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Recommendations for the Use of Ambulatory Blood-Pressure Monitoring

In addition to the prediction of cardiovascular risk, ambulatory blood-pressure monitoring, when used in conjunction with clinic blood-pressure assessments, is of potential value in a variety of other clinical conditions. Some of these conditions are:
Continue reading “Recommendations for the Use of Ambulatory Blood-Pressure Monitoring”

Perioperative Cardiovascular Evaluation for Noncardiac Surgery

Clinical Predictors of Increased Perioperative Cardiovascular Risk (Myocardial Infarction, Heart Failure, Death)

Major

Diagnostic Criteria for Myocarditis

Myocarditis may present with a wide range of symptoms, ranging from mild dyspnea or chest pain that resolves without specific therapy to cardiogenic shock and death. Dilated cardiomyopathy with chronic heart failure is the major long-term sequela of myocarditis. Most often, myocarditis results from common viral infections; less commonly, specific forms of myocarditis may result from other pathogens, toxic or hypersensitivity drug reactions, giant-cell myocarditis, or sarcoidosis.  Continue reading “Diagnostic Criteria for Myocarditis”

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

Wells Clinical Prediction Rule for Pulmonary Embolism (PE) Continue reading “Wells Clinical Prediction Rule for Pulmonary Embolism and Deep Venous Thrombosis”

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)”

Causes of Syncope

Cardiac causes

    • Structural cardiac or cardiopulmonary disease (aortic stenosis, mitral stenosis, pulmonary stenosis, left atrial myxoma, aortic dissection, acute myocardial infarction, cardiac tamponade, pulmonary embolism, obstructive cardiomyopathy)

    • Cardiac arrhythmias (tachyarrhythmias, bradyarrhythmias)

    • Neurally mediated syncopal syndrome (includes neurocardiogenic or vasovagal syncope, carotid sinus syncope, and situational syncope)

    • Orthostatic (or postural) hypotension

Continue reading “Causes of Syncope”

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