Congestive heart failure cardiac catheterization: Difference between revisions

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{{Congestive heart failure}}
{{Congestive heart failure}}
{{CMG}}; {{AOEIC}} {{LG}}
{{CMG}}; {{AOEIC}} {{Sara.Zand}} {{LG}} {{EdzelCo}}


==Cardiac Catheterization==
==Overview==
===Coronary Angiography===
[[Coronary angiography]] is recommended in [[patients]] with [[heart failure]], who have [[angina pectoris ]] or an [[angina equivalent]] despite pharmacological therapy, in order to establish the diagnosis of [[CAD]] and its severity. [[Coronary angiography]] may also be considered in [[patients]] with [[HFrEF]] who have an intermediate to high pre-test probability of [[CAD]] and who are considered potentially suitable for [[coronary revascularization]].
[[Coronary angiography]] is perfomred in patients with heart failure in whom there is a suspicion of underlying atherosclerosis as the basis for the heart failure. Patients who are [[troponin]] or CK-MB positive, who have dynamic EKG changes or other signs and symptoms of an [[acute coronary syndrome]] who are revascularization candidates should undergo coronary angiography.


===Hemodynamic Assessment===
==[[Cardiac Catheterization]]==
=====Right Heart Catheterization=====
 
Right heart catheterization can be useful to assess the following:
===[[Coronary Angiography]]===
* [[Invasive coronary angiography]] is useful to rule out significant [[CAD]] in [[patients]] with [[cardiac dysfunction]].
* It is recommended in [[patients]] with [[angina]] despite pharmacological therapy or symptomatic [[ventricular arrhythmias]].
* In [[patients]] with [[HFrEF]] with an intermediate to high pre-test probability of [[CAD]] and the presence of [[ischaemia]] in noninvasive [[stress tests]], [[invasive coronary angiography]] may be considered.
 
===[[Hemodynamic]] Assessment===
 
====Right Heart Catheterization====
[[Right heart catheterization]] can be useful to assess the following:
* [[Pulmonary capillary wedge pressure]]
* [[Pulmonary capillary wedge pressure]]
* [[Pulmonary artery pressure]] to diagnose [[pulmonary hypertension]] and response to therapy
* [[Pulmonary artery pressure]] to diagnose [[pulmonary hypertension]] and respond to therapy
*:[[Right heart catheterization]] should be considered in [[patients]] where [[HF]] is thought to be due to [[constrictive pericarditis]], [[restrictive cardiomyopathy]], [[congenital heart disease]], and high [[output states]].
 
===[[Computed tomography coronary angiography]] ([[CTCA]])===


=====Left Heart Catheterization=====
*[[Computed tomography coronary angiography]] ([[CTCA]]) may be considered in [[patients]] with a low to intermediate pre-test probability of[[CAD]], or equivocal result of non-invasive [[stress tests]] in order to exclude the diagnosis of [[CAD]].<ref name="pmid31504439">{{cite journal |vauthors=Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, Prescott E, Storey RF, Deaton C, Cuisset T, Agewall S, Dickstein K, Edvardsen T, Escaned J, Gersh BJ, Svitil P, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Valgimigli M, Achenbach S, Bax JJ |title=2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes |journal=Eur Heart J |volume=41 |issue=3 |pages=407–477 |date=January 2020 |pmid=31504439 |doi=10.1093/eurheartj/ehz425 |url=}}</ref>
Left heart catheterization can be useful to assess the following:
* The [[aortic valve]] gradient, and diagnose [[aortic stenosis]] and track its severity
* The [[left ventricular end diastolic pressure]] ([[LVEDP]])
* Simultaneous assessment of the [[LVEDP]] and [[pulmonary capillary wedge pressure]] allows for the diagnosis and assessment of [[mitral stenosis]].
* Dye can be injected to perform a [[left ventriculogram]] and assess for regional wall motion abnormalities, [[aortic insufficiency]], and [[mitral insufficiency]].


