wikidoc - Changes related to "Category:Disease" [en]

Chronic stable angina overview

2026-04-25T15:44:25Z

Treatment

Cardiomyopathy overview

2026-04-25T14:08:19Z

← Older revision		Revision as of 14:08, 25 April 2026
(15 intermediate revisions by the same user not shown)
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	__NOTOC__		__NOTOC__
	{{Cardiomyopathy}}		{{Cardiomyopathy}}
	{{CMG}}; {{AE}} {{EdzelCo}}		{{CMG}}; {{AE}} {{EdzelCo}} {{MSD}}

	==Overview==		==Overview==
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	==Treatment==		==Treatment==
	===Medical Therapy===		===Medical Therapy===
	Treatment ~~depends~~ on the ~~type~~ of cardiomyopathy, ~~but may include medication~~, ~~implanted [[artificial pacemaker\|pacemakers]]~~, ~~[[Implantable cardioverter~~-~~defibrillator~~\|~~defribillators]]~~, ~~or [[ventricular assist device]]s (LVADs)~~, ~~or [[ablation]]~~. ~~The goal of treatment is often~~ symptom relief, and ~~some~~ patients ~~may eventually require a [[~~heart transplant]]. ~~Treatment~~ of ~~cardiomyopathy (~~and ~~other heart diseases) using alternative methods such as [[stem cell therapy]] is commercially available but is not supported by convincing evidence~~.		Treatment is phenotype-directed and includes guideline-directed medical therapy (GDMT) for heart failure syndromes and targeted therapy for specific cardiomyopathies such as hypertrophic cardiomyopathy (HCM). In HCM, management includes symptom-directed pharmacotherapy (beta-blocker or nondihydropyridine calcium-channel blocker, with disopyramide or a cardiac myosin inhibitor in selected adults with obstructive physiology), risk-based use of ICDs, and septal reduction therapy at experienced centers when symptoms persist despite medical therapy.<ref name="pmid38718139">{{cite journal \|vauthors=Ommen SR, Ho CY, Asif IM, Balaji S, Burke MA, Day SM, Dearani JA, Epps KC, Evanovich L, Ferrari VA, Joglar JA, Khan SS, Kim JJ, Kittleson MM, Krittanawong C, Martinez MW, Mital S, Naidu SS, Saberi S, Semsarian C, Times S, Waldman CB \|title=2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=149 \|issue=23 \|pages=e1239–e1311 \|date=June 2024 \|pmid=38718139 \|doi=10.1161/CIR.0000000000001250 \|url=}}</ref> <ref name="pmid35363499">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e895–e1032 \|date=May 2022 \|pmid=35363499 \|doi=10.1161/CIR.0000000000001063 \|url=}}</ref>For cardiomyopathy with HFrEF, foundational GDMT consists of an ARNI/ACE inhibitor/ARB, evidence-based beta-blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor, with additional therapies and device-based treatment individualized by EF, QRS, symptoms, and comorbidities.<ref name="pmid35363499">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e895–e1032 \|date=May 2022 \|pmid=35363499 \|doi=10.1161/CIR.0000000000001063 \|url=}}</ref> Goals include symptom relief, prevention of sudden cardiac death (when relevant, e.g., HCM), and modification of heart-failure trajectory; patients with advanced heart failure despite GDMT should be referred to an advanced HF team for consideration of transplant and/or durable mechanical circulatory support.<ref name="pmid35363500">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e876–e894 \|date=May 2022 \|pmid=35363500 \|doi=10.1161/CIR.0000000000001062 \|url=}}</ref> In HCM with atrial fibrillation, oral anticoagulation is recommended irrespective of CHA₂DS₂-VASc, and rhythm and/or rate control should be individualized.<ref name="pmid38718139">{{cite journal \|vauthors=Ommen SR, Ho CY, Asif IM, Balaji S, Burke MA, Day SM, Dearani JA, Epps KC, Evanovich L, Ferrari VA, Joglar JA, Khan SS, Kim JJ, Kittleson MM, Krittanawong C, Martinez MW, Mital S, Naidu SS, Saberi S, Semsarian C, Times S, Waldman CB \|title=2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=149 \|issue=23 \|pages=e1239–e1311 \|date=June 2024 \|pmid=38718139 \|doi=10.1161/CIR.0000000000001250 \|url=}}</ref>

