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Electrocardiographic Diagnosis of Left Ventricular Hypertrophy (LVH)

Sokolow-Lyon index:

There are two criteria with these widely used indices:

* Sum of S wave in V1 and R wave in V5 or V6 >/= 3.5 mV (35 mm)

and/or

* R wave in aVL >/= 1.1 mV (11 mm)

Continue reading “Electrocardiographic Diagnosis of Left Ventricular Hypertrophy (LVH)”

TIMI Risk Score for ST-Elevation Myocardial Infarction (STEMI)

The TIMI risk score, based upon data from 15,000 patients with an ST segment elevation myocardial infarction eligible for fibrinolytic therapy, is a simple arithmetic sum of eight independent predictors of mortality.

Continue reading “TIMI Risk Score for ST-Elevation Myocardial Infarction (STEMI)”

Indications and Contraindications for Tilt Table Testing

Indications

  • Recurrent syncope or single syncopal episode accompanied by physical injury or motor vehicle crash or occurring in a high-risk setting (for example, pilot, surgeon, commercial vehicle driver) and no evidence of structural cardiovascular disease; or presence of structural cardiovascular disease, but other causes of syncope ruled out by diagnostic testing

  • Syncope induced by or associated with exercise

  • Further evaluation of patients in whom an apparent specific cause of syncope has been established (for example, asystole, high atrioventricular block) but susceptibility to neurocardiogenic syncope may affect treatment plan

Continue reading “Indications and Contraindications for Tilt Table Testing”

Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis

The Wells Clinical Prediction Rule is a diagnostic tool used during review of systems to identify possible pulmonary embolism (PE) and deep vein thrombosis (DVT). Continue reading “Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis”

Diagnostic Criteria for Essential Thrombocytopaenia (ET)

Polycythemia Vera Study Group (PVSG) Diagnostic Criteria for Essential Thrombocytopaenia (ET)

All of the following criteria must be fulfilled to make a diagnosis of ET

  1. Platelet count greater than 600 x 109/L

  2. Hematocrit less than 40 or normal red blood cell mass

  3. Stainable iron in the marrow or normal RBC mean corpuscular volume (If these measurements suggest iron deficiency, polycythemia vera cannot be excluded unless a trial of iron therapy fails to increase the red blood cell mass into the polycythemic range.)

  4. No Philadelphia chromosome or bcr/abl gene rearrangement

  5. Collagen fibrosis of the bone marrow absent or less than one third of the biopsy area without both marked splenomegaly and a leukoerythroblastic blood film

  6. No cytogenetic or morphologic evidence for a myelodysplastic syndrome

  7. No cause for a reactive thrombocytosis

    Continue reading “Diagnostic Criteria for Essential Thrombocytopaenia (ET)”

Diagnostic Criteria for Heparin-Induced Thrombocytopenia (HIT)

Diagnostic Criteria for Heparin-Induced Thrombocytopenia (HIT)

  • Heparin exposure >5 days
  • Relative thrombocytopenia: decrease in platelet count by 50% from baseline OR absolute thrombocytopenia: decrease in platelet count to less than 100 to 150 x 109/L
  • Absence of other causes of thrombocytopenia
  • Development of new thrombosis, or extension of pre-existing thrombosis, while receiving heparin therapy
  • Confirmation by laboratory testing
  • Return to normal platelet count when heparin is discontinued Continue reading “Diagnostic Criteria for Heparin-Induced Thrombocytopenia (HIT)”
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