==2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult (DO NOT EDIT) <ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>==
==2021 European Society of Cardiology (DO NOT EDIT) <ref name="pmid34447992">{{cite journal |vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A |title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure |journal=Eur Heart J |volume=42 |issue=36 |pages=3599–3726 |date=September 2021 |pmid=34447992 |doi=10.1093/eurheartj/ehab368 |url=}}</ref>==


===Cardiac Catheterization in Patients Presenting With Heart Failure (DO NOT EDIT) <ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>===
===[[Coronary Angiography]]===


{|class="wikitable" style="width:80%"
{|class="wikitable" style="width:80%"
|-
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC guidelines classification scheme#Classification of Recommendations|Class I]]


|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[Coronary arteriography]] should be performed in patients presenting with [[heart failure]] who have [[angina]] or significant [[ischemia]] unless the patient is not eligible for [[revascularization]] of any kind.<ref name="pmid6352078">{{cite journal |author=Alderman EL, Fisher LD, Litwin P, Kaiser GC, Myers WO, Maynard C, Levine F, Schloss M |title=Results of coronary artery surgery in patients with poor left ventricular function (CASS) |journal=[[Circulation]] |volume=68 |issue=4 |pages=785–95 |year=1983 |month=October |pmid=6352078 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=6352078 |accessdate=2012-04-05}}</ref><ref name="pmid15466654">{{cite journal |author=Eagle KA, Guyton RA, Davidoff R, Edwards FH, Ewy GA, Gardner TJ, Hart JC, Herrmann HC, Hillis LD, Hutter AM, Lytle BW, Marlow RA, Nugent WC, Orszulak TA |title=ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery) |journal=[[Circulation]] |volume=110 |issue=14 |pages=e340–437 |year=2004 |month=October |pmid=15466654 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15466654 |accessdate=2012-04-05}}</ref><ref name="pmid11161934">{{cite journal |author=Fox KF, Cowie MR, Wood DA, Coats AJ, Gibbs JS, Underwood SR, Turner RM, Poole-Wilson PA, Davies SW, Sutton GC |title=Coronary artery disease as the cause of incident heart failure in the population |journal=[[European Heart Journal]] |volume=22 |issue=3 |pages=228–36 |year=2001 |month=February |pmid=11161934 |doi=10.1053/euhj.2000.2289 |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=11161934 |accessdate=2012-04-05}}</ref><ref name="pmid15219526">{{cite journal |author=Arques S, Ambrosi P, Gelisse R, Roux E, Lambert M, Habib G |title=Prevalence of angiographic coronary artery disease in patients hospitalized for acute diastolic heart failure without clinical and electrocardiographic evidence of myocardial ischemia on admission |journal=[[The American Journal of Cardiology]] |volume=94 |issue=1 |pages=133–5 |year=2004 |month=July |pmid=15219526 |doi=10.1016/j.amjcard.2004.03.046 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002914904004606 |accessdate=2012-04-05}}</ref><ref name="pmid16835970">{{cite journal |author=Kurtz CE, Gerber Y, Weston SA, Redfield MM, Jacobsen SJ, Roger VL |title=Use of ejection fraction tests and coronary angiography in patients with heart failure |journal=[[Mayo Clinic Proceedings. Mayo Clinic]] |volume=81 |issue=7 |pages=906–13 |year=2006 |month=July |pmid=16835970 |doi=10.4065/81.7.906 |url=http://linkinghub.elsevier.com/retrieve/pii/S0025-6196(11)61483-3 |accessdate=2012-04-05}}</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>Invasive [[coronary angiography]] is recommended in [[patients]] with [[angina]] despite medical therapy or [[symptomatic]] [[ventricular arrhythmias]].([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki> Invasive [[coronary angiography]] may be considered in [[patients]] with [[HFrEF]] with an intermediate to high pre-test probability of [[CAD]] and the presence of [[ischemia]] in [[non-invasive stress tests]].([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki> [[Right heart catheterization]] is recommended in [[patients]] with severe [[HF]] being evaluated for [[heart transplantation]] or [[mechanical circulatory support]] ([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki> [[Right heart catheterization]] is reasonable in [[HF]]  [[patients]] with suspicion of [[constrictive pericarditis]], [[restrictive cardiomyopathy]], [[congenital heart disease]], and [[high output states]].([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki> [[Right heart catheterization]] may be considered in selected [[patients]] with [[HFpEF]] to confirm the diagnosis..([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|}
|}
===[[Coronary CT Angiography]] ===