	===Surgery===		===Surgery===
	~~There~~ are ~~several types~~ of ~~surgery used~~ to ~~treat cardiomyopathy. They include~~ septal ablation, ~~[[septal myectomy]]~~, ~~surgically implanted devices to improve~~ the ~~function~~ of the ~~heart~~, ~~and [[heart transplant]]~~.		Procedural and surgical options are phenotype-specific and should be performed at experienced centers when indicated.<ref name="pmid38718139">{{cite journal \|vauthors=Ommen SR, Ho CY, Asif IM, Balaji S, Burke MA, Day SM, Dearani JA, Epps KC, Evanovich L, Ferrari VA, Joglar JA, Khan SS, Kim JJ, Kittleson MM, Krittanawong C, Martinez MW, Mital S, Naidu SS, Saberi S, Semsarian C, Times S, Waldman CB \|title=2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=149 \|issue=23 \|pages=e1239–e1311 \|date=June 2024 \|pmid=38718139 \|doi=10.1161/CIR.0000000000001250 \|url=}}</ref> For symptomatic obstructive HCM refractory to medical therapy, septal reduction therapy includes surgical septal myectomy or (in selected patients) alcohol septal ablation. Advanced heart failure may require durable mechanical circulatory support and/or heart transplantation after evaluation by an advanced HF team.<ref name="pmid38718139">{{cite journal \|vauthors=Ommen SR, Ho CY, Asif IM, Balaji S, Burke MA, Day SM, Dearani JA, Epps KC, Evanovich L, Ferrari VA, Joglar JA, Khan SS, Kim JJ, Kittleson MM, Krittanawong C, Martinez MW, Mital S, Naidu SS, Saberi S, Semsarian C, Times S, Waldman CB \|title=2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=149 \|issue=23 \|pages=e1239–e1311 \|date=June 2024 \|pmid=38718139 \|doi=10.1161/CIR.0000000000001250 \|url=}}</ref><ref name="pmid35363500">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e876–e894 \|date=May 2022 \|pmid=35363500 \|doi=10.1161/CIR.0000000000001062 \|url=}}</ref>

	===Primary Prevention===		===Primary Prevention===
	~~Methods of primary~~ prevention ~~for cardiomyopathy include; maintaining a healthy weight~~, ~~not smoking~~, ~~avoiding~~ alcohol and illicit drugs, ~~reducing stress~~, and ~~treating underlying conditions such as [[diabetes]] and [[high blood pressure]]~~.		Primary prevention focuses on ‘at risk’ (Stage A) and ‘pre-HF’ (Stage B) management: control hypertension, diabetes, obesity, and other cardiovascular risk factors; avoid cardiotoxins (including excess alcohol and illicit drugs); and treat structural heart disease early to prevent progression to symptomatic HF.<ref name="pmid35363500">{{cite journal \|vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW \|title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=145 \|issue=18 \|pages=e876–e894 \|date=May 2022 \|pmid=35363500 \|doi=10.1161/CIR.0000000000001062 \|url=}}</ref><ref name="pmid38033089">{{cite journal \|vauthors=Joglar JA, Chung MK, Armbruster AL, Benjamin EJ, Chyou JY, Cronin EM, Deswal A, Eckhardt LL, Goldberger ZD, Gopinathannair R, Gorenek B, Hess PL, Hlatky M, Hogan G, Ibeh C, Indik JH, Kido K, Kusumoto F, Link MS, Linta KT, Marcus GM, McCarthy PM, Patel N, Patton KK, Perez MV, Piccini JP, Russo AM, Sanders P, Streur MM, Thomas KL, Times S, Tisdale JE, Valente AM, Van Wagoner DR \|title=2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \|journal=Circulation \|volume=149 \|issue=1 \|pages=e1–e156 \|date=January 2024 \|pmid=38033089 \|pmc=11095842 \|doi=10.1161/CIR.0000000000001193 \|url=}}</ref>

	==Preferences==		==Preferences==

Heart failure resident survival guide

2026-04-21T11:24:22Z

Treatment of Heart Failure in Stage C and D

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Congestive heart failure Management of Acute heart failure

2026-04-18T10:39:34Z

Transitional care plan: components (Class 1 recommendation):[2]

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Coronary heart disease overview

2026-04-16T12:01:21Z

← Older revision		Revision as of 12:01, 16 April 2026
(4 intermediate revisions by the same user not shown)
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	__NOTOC__		__NOTOC__
	{{Coronary heart disease}} {{CMG}}		{{Coronary heart disease}} {{CMG}} {{AE}} {{MSD}}

