MURMURS (C.DAS)
* Aortic Stenosis

THIRD HEART SOUND (CeMeNT)
C = CCF
e
M = MR
e
N = Normal upto 30yrs
T = TR

Conditions which can cause Congestive cardiac failure in Tetrology of Fallot

AIMS

Anemia, Aortic regurgitation
Infective endocarditis
Myocarditis
Systemic hypertension