[Verse 1]
Ischemic heart disease, the plaque narrows down the pipe
A stent was placed last Tuesday — wrong timing for the knife
Bare metal needs four weeks, drug-eluting needs a year
DAPT disruption mid-elution, thrombosis is the fear
CABG patients carry grafts like detoured arterial maps
The left internal mammary bridging coronary gaps
Before you touch the chest wall, know the anatomy cold
Stress test findings, ejection fraction, vessels manifold
[Chorus]
Keep the rate down in stenosis, keep the preload full
Regurgitant valves want afterload pulled
MINS hides in silence, troponin tells the tale
Check the VISION protocol — don't let surveillance fail
Rate, load, rhythm, pressure — four pillars holding the hall
Know the magnet behavior before you make the call
[Verse 2]
Heart failure splits in two — preserved and then reduced
HFrEF pumps weakly out, HFpEF is stiff and bruised
Cardiomyopathy dilated wants offload and rate control
Hypertrophic obstructive — vasopressors take a toll
Phenylephrine holds the gradient closed, avoid vasodilation
Inotropes in HOCM fan the obstruction like inflation
Hold the ACE inhibitor the morning of the case
ARBs too — refractory hypotension is the price you'll face
[Chorus]
Keep the rate down in stenosis, keep the preload full
Regurgitant valves want afterload pulled
MINS hides in silence, troponin tells the tale
Check the VISION protocol — don't let surveillance fail
Rate, load, rhythm, pressure — four pillars holding the hall
Know the magnet behavior before you make the call
[Verse 3]
Aortic stenosis — maintain sinus, keep the rate around sixty
Vasodilation drops perfusion pressure, outcomes aren't pretty
Mitral stenosis mirrors it — slow the rate, fill the left
Regurgitant lesions flip the script, unload to manage stress
Prosthetic valves and anticoagulation, bridging is the question
Mechanical mitral carries highest risk — don't skip the consultation
Pulmonary hypertension spikes with hypoxia and pain
Nitric oxide standing by, avoid what raised it in the first place again
[Bridge]
Pacemaker in the field — place the magnet, asynchronous mode
ICD gets silenced so the shock won't interfere with your load
HRS and ASA consensus — program before elective cases start
Congenital adults with Fontan circulations need a careful heart
Single ventricle physiology — preload is everything here
Systemic RV function, fenestrations, shunt direction unclear
[Chorus]
Keep the rate down in stenosis, keep the preload full
Regurgitant valves want afterload pulled
MINS hides in silence, troponin tells the tale
Check the VISION protocol — don't let surveillance fail
Rate, load, rhythm, pressure — four pillars holding the hall
Know the magnet behavior before you make the call