	==Overview==		==Overview==
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	==Treatment==		==Treatment==
	===Medical Therapy===		===Medical Therapy===
	Goals for treating coronary artery disease include lowering [[blood pressure]], ~~maintaining [[~~HbA1c~~]] levels to less than~~ 7%, and lowering [[LDL]] cholesterol. Long-term treatment will generally depend on the symptoms and severity of disease, and include [[aspirin]], [[ACE inhibitors]], and other ani-coagulant and anti-platelet regimens. The mainstay of treatment for [[chronic stable angina\|stable angina]] which occurs with exertion, includes [[nitroglycerin]]. When unstable angina causes symptoms at rest, or in the setting of an acute [[myocardial infarction]], the immediate therapy is [[morphine]], [[oxygen]], [[nitrate]] and [[aspirin]]. [[Angioplasty]] may also be required in cases of [[acute coronary syndrome]].		Goals for treating coronary artery disease include lowering [[blood pressure]], managing diabetes with cardiovascular-risk-reducing agents such as SGLT2 inhibitors and GLP-1 receptor agonists, independent of HbA1c target<ref name="pmid39289001">{{cite journal \|vauthors=Galli M, Gragnano F, Vrints C, Andreotti F \|title=2024 ESC guidelines on chronic coronary syndromes: what is new in pharmacotherapy? \|journal=Eur Heart J Cardiovasc Pharmacother \|volume=10 \|issue=7 \|pages=572–574 \|date=November 2024 \|pmid=39289001 \|doi=10.1093/ehjcvp/pvae069 \|url=}}</ref>, and lowering [[LDL]] cholesterol. Long-term treatment will generally depend on the symptoms and severity of disease, and include [[aspirin]], [[ACE inhibitors]], and other ani-coagulant and anti-platelet regimens.Low-dose colchicine (0.5 mg daily) should also be considered as an adjunctive anti-inflammatory therapy for long-term management. <ref name="pmid37558377">{{cite journal \|vauthors=Nelson K, Fuster V, Ridker PM \|title=Low-Dose Colchicine for Secondary Prevention of Coronary Artery Disease: JACC Review Topic of the Week \|journal=J Am Coll Cardiol \|volume=82 \|issue=7 \|pages=648–660 \|date=August 2023 \|pmid=37558377 \|doi=10.1016/j.jacc.2023.05.055 \|url=}}</ref> The mainstay of treatment for [[chronic stable angina\|stable angina]] which occurs with exertion, includes [[nitroglycerin]]. When unstable angina causes symptoms at rest, or in the setting of an acute [[myocardial infarction]], the immediate therapy is [[morphine]], supplemental oxygen (only if SpO₂ <90%), nitrate, and aspirin. [[Angioplasty]] may also be required in cases of [[acute coronary syndrome]].Beta-blockers should be used selectively: they are indicated when LVEF is <50%, or in the presence of angina, arrhythmias, or hypertension, but are no longer routinely recommended for all patients with chronic coronary disease.<ref name="pmid38766996">{{cite journal \|vauthors=Khorsandi M, Blumenthal RS, Blaha MJ, Kohli P \|title=The ABCs of the 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease \|journal=Clin Cardiol \|volume=47 \|issue=5 \|pages=e24284 \|date=May 2024 \|pmid=38766996 \|pmc=11103637 \|doi=10.1002/clc.24284 \|url=}}</ref>

	===Primary Prevention===		===Primary Prevention===
	The [[LDL]] target in primary prevention depends upon the patient's [[risk factors]]. If the ~~patient has CHD or its equivalent~~, ~~then the LDL goal is under 100 mg~~/dl. ~~If the patient has 2~~ risk ~~factors~~, the LDL ~~goal is 130 mg~~/dl. ~~If the patient has~~ < ~~2 risk factors~~, ~~the LDL goal~~ is < ~~160 mg~~/dl. Attempts should be made to reduce [[triglyceride]] levels and to increase [[HDL]] levels. The underlying causes for existing [[dyslipidemia]]s should be identified and appropriately managed. Drugs that cause dyslipidemias should be avoided. Patients should be evaluated reguarly for the presence of risk factors for coronary heart disease, and those with increased risk should be counseled on the beneficial effects of daily [[aspirin]] therapy. Patients should also regularly be counseled about modifying risk factors such as [[obesity]], [[hypertension]], [[smoking]], and the benefits of an [[exercise]] plan.		The [[LDL]] target in primary prevention depends upon the patient's [[risk factors]]. LDL targets in primary prevention should be guided by estimated 10-year ASCVD risk using the PREVENT™ equations<ref name="urlACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology">{{cite web \|url=https://www.acc.org/latest-in-cardiology/journal-scans/2026/03/13/15/20/acc-aha-release-new-clinical-guideline-for-managing-dyslipidemia \|title=ACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology \|format= \|work= \|accessdate=}}</ref>. Statin therapy is recommended for those with intermediate risk (5–<10%) and reasonable for those with borderline risk (3–<5%) after shared decision-making, with the goal of achieving at least a 50% LDL-C reduction from baseline<ref name="urlACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology">{{cite web \|url=https://www.acc.org/latest-in-cardiology/journal-scans/2026/03/13/15/20/acc-aha-release-new-clinical-guideline-for-managing-dyslipidemia \|title=ACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology \|format= \|work= \|accessdate=}}</ref>.Non-statin therapies — including ezetimibe, bempedoic acid, and PCSK9 inhibitors should be considered when statin therapy alone is insufficient.<ref name="urlACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology">{{cite web \|url=https://www.acc.org/latest-in-cardiology/journal-scans/2026/03/13/15/20/acc-aha-release-new-clinical-guideline-for-managing-dyslipidemia \|title=ACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology \|format= \|work= \|accessdate=}}</ref> Attempts should be made to reduce [[triglyceride]] levels and to increase [[HDL]] levels.Coronary artery calcium (CAC) scoring and Lp(a) measurement should be considered to further refine cardiovascular risk and guide treatment intensity.<ref name="urlACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology">{{cite web \|url=https://www.acc.org/latest-in-cardiology/journal-scans/2026/03/13/15/20/acc-aha-release-new-clinical-guideline-for-managing-dyslipidemia \|title=ACC, AHA Release New Clinical Guideline For Managing Dyslipidemia - American College of Cardiology \|format= \|work= \|accessdate=}}</ref> The underlying causes for existing [[dyslipidemia]]s should be identified and appropriately managed. Drugs that cause dyslipidemias should be avoided. Patients should be evaluated reguarly for the presence of risk factors for coronary heart disease, and those with increased risk should be counseled on the beneficial effects of daily [[aspirin]] therapy. Patients should also regularly be counseled about modifying risk factors such as [[obesity]], [[hypertension]], [[smoking]], and the benefits of an [[exercise]] plan.

