Thoracic aortic aneurysm diagnostic study of choice: Difference between revisions

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== Overview ==
== Overview ==


== Diagnostic Study of Choice ==
==2014 ESC Guidelines on the Diagnosis and Treatment of Aortic Diseases (DO NOT EDIT)<ref name="pmid25173340">{{cite journal |vauthors=Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwöger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RS, Vrints CJ |title=2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC) |journal=Eur. Heart J. |volume=35 |issue=41 |pages=2873–926 |date=November 2014 |pmid=25173340 |doi=10.1093/eurheartj/ehu281 |url=}}</ref>==
===Diagnostic Work-up of Patients Suspicious of Acute Aortic Syndrome===
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC guidelines classification scheme#Classification of Recommendations|Class I]]
|-
|bgcolor="LightGreen" |<nowiki>"</nowiki>''Initial recommended [[imaging]] study for the [[diagnosis]] of [[acute aortic syndrome]] is [[transthoracic echocardiography]]. ([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|bgcolor="LightGreen" |<nowiki>"</nowiki>''In case of initially negative [[imaging]] study, repetitive [[imaging]] study (including [[CT]] or [[MRI]]) is recommended if the suspicion for [[acute aortic syndrome]] is high. ([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|-
|bgcolor="LightGreen" |<nowiki>"</nowiki>''Repeated [[imaging]] study (including [[CT]] or [[MRI]]) is recommended in case of uncomplicated medially treated aortic dissection type B in the first few days of treatment. ([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
|}


=== Study of choice ===
===Patients with Unstable Hemodynamic ===
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
{|class="wikitable"
 
|-
OR
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC guidelines classification scheme#Classification of Recommendations|Class I]]
 
|-
The following result of [gold standard test] is confirmatory of [disease name]:
|bgcolor="LightGreen" |<nowiki>"</nowiki>''In [[patients]] with hemodynamic stability, [[transoesophageal echocardiography]] or [[computed tomography]] are the recommended [[imaging]] studies. preferred modality is chosen according to local availability or expertise. ([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
* [Result 1]
|}
* [Result 2]
===Patients with Stable Hemodynamic<ref name="pmid25173340">{{cite journal |vauthors=Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwöger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RS, Vrints CJ |title=2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC) |journal=Eur. Heart J. |volume=35 |issue=41 |pages=2873–926 |date=November 2014 |pmid=25173340 |doi=10.1093/eurheartj/ehu281 |url=}}</ref>===
 
{|class="wikitable"
OR
|-
 
| colspan="1" style="text-align:center; background:LightGreen"|[[ESC guidelines classification scheme#Classification of Recommendations|Class I]]
[Name of the investigation] must be performed when:
|-
* The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
|bgcolor="LightGreen" |<nowiki>"</nowiki>''In stable [[patients]], [[computed tomography]] or [[magnetic resonance imaging]] are the recommended [[imaging]] studies. prefered modality is chosen according to local availabilty or expertise. ([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
* A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
|}
 
{|class="wikitable"
OR
 
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
 
OR
 
The diagnostic study of choice for [disease name] is [name of the investigation].
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name].  
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
 
OR
 
[Disease name] is primarily diagnosed based on the clinical presentation.
 
OR
 
Investigations:
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
 
==== The comparison of various diagnostic studies for [disease name] ====
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ESC guidelines classification scheme#Classification of Recommendations|Class IIa]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|-
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
|bgcolor="LemonChiffon" |<nowiki>"</nowiki>''In stable [[patients]], [[transoesophageal echocardiography]] is the recommended [[imaging]] study. ([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|}
|}
<small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small>
===== Diagnostic results =====
The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
* [Finding 1]
* [Finding 2]
===== Sequence of Diagnostic Studies =====
The [name of investigation] must be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
OR
The various investigations must be performed in the following order:
* [Initial investigation]
* [2nd investigation]
=== Name of Diagnostic Criteria ===
'''It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.'''
[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
OR
There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
OR
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
* Criteria 1
* Criteria 2
* Criteria 3
OR
'''IF there are clear, established diagnostic criteria'''
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
'''IF there are no established diagnostic criteria'''
There are no established criteria for the diagnosis of [disease name].


==References==
==References==

Revision as of 20:51, 22 January 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

2014 ESC Guidelines on the Diagnosis and Treatment of Aortic Diseases (DO NOT EDIT)[1]

Diagnostic Work-up of Patients Suspicious of Acute Aortic Syndrome

Class I
"Initial recommended imaging study for the diagnosis of acute aortic syndrome is transthoracic echocardiography. (Level of Evidence: C)"
"In case of initially negative imaging study, repetitive imaging study (including CT or MRI) is recommended if the suspicion for acute aortic syndrome is high. (Level of Evidence: C)"
"Repeated imaging study (including CT or MRI) is recommended in case of uncomplicated medially treated aortic dissection type B in the first few days of treatment. (Level of Evidence: C)"

Patients with Unstable Hemodynamic

Class I
"In patients with hemodynamic stability, transoesophageal echocardiography or computed tomography are the recommended imaging studies. preferred modality is chosen according to local availability or expertise. (Level of Evidence: C)"

Patients with Stable Hemodynamic[1]

Class I
"In stable patients, computed tomography or magnetic resonance imaging are the recommended imaging studies. prefered modality is chosen according to local availabilty or expertise. (Level of Evidence: C)"
Class IIa
"In stable patients, transoesophageal echocardiography is the recommended imaging study. (Level of Evidence: C)"

References

  1. ↑ 1.0 1.1 Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, Evangelista A, Falk V, Frank H, Gaemperli O, Grabenwöger M, Haverich A, Iung B, Manolis AJ, Meijboom F, Nienaber CA, Roffi M, Rousseau H, Sechtem U, Sirnes PA, Allmen RS, Vrints CJ (November 2014). "2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC)". Eur. Heart J. 35 (41): 2873–926. doi:10.1093/eurheartj/ehu281. PMID 25173340.

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