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PIOPED II, PISAPED and CTPA Criteria for Diagnosis of Pulmonary Embolus

Efficacy and continued technical improvements in CT pulmonary angiography (CTPA) have produced a significant rise in its use for the diagnosis of acute pulmonary embolism (PE). The growth of CTPA has produced a corresponding reduction in the utilization of pulmonary scintigraphy to the extent that some publications have suggested that lung scanning has become a second-line test. Lung ventilation/perfusion (V/Q) scintigraphy along with modified prospective investigation of pulmonary embolism diagnosis (PIOPED) interpretation criteria has been utilized to diagnose acute PE. More recently, a simplified algorithm comprising pulmonary perfusion scan along with prospective investigative study of pulmonary embolism diagnosis (PISAPED) interpretation criteria has shown a reduction of intermediate probability as one of the lung scan readings generated by the modified PIOPED criteria and has improved the sensitivity and specificity of the lung scintigraphy along with the modified PIOPED criteria to detect acute PE. Continue reading “PIOPED II, PISAPED and CTPA Criteria for Diagnosis of Pulmonary Embolus”

Criteria for Acute Myocardial Infarction in the Left Bundle Branch Block

In the Emergency Department, the diagnosis of acute myocardial infarction (AMI) relies initially on a patient’s history and the 12-lead electrocardiogram (ECG). Establishing the diagnosis of AMI in the left bundle branch block (LBBB) is difficult and can result in delay of definitive treatment. In 1996, Sgarbossa found 3 ECG criteria to evaluate for AMI in patients with LBBB. Continue reading “Criteria for Acute Myocardial Infarction in the Left Bundle Branch Block”

Guidelines for Intervention in Patients with Chronic Severe Secondary Mitral Regurgitation

International practice guidelines for the care of patients with valvular heart disease were most recently updated in 2017, before the publication of the results of the COAPT and MITRA-FR trials in 2018, and these guidelines were conservative in their recommendations regarding surgery for secondary mitral regurgitation. Continue reading “Guidelines for Intervention in Patients with Chronic Severe Secondary Mitral Regurgitation”

Principles and Techniques of Blood Pressure Measurement

The accurate measurement of blood pressure (BP) is essential for the diagnosis and management of hypertension. Regardless of who is measuring BP or the method used (eg, auscultatory or oscillometric), the accuracy of the BP readings relies on standardized techniques and appropriate observer training.  Continue reading “Principles and Techniques of Blood Pressure Measurement”

Killip-Kimball Classification for Acute Myocardial Infarction

The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU). Continue reading “Killip-Kimball Classification for Acute Myocardial Infarction”

Definitions and Diagnostic Criteria for Pericarditis

Pericardial syndromes include different clinical presentations of pericardial diseases with distinctive signs and symptoms that can be grouped in specific ‘syndromes’. The classical pericardial syndromes include pericarditis, pericardial effusion, cardiac tamponade and constrictive pericarditis. Continue reading “Definitions and Diagnostic Criteria for Pericarditis”

New Diagnostic and Treatment Criteria for Hypertension in Adults

The definition of hypertension was recently changed by the American College of Cardiology – American Heart Association to a systolic arterial pressure of more than 130 mm Hg, a diastolic pressure of more than 80 mm Hg, or both. Continue reading “New Diagnostic and Treatment Criteria for Hypertension in Adults”

Diagnostic Criteria for the Brugada Syndrome (BrS)

Brugada syndrome (BrS) is a rare inherited arrhythmia syndrome leading to an increased risk of sudden cardiac death, despite a structurally normal heart. Diagnosis is based on a specific electrocardiogram pattern, observed either spontaneously or during a sodium channel blocker test. Continue reading “Diagnostic Criteria for the Brugada Syndrome (BrS)”

Diagnostic Criteria for Vasospastic Angina (VSA)

Vasospastic angina (VSA) is a variant form of angina pectoris, in which angina occurs at rest, with transient electrocardiogram modifications and preserved exercise capacity. VSA can be involved in many clinical scenarios, such as stable angina, sudden cardiac death, acute coronary syndrome, arrhythmia or syncope. Continue reading “Diagnostic Criteria for Vasospastic Angina (VSA)”

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