{|class="wikitable" style="width:80%"
{|class="wikitable" style="width:80%"
|-
|-
| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC guidelines classification scheme#Classification of Recommendations|Class IIa]]


|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Coronary arteriography]] is reasonable for patients presenting with [[heart failure]] who have [[chest pain]] that may or may not be of cardiac origin who have not had evaluation of their coronary anatomy and who have no contraindications to [[coronary revascularization]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>[[Coronary CT angiography]] should be considered in [[patients]] with a low to intermediate pre-test probability of [[CAD]] or those with equivocal [[non-invasive stress tests]] in order to rule out [[coronary artery stenosis]].([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' [[Coronary arteriography]] is reasonable for patients presenting with [[heart failure]] who have known or suspected [[coronary artery disease]] but who do not have [[angina]] unless the patient is not eligible for [[revascularization]] of any kind. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|}
|}


==External Links==
{|class="wikitable" style="width:80%"
*[http://circ.ahajournals.org/content/112/12/e154.full.pdf The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult] <ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</ref>
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC guidelines classification scheme#Classification of Recommendations|Class IIa]]


*[http://content.onlinejacc.org/cgi/reprint/53/15/1343.pdf 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation] <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>[[Endomyocardial biopsy]] should be considered in [[patients]] with rapidly progressive [[HF]] despite standard therapy when there is a probability of a specific diagnosis, which can be confirmed only in [[myocardial]] samples.([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|-
|}
 
 
===Genetic Evaluation and Testing 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| 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 | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500  }} </ref> ===
 
{|class="wikitable" style="width:80%"
|-
|colspan="1" style="text-align:center; background:LightGreen"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
 
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' In first-degree relatives of selected [[patients]] with [[genetic]] or [[inherited]] [[cardiomyopathies]], [[genetic screening]] and counseling are recommended to detect [[cardiac disease]] and prompt consideration of [[treatments]] to decrease [[HF]] progression and sudden [[death]]. <ref name="pmid32624524">{{cite journal| author=Marume K, Noguchi T, Tateishi E, Morita Y, Miura H, Nishimura K | display-authors=etal| title=Prognosis and Clinical Characteristics of Dilated Cardiomyopathy With Family History via Pedigree Analysis. | journal=Circ J | year= 2020 | volume= 84 | issue= 8 | pages= 1284-1293 | pmid=32624524 | doi=10.1253/circj.CJ-19-1176 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32624524  }} </ref><ref name="pmid26925241">{{cite journal| author=Waddell-Smith KE, Donoghue T, Oates S, Graham A, Crawford J, Stiles MK | display-authors=etal| title=Inpatient detection of cardiac-inherited disease: the impact of improving family history taking. | journal=Open Heart | year= 2016 | volume= 3 | issue= 1 | pages= e000329 | pmid=26925241 | doi=10.1136/openhrt-2015-000329 | pmc=4762189 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26925241  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki>
|}
 
{|class="wikitable" style="width:80%"
|-
|colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' In select [[patients]] with [[nonischemic cardiomyopathy]], referral for [[genetic counseling]] and testing is reasonable to identify conditions that could guide [[treatment]] for [[patients]] and [[family]] members.<ref name="pmid24503780">{{cite journal| author=Pugh TJ, Kelly MA, Gowrisankar S, Hynes E, Seidman MA, Baxter SM | display-authors=etal| title=The landscape of genetic variation in dilated cardiomyopathy as surveyed by clinical DNA sequencing. | journal=Genet Med | year= 2014 | volume= 16 | issue= 8 | pages= 601-8 | pmid=24503780 | doi=10.1038/gim.2013.204 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24503780  }} </ref><ref name="pmid25163546">{{cite journal| author=Haas J, Frese KS, Peil B, Kloos W, Keller A, Nietsch R | display-authors=etal| title=Atlas of the clinical genetics of human dilated cardiomyopathy. | journal=Eur Heart J | year= 2015 | volume= 36 | issue= 18 | pages= 1123-35a | pmid=25163546 | doi=10.1093/eurheartj/ehu301 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25163546  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki>
|}


==References==
==References==

Latest revision as of 23:08, 22 June 2022
Resident
Survival
Guide
Congestive Heart Failure Microchapters

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ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
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Coordinating Care for Patients With Chronic HF
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Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

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Risk calculators and risk factors for Congestive heart failure cardiac catheterization

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Sara Zand, M.D.[2] Lakshmi Gopalakrishnan, M.B.B.S. [3] Edzel Lorraine Co, DMD, MD[4]

Overview

Coronary angiography is recommended in patients with heart failure, who have angina pectoris or an angina equivalent despite pharmacological therapy, in order to establish the diagnosis of CAD and its severity. Coronary angiography may also be considered in patients with HFrEF who have an intermediate to high pre-test probability of CAD and who are considered potentially suitable for coronary revascularization.

