2019_ESC_Guidelines_for_the_diagnosis_and_management[1] (2).pptx
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This document provides guidelines for managing patients with stable coronary artery disease (CAD). It defines CAD and describes typical clinical scenarios. It recommends risk stratification using tools like the SCORE system and basic testing including biomarkers, ECG, echo, and chest X-ray. Depending on pre-test probability of CAD, it suggests functional or anatomical non-invasive testing. It provides guidance on lifestyle modifications, pharmacological management, and decisions regarding invasive versus non-invasive treatment. The guidelines emphasize risk stratification, appropriate clinical testing, and management tailored to a patient's risk level.
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coronaryheartdiseases-hanaalharbi-131024020826-phpapp02 (1).pdf
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Chronic stable angina
The document discusses the management of chronic stable angina. It defines angina and stability, and outlines the typical treatment approach which includes patient education, risk factor modification through lifestyle changes and medical therapy, and consideration of revascularization. The mainstay of treatment is optimal medical therapy focusing on symptom control through anti-anginal medications like beta-blockers, calcium channel blockers, and nitrates, as well as prevention of adverse outcomes with aspirin and other drugs.
Lo mejor en anticoagulación
The document discusses updates to guidelines for the management of valvular heart disease and atrial fibrillation. Some of the key changes in the 2021 guidelines compared to 2017 include:
- Left atrial appendage occlusion should be considered for stroke prevention in AF patients undergoing valve surgery with a CHA2DS2-VASc score of 2 or higher.
- NOACs are now recommended over VKAs for stroke prevention in AF patients with aortic stenosis, aortic regurgitation, or mitral regurgitation.
- Low-dose aspirin or VKAs should be considered for the first 3 months after surgical implantation of a bioprosthetic aortic valve in patients without an indication for oral
Coronary artery disease (CAD)
The document discusses coronary artery disease (CAD). It begins with an introduction to coronary circulation and the importance of the coronary arteries in delivering blood to the heart muscle. It then discusses atherosclerosis, the primary cause of CAD. CAD is defined as the narrowing of one or more coronary arteries due to atherosclerotic plaque buildup, reducing blood flow to the heart. Risk factors, pathophysiology, clinical manifestations, diagnostic tests, medical and surgical management, and lifestyle changes are summarized. Nursing assessment and management of patients with CAD are also outlined.
Acs0604 Acute Mesenteric Ischemia
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Cardiac Arrhythmia PDF
This document summarizes a seminar on cardiac arrhythmia and its treatment. It discusses the epidemiology of cardiac arrhythmia, noting it affects between 180,000-450,000 people annually in the US. It also discusses the genetics involved, noting mutations in ion channel genes can cause long QT syndrome, short QT syndrome, and Brugada syndrome. The document also provides a detailed classification and discussion of drug treatments for cardiac arrhythmia, separating drugs into Classes I-III.
Acs0609 Surgical Treatment Of Carotid Artery Disease
1) Surgical treatment of carotid artery disease aims to prevent stroke by operating on patients with carotid stenosis.
2) Carotid endarterectomy has been shown to reduce stroke risk in patients with symptomatic stenosis >50% or asymptomatic stenosis >60%.
3) Preoperative evaluation assesses patient health and imaging identifies carotid lesions. Proper positioning and anesthesia are also important.
4) The operative technique involves incising along the carotid sheath and carefully exposing and mobilizing the carotid artery and bifurcation while protecting surrounding nerves.
Diastolic heart failure
Diastolic heart failure occurs when a patient exhibits signs and symptoms of heart failure but has a normal left ventricular ejection fraction over 45%. It accounts for approximately 40-60% of heart failure cases. The main causes are hypertension and coronary artery disease. Diagnosis involves clinical signs and echocardiographic evidence of abnormal diastolic function with normal systolic function. Management focuses on controlling blood pressure, heart rate, and congestion with diuretics, along with revascularization for underlying coronary artery disease.
Diastolic heart failure
Diastolic heart failure occurs when a patient exhibits signs and symptoms of heart failure but has a normal left ventricular ejection fraction over 45%. It accounts for approximately 40-60% of heart failure cases. The main causes are hypertension and coronary artery disease. Diagnosis involves clinical signs and echocardiographic evidence of abnormal diastolic function with normal systolic function. Management focuses on controlling blood pressure, heart rate, and congestion with diuretics, along with revascularization for underlying coronary artery disease.
