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NYHA Functional Classification for Congestive Heart Failure

The New York Heart Association (NYHA) Functional Classification provides a simple way of classifying heart disease (originally cardiac failure), useful for preoperative assessment. It places patients in one of four categories, based on how much they are limited during physical activity:

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Estimate of 10-Year Risk for Coronary Heart Disease for Women (Framingham Point Scores)

Coronary Heart Disease (CHD) score sheet for women using TC or LDL-C categories. Uses age, TC, HDL-C, blood pressure, diabetes, and smoking. Estimates risk for CHD over a period of 10 years based on Framingham experience in women 30 to 74 years old at baseline. Average risk estimates are based on typical Framingham subjects, and estimates of idealized risk are based on optimal blood pressure, TC 160 to 199 mg/dL (or LDL 100 to 129 mg/dL), HDL-C of 55 mg/dL in women, no diabetes, and no smoking. Use of the LDL-C categories is appropriate when fasting LDL-C measurements are available. Pts indicates points. Continue reading “Estimate of 10-Year Risk for Coronary Heart Disease for Women (Framingham Point Scores)”

Estimate of 10-Year Risk for Coronary Heart Disease for Men (Framingham Point Scores)

Coronary Heart Disease (CHD) score sheet for men using TC or LDL-C categories. Uses age, TC (or LDL-C), HDL-C, blood pressure, diabetes, and smoking. Estimates risk for CHD over a period of 10 years based on Framingham experience in men 30 to 74 years old at baseline. Average risk estimates are based on typical Framingham subjects, and estimates of idealized risk are based on optimal blood pressure, TC 160 to 199 mg/dL (or LDL 100 to 129 mg/dL), HDL-C of 45 mg/dL in men, no diabetes, and no smoking. Use of the LDL-C categories is appropriate when fasting LDL-C measurements are available. Pts indicates points. Continue reading “Estimate of 10-Year Risk for Coronary Heart Disease for Men (Framingham Point Scores)”

Modified Duke Criteria for the Clinical Diagnosis of Infective Endocarditis (IE)

The diagnosis of infective endocarditis is generally based on clinical, microbiologic, and echocardiographic findings. The Duke criteria have sensitivity and specificity of more than 80% and are the reference criteria for diagnosis.

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Diagnostic Criteria for Diastolic Heart Failure

Diastolic heart failure is defined as a condition caused by increased resistance to the filling of one or both ventricles; this leads to symptoms of congestion from the inappropriate upward shift of the diastolic pressure-volume relation.

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Common Diagnostic Criteria for Left and Right Atrial Abnormalities

Left Atrial Abnormality

  • Prolonged P wave duration of >120 msec in lead II
  • Prominent notching of the P wave, usually most obvious in lead II, with an interval between the notches of >40 msec (p mitrale)
  • Ratio between the duration of the P wave in lead II and the duration of the PR segment of >1.6
  • Increased duration and depth of the terminal negative portion of the P wave in lead V1 (the P terminal force) so that the area subtended by it exceeds 0.04 mm-sec (Morris index)
  • Leftward shift of the mean P wave axis to between -30 and +45 degrees Continue reading “Common Diagnostic Criteria for Left and Right Atrial Abnormalities”
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