	===Secondary Prevention===		===Secondary Prevention===
	Patients who should be treated with secondary prevention are those with established atherosclerosis including peripheral artery		Patients who should be treated with secondary prevention are those with established atherosclerosis including peripheral artery disease; carotid artery disease; atherosclerotic aortic disease; diabetes and those with a 10-year ASCVD risk >20% by contemporary risk calculators (e.g., PREVENT™ equations or SCORE2).<ref name="url2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \| Circulation">{{cite web \|url=https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423 \|title=2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines \| Circulation \|format= \|work= \|accessdate=}}</ref> There are 13 aspects of secondary prevention: Smoking cessation; blood pressure control; lipid-lowering; increasing physical activity; weight loss; diabetes control; antiplatelet agents/anticoagulants; RAS blockers; beta-blockers; depression management; cardiac rehabilitation, influenza vaccine and low-dose colchicine (0.5 mg/day) for anti-inflammatory residual risk reduction.<ref>SEC Working Group for the 2024 ESC guidelines for the management of chronic coronary syndromes and SEC Guidelines Committee. (2025). Comments on the ESC 2024 guidelines for the management of chronic coronary syndromes. ''Revista Espanola de Cardiologia (English Ed.)'', ''78''(3), 170–175. <nowiki>https://doi.org/10.1016/j.rec.2024.10.007</nowiki></ref> Please note that secondary prevention guidelines, especially, those involving medication, may differ between [[Unstable Angina\|UA/NSTEMI]]; [[STEMI]]; and [[Chronic Stable Angina]].
	disease; carotid artery disease; atherosclerotic aortic disease; diabetes and those with a ~~Framingham Risk Score of~~ > 20%.
	There are 12 aspects of secondary prevention: Smoking cessation; blood pressure control; lipid-lowering; increasing physical activity; weight loss; diabetes control; antiplatelet agents/anticoagulants; RAS blockers; beta-blockers; depression management; cardiac rehabilitation ~~and~~ influenza vaccine. Please note that secondary prevention guidelines, especially, those involving medication, may differ between [[Unstable Angina\|UA/NSTEMI]]; [[STEMI]]; and [[Chronic Stable Angina]].

	==References==		==References==

Back pain

2026-04-12T19:14:31Z

Treatment

← Older revision		Revision as of 19:14, 12 April 2026
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	==Treatment==		==Treatment==

	[[Back pain medical therapy\|Medical Therapy]] \| [[Back pain surgery\|Surgery]] \| [[Back pain primary prevention\|Primary Prevention]] \| [[Back pain secondary prevention\|Secondary Prevention]] \| [[Back pain cost-effectiveness of therapy\|Cost-Effectiveness of Therapy]] \| [[Back pain future or investigational therapies\|Future or Investigational Therapies]] \| [[Back pain monitoring response to therapy\| Monitoring Response to Therapy]]		[[Back pain medical therapy\|Medical Therapy]] \| [[Low back pain conservative management]] \| [[Back pain surgery\|Surgery]] \| [[Back pain primary prevention\|Primary Prevention]] \| [[Back pain secondary prevention\|Secondary Prevention]] \| [[Back pain cost-effectiveness of therapy\|Cost-Effectiveness of Therapy]] \| [[Back pain future or investigational therapies\|Future or Investigational Therapies]] \| [[Back pain monitoring response to therapy\| Monitoring Response to Therapy]]

	==Lecture==		==Lecture==