Esc asymptomatic arrhythmia2019
The document discusses several factors related to arrhythmias and their potential to cause symptoms. The type and origin of the arrhythmia can influence whether it is symptomatic. Short, isolated episodes are less likely to cause symptoms than sustained episodes of the same rhythm abnormality. Faster heart rates, lower ejection fractions, and the presence of comorbidities make arrhythmias more likely to be symptomatic.
Antithrombotic therapy in Diabetes management
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medppt.pptx
This document provides information on a seminar about coronary artery disease presented by Ms. Umadevi. K. It defines coronary artery disease as a narrowing of the coronary arteries that limits blood supply to the heart muscle. Risk factors include conditions like high cholesterol, smoking, hypertension, and diabetes. Symptoms include chest pain and diagnostic tests involve ECGs, cardiac enzymes, echocardiograms, and angiography. Treatment includes medications, angioplasty, stents, bypass surgery, lifestyle changes, and managing risk factors.
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- 2. INTRODUCTION GUIDELINES SUMMARIZE AND EVALUATE AVAILABLE EVIDENCE WITH THE AIM OF ASSISTING HEALTH PROFESSIONALS IN PROPOSING THE BEST MANAGEMENT STRATEGIES FOR ANINDIVIDUAL PATIENT WITH A GIVEN CONDITION. CORONARY ARTERY DISEASE (CAD) IS A PATHOLOGICAL PROCESS CHARACTERIZED BY ATHEROSCLEROTIC PLAQUE ACCUMULATION IN THE EPICARDIAL ARTERIES,WHETHER OBSTRUCTIVE OR NON-OBSTRUCTIVE.
- 3. INTRODUCTION
- 4. DEFINITION OF CCS • TERM OF CORONARY ARTERY DISEASE THAT HAS A CHRONIC PROGRESSIVE COURSE THAT CAN BE ALTERED, STABILIZED OR IMPROVED BY LIFESTYLE MODIFICATIONS,PHARAMACOTHERAPY AND CORONARY REVASCULARIZATION
- 5. CLINICAL SCENARIO MOST COMMONLY FOUND Suspected ‘stable angina’ symptom New onset heart failure of left ventricular dysfuntion Asymptomatic / Symptomatic < 12 months of an ACS or revascularisation > 12 months after initial angina diagnosis or revascularisation Angina and suspected vasospastic or microvascular disease Asymptomatic patient CAD is detected at screening
- 7. BASIC DIAGNOSIS AND RISK ASSESTMENT
- 8. “STABLE” VS UNSTABLE If UAP follow ACS Guidelines
- 9. RISK STRATIFICATION IN COMORBIDITIES General health, comorbid, quality of life Non anginal Chest pain ? Risk factor modification (SCORE system )
- 10. SYSTEMATIC CORONARY RISK EVALUATION
- 11. BASIC TESTING Biochemical Test Resting ECG and Ambulatory monitoring Echo and MRI at rest Chest X ray
- 15. ASSESTMENT OF PTP AND CLINICAL LIKEHOOD OF CAD
- 17. APPROPRIATE NON INVASIVE TESTING CAD clinical assestment is uncertain Funtional non invasive Test Anatomical non invasive Test ECG on exercise
- 21. ASSESSMENT OF EVENT RISK
- 25. PHARMACOLOGICAL MANAGEMENT Anti Ischemic drugs Event Prevention I via DAPT, Event Prevention II via Statin lipid lowering drugs , RAAS Blocker
- 31. INVASIVE VS NON INVASIVE ? Risk Stratification and Quality of Life Unresponsive to Pharamoclogical Treatment Sign of New Onset Heart Failure
- 33. HEART FAILURE ?
- 34. WHEN TO SUSPECT MICROVASCULAR ANGINA Microvascular angina is almost indistinguishable in clinical setting Exercise related angina Only suspected if excluding Epicardial coronary stenoses
- 35. WHAT IF THE PATIENT IS ASYMPTOMATIC ?
- 36. CONCLUSION Chronic progressive and can be modified Risk Stratification Perform appropriate clinical testing Management according to High risk or Low risk Routine Follow Up