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Common Diagnostic Criteria for Left and Right Atrial Abnormalities

22 February, 2009

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”

Braunwald Classification of Unstable Angina (UA)

19 February, 2009

A classification has been proposed by Braunwald to facilitate the assignation of patients to a particular risk group. This classification takes into account the severity of symptoms, the clinical circumstances surrounding the anginal episode, and the intensity of treatment.

Continue reading “Braunwald Classification of Unstable Angina (UA)”

Criteria for Chronic Stable Refractory Angina

19 February, 2009

The criteria for chronic stable refractory angina were defined by Mannheimer and colleagues in 2002 as a chronic condition characterized by the presence of angina caused by coronary insufficiency in the presence of coronary artery disease which cannot be controlled by a combination of medical therapy, angioplasty and coronary bypass surgery. The presence of reversible myocardial ischemia should be clinically established to be the cause of the symptoms. Chronic is defined as a duration of more than 3 months. Continue reading “Criteria for Chronic Stable Refractory Angina”

Classification and Severity of Angina

18 February, 2009

Class I

No angina with ordinary physical activity (e.g., walking, climbing stairs). Angina with strenuous or prolonged exertion.

Class II

Early-onset limitation of ordinary activity (e.g., walking rapidly or walking >2 blocks; climbing stairs rapidly or climbing >1 flight); angina may be worse after meals, in cold temperatures, or with emotional stress.

Continue reading “Classification and Severity of Angina”

Diagnostic Criteria for Amiodarone-Induced Pulmonary Toxicity (APT)

13 February, 2009

The clinical diagnosis of amiodarone-induced pulmonary toxicity (APT) requires two or more of the following criteria:

  1. new onset of pulmonary symptoms such as dyspnea, cough, or pleuritic chest pain;
  2. new chest radiographic abnormality such as an interstitial or alveolar infiltrate;
  3. a decrease in the DLCO of 20% from the pretreatment value, or if none is available, a value less than 80% of predicted;
  4. abnormal lung uptake with gallium-67 radioisotope; and
  5. characteristic histologic changes of lung tissue obtained by bronchoscopic or open lung biopsy.

Continue reading “Diagnostic Criteria for Amiodarone-Induced Pulmonary Toxicity (APT)”

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