Showing posts with label Cardiology. Show all posts
Showing posts with label Cardiology. Show all posts

Wednesday, December 29, 2021

S' Tissue Doppler Imaging - Derived Tricuspid Lateral Annular Systolic Velocity mnemonic

S’ Wave: Tissue doppler imaging-Derived Tricuspid Lateral Annular Systolic Velocity

S’ value less than 9.5 cm/sec indicating RV dysfunction. Mnemonic... If you stare at the number long enough you'll see 9.5 in it lol. 

The first peak above baseline that is timed with the QRS represents isovolumetric contraction and not the tricuspid annular velocity.

-IkaN (Nakeya Dewaswala Bhopalwala) 

Relative wall thickness 0.42 mnemonic

The RWT reports the relationship between the wall thickness and cavity size. It is an index of LV concentricity. 

The golden number to remember for RWT is 0.42 as it allows further classification of LV mass increase as either concentric hypertrophy (RWT >0.42) or eccentric hypertrophy (RWT ≤0.42). 

Since there are so many numbers to remember in echocardiography, I made a mnemonic for RWT. 

Relative = 0 (Relative zero)
Wall = 4 (4 letters in the word wall)
Thickness = 2 (2 strokes in the letter T) 

Hope this helps! 

-IkaN (Nakeya Dewaswala Bhopalwala) 

Tuesday, December 28, 2021

Monday, December 27, 2021

Relative wall thickness on echocardiography

Relative wall thickness (RWT) is calculated as two times posterior wall thickness (PWT) divided by the left ventricular internal diastolic diameter (LVIDd). 

RWT allows further classification of LV mass increase as either concentric hypertrophy (RWT >0.42) or eccentric hypertrophy (RWT ≤0.42).

-IkaN (Nakeya Dewaswala Bhopalwala) 

Infective endocarditis vegetations - which side do they develop?

Infective endocarditis vegetations tend to develop on the upstream side of the valve (flow side) which is typically tend to be the lower pressure side. These are the ventricular side of the aortic valve and the atrial side of the mitral or tricuspid valve. 

Image shows parasternal long axis view on echocardiography showing vegetations on the mitral and aortic valve (green vegetations because vegetables are green lol!)


Saturday, December 18, 2021

Mitral valve anatomy and types of mitral regurgitation mnemonic

Prolapse tip points towards LV
Flail tip flips away from LV
Secondary stay away from each other (dilation) 

Tuesday, December 14, 2021

Metoprolol tartrate vs succinate dosing mnemonic

Metoprolol tartrate is short acting. 

Metoprolol succinate is long acting. 

Mnemonic succinate single dose, tartrate two doses.

-IkaN (Nakeya Dewaswala Bhopalwala) 

Wednesday, November 17, 2021

Wednesday, November 10, 2021

Treatment of myocardial infarction associated pericarditis

Hi everyone! There are two types of myocardial infarction associated with pericarditis. Let
s learn more about the management!

Early infarct-associated pericarditis: Occurs 1 to 3 days after transmural myocardial infarction (because of the interaction of the healing necrotic epicardium with the overlying pericardium). 
Late post-myocardial infarction pericarditis (Dressler’s syndrome): Occurs weeks to months after myocardial infarction. 

Initial therapy includes high-dose aspirin (650 to 1,000 mg every 6 to 8 hours).
Proton pump inhibitor (PPI)  - improves the gastric tolerability of the aspirin. 
Acetominophen can be added for pain management.

Dosing of aspirin:
Initial: 650 mg to 1 g every 8 hours until resolution of symptoms for at least 24 hours and normalization of inflammatory biomarkers (eg, C-reactive protein). A treatment period of one to two weeks before tapering is usually sufficient. 
Taper: Decrease each dose by 250 to 500 mg every 1 to 2 weeks. Ensure patient remains asymptomatic and inflammatory biomarkers are normal. 

There is no published experience on the use of colchicine in peri-infarction pericarditis. Colchicine may reduce the need for pericardiocentesis or other pericardial interventions and is usually given at a dose of 0.6 mg twice daily for a month, or longer if the patient has a recurrence of symptoms.

Why are NSAIDs such as ibuprofen avoided in the peri-infarct period?
Interferes with the antiplatelet aggregation effects of aspirin. 
Interferes with myocardial healing.
PS: Acetominophen does not affect the coagulation system and can be used.


-IkaN (Nakeya Dewaswala)

Monday, November 1, 2021

Normal P wave ECG notes and mnemonic

Here is the video:



Sinus P waves
Axis: 0 and +75 degrees
Upright: Leads I, II, V5, V6
Inverted: aVR
Duration: <120ms or 3 small squares
Limb leads: < 2.5 mm (0.25mV)
Precordial leads: < 1.5 mm (0.15mV)


Determining pacemaker type from EKG (RV pacing vs biventricular pacing)

 Hello, cardiowesomites!

Today we are going to learn how to determine pacemaker type from EKG (RV pacing vs biventricular pacing)


Thursday, October 21, 2021

LV aneurysm: Difference between true LV aneurysm and LV pseudoaneurysm

LV aneurysms are most commonly caused by myocardial infarction. What's the difference between true aneurysm and pseudoaneurysm?

Thursday, October 14, 2021

Types of pulmonary hypertension mnemonic

Here are my notes and a video on types of pulmonary hypertension - WHO classification! It comes with a mnemonic :)

Saturday, September 25, 2021

Cardiovascular drugs that can cause digoxin toxicity

A number of cardiovascular drugs predispose patients to digoxin toxicity, including verapamil, quinidine, and amiodarone. The dosage of digoxin must be reduced if given concomitantly with these drugs. The presumed mechanism underlying this interaction involves the ability of these drugs to inhibit the P-glycoprotein transporter.

Mnemonic: These drugs cause you to go whack! VAQ - Verapamil, Amiodarone, Quinidine

Other drugs to keep in mind are Diltiazem, Spironolactone, Flecainide.

Mnemonic by Huzefa Bhopalwala


Waldorff S, Hansen PB, Egeblad H, Berning J, Buch J, Kjaergård H, Steiness E. Interactions between digoxin and potassium-sparing diuretics. Clin Pharmacol Ther. 1983 Apr;33(4):418-23. doi: 10.1038/clpt.1983.56. PMID: 6831820.

Andrejak M, Hary L, Andrejak MT, Lesbre JP. Diltiazem increases steady state digoxin serum levels in patients with cardiac disease. J Clin Pharmacol. 1987 Dec;27(12):967-70. doi: 10.1002/j.1552-4604.1987.tb05598.x. PMID: 3437068.

Lewis GP, Holtzman JL. Interaction of flecainide with digoxin and propranolol. Am J Cardiol. 1984 Feb 27;53(5):52B-57B. doi: 10.1016/0002-9149(84)90502-2. PMID: 6695818.


Saturday, September 18, 2021

SYNTAX score mnemonic

In the SYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) trial, patients with 3-vessel and left main coronary artery disease (LMCAD) treated with coronary artery bypass graft surgery (CABG) compared with percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES) had lower 5-year rates of death, myocardial infarction (MI), stroke, or unplanned revascularization.