Cardiac Catheterization

Coronary Angiography

Hemodynamic Assessment

Right Heart Catheterization

Right heart catheterization can be useful to assess the following:

Computed tomography coronary angiography (CTCA)

2021 European Society of Cardiology (DO NOT EDIT) [2]

Coronary Angiography

Class I
"Invasive coronary angiography is recommended in patients with angina despite medical therapy or symptomatic ventricular arrhythmias.(Level of Evidence: B) "
Class IIb
" Invasive coronary angiography may be considered in patients with HFrEF with an intermediate to high pre-test probability of CAD and the presence of ischemia in non-invasive stress tests.(Level of Evidence: B) "
Class I
" Right heart catheterization is recommended in patients with severe HF being evaluated for heart transplantation or mechanical circulatory support (Level of Evidence: C) "
Class IIa
" Right heart catheterization is reasonable in HF patients with suspicion of constrictive pericarditis, restrictive cardiomyopathy, congenital heart disease, and high output states.(Level of Evidence: C) "
Class IIb
" Right heart catheterization may be considered in selected patients with HFpEF to confirm the diagnosis..(Level of Evidence: C) "

Coronary CT Angiography

Class IIa
"Coronary CT angiography should be considered in patients with a low to intermediate pre-test probability of CAD or those with equivocal non-invasive stress tests in order to rule out coronary artery stenosis.(Level of Evidence: C) "
Class IIa
"Endomyocardial biopsy should be considered in patients with rapidly progressive HF despite standard therapy when there is a probability of a specific diagnosis, which can be confirmed only in myocardial samples.(Level of Evidence: C) "


Genetic Evaluation and Testing 2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [3]

Class I
"1. In first-degree relatives of selected patients with genetic or inherited cardiomyopathies, genetic screening and counseling are recommended to detect cardiac disease and prompt consideration of treatments to decrease HF progression and sudden death. [4][5] (Level of Evidence: B-NR) "
Class IIa
"1. In select patients with nonischemic cardiomyopathy, referral for genetic counseling and testing is reasonable to identify conditions that could guide treatment for patients and family members.[6][7] (Level of Evidence: B-NR) "

References

  1. ↑ Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, Prescott E, Storey RF, Deaton C, Cuisset T, Agewall S, Dickstein K, Edvardsen T, Escaned J, Gersh BJ, Svitil P, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Valgimigli M, Achenbach S, Bax JJ (January 2020). "2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes". Eur Heart J. 41 (3): 407–477. doi:10.1093/eurheartj/ehz425. PMID 31504439.
  2. ↑ McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland J, Coats A, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam C, Lyon AR, McMurray J, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano G, Ruschitzka F, Kathrine Skibelund A (September 2021). "2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure". Eur Heart J. 42 (36): 3599–3726. doi:10.1093/eurheartj/ehab368. PMID 34447992 Check |pmid= value (help). Vancouver style error: initials (help)
  3. ↑ Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "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". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check |pmid= value (help).
  4. ↑ Marume K, Noguchi T, Tateishi E, Morita Y, Miura H, Nishimura K; et al. (2020). "Prognosis and Clinical Characteristics of Dilated Cardiomyopathy With Family History via Pedigree Analysis". Circ J. 84 (8): 1284–1293. doi:10.1253/circj.CJ-19-1176. PMID 32624524 Check |pmid= value (help).
  5. ↑ Waddell-Smith KE, Donoghue T, Oates S, Graham A, Crawford J, Stiles MK; et al. (2016). "Inpatient detection of cardiac-inherited disease: the impact of improving family history taking". Open Heart. 3 (1): e000329. doi:10.1136/openhrt-2015-000329. PMC 4762189. PMID 26925241.
  6. ↑ Pugh TJ, Kelly MA, Gowrisankar S, Hynes E, Seidman MA, Baxter SM; et al. (2014). "The landscape of genetic variation in dilated cardiomyopathy as surveyed by clinical DNA sequencing". Genet Med. 16 (8): 601–8. doi:10.1038/gim.2013.204. PMID 24503780.
  7. ↑ Haas J, Frese KS, Peil B, Kloos W, Keller A, Nietsch R; et al. (2015). "Atlas of the clinical genetics of human dilated cardiomyopathy". Eur Heart J. 36 (18): 1123–35a. doi:10.1093/eurheartj/ehu301. PMID 25163546.

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