Valvular heart disease echocardiography or ultrasound: Difference between revisions
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==2006 ACC/AHA Guidelines for the Management of Patients | ==2008 and incorporated 2006 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>== | ||
===Recommendations for Echocardiography (DO NOT EDIT) <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>=== | |||
{|class="wikitable" | {|class="wikitable" | ||
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| 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"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[Echocardiography]] is recommended for asymptomatic patients with [[diastolic murmurs]], continuous murmurs, [[Systolic murmurs|holosystolic murmurs]], [[Systolic murmurs|late systolic murmurs]], murmurs associated with ejection clicks or murmurs that radiate to the neck or back. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]]) <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[Echocardiography]] is recommended for asymptomatic patients with [[diastolic murmurs]], continuous murmurs, [[Systolic murmurs|holosystolic murmurs]], [[Systolic murmurs|late systolic murmurs]], murmurs associated with ejection clicks or murmurs that radiate to the neck or back. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' [[Echocardiography]] is recommended for patients with [[heart murmurs]] and symptoms or signs of [[heart failure]], [[myocardial ischemia]]/infarction, [[syncope]], [[thromboembolism]], [[infective endocarditis]], or other clinical evidence of [[structural heart disease]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])<nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' [[Echocardiography]] is recommended for patients with [[heart murmurs]] and symptoms or signs of [[heart failure]], [[myocardial ischemia]]/infarction, [[syncope]], [[thromboembolism]], [[infective endocarditis]], or other clinical evidence of [[structural heart disease]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]]'')<nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' [[Echocardiography]] is recommended for asymptomatic patients who have grade 3 or louder [[Systolic murmurs|midpeaking systolic murmurs]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])<nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' [[Echocardiography]] is recommended for asymptomatic patients who have grade 3 or louder [[Systolic murmurs|midpeaking systolic murmurs]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
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|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm) | |colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm) | ||
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|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' [[Echocardiography]] is not recommended for patients who have a grade 2 or softer [[Systolic murmurs|midsystolic murmur]] identified as innocent or functional by an experienced observer. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' [[Echocardiography]] is not recommended for patients who have a grade 2 or softer [[Systolic murmurs|midsystolic murmur]] identified as innocent or functional by an experienced observer. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
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| 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:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Echocardiography]] can be useful for the evaluation of asymptomatic patients with [[murmurs]] associated with other abnormal cardiac physical findings or [[murmurs]] associated with an abnormal [[ECG]] or [[chest X-ray]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Echocardiography]] can be useful for the evaluation of asymptomatic patients with [[murmurs]] associated with other abnormal cardiac physical findings or [[murmurs]] associated with an abnormal [[ECG]] or [[chest X-ray]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' [[Echocardiography]] can be useful for patients whose symptoms and/or signs are likely noncardiac in origin but in whom a cardiac basis cannot be excluded by standard evaluation. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' [[Echocardiography]] can be useful for patients whose symptoms and/or signs are likely noncardiac in origin but in whom a cardiac basis cannot be excluded by standard evaluation. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|} | |} | ||
== | ===Aortic Stenosis Asymptomatic Patient (DO NOT EDIT) <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>=== | ||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' Transthoracic echocardiography is recommended for re-evaluation of asymptomatic patients: every year for severe AS; every 1 to 2 years for moderate AS; and every 3 to 5 years for mild AS. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''5.''' Transthoracic echocardiography is recommended for re-evaluation of asymptomatic patients: every year for severe AS; every 1 to 2 years for moderate AS; and every 3 to 5 years for mild AS. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
==Sources== | |||
*2008 and incorporated 2006 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref> | |||
==References== | ==References== | ||
Revision as of 18:07, 7 November 2012
|
Valvular heart disease Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
2008 and incorporated 2006 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease [1]
Recommendations for Echocardiography (DO NOT EDIT) [1]
| Class I |
| "1. Echocardiography is recommended for asymptomatic patients with diastolic murmurs, continuous murmurs, holosystolic murmurs, late systolic murmurs, murmurs associated with ejection clicks or murmurs that radiate to the neck or back. (Level of Evidence: C) " |
| "2. Echocardiography is recommended for patients with heart murmurs and symptoms or signs of heart failure, myocardial ischemia/infarction, syncope, thromboembolism, infective endocarditis, or other clinical evidence of structural heart disease. (Level of Evidence: C)" |
| "3. Echocardiography is recommended for asymptomatic patients who have grade 3 or louder midpeaking systolic murmurs. (Level of Evidence: C)" |
| Class III (Harm) |
| "1. Echocardiography is not recommended for patients who have a grade 2 or softer midsystolic murmur identified as innocent or functional by an experienced observer. (Level of Evidence: C) " |
| Class IIa |
| "1. Echocardiography can be useful for the evaluation of asymptomatic patients with murmurs associated with other abnormal cardiac physical findings or murmurs associated with an abnormal ECG or chest X-ray. (Level of Evidence: C)" |
| "2. Echocardiography can be useful for patients whose symptoms and/or signs are likely noncardiac in origin but in whom a cardiac basis cannot be excluded by standard evaluation. (Level of Evidence: C)" |
Aortic Stenosis Asymptomatic Patient (DO NOT EDIT) [1]
| Class I |
| "1. Echocardiography is recommended for the diagnosis and assessment of AS severity. (Level of Evidence: B) " |
| "2. Echocardiography is recommended in patients with AS for the assessment of LV wall thickness, size, and function. (Level of Evidence: B) " |
| "3. Echocardiography is recommended for re-evaluation of patients with known AS and changing symptoms or signs. (Level of Evidence: B) " |
| "4. Echocardiography is recommended for the assessment of changes in hemodynamic severity and LV function in patients with known AS during pregnancy. (Level of Evidence: B) " |
| "5. Transthoracic echocardiography is recommended for re-evaluation of asymptomatic patients: every year for severe AS; every 1 to 2 years for moderate AS; and every 3 to 5 years for mild AS. (Level of Evidence: B) " |
Sources
- 2008 and incorporated 2006 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease [1]
References
- ↑ 1.0 1.1 1.2 1.3 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter
|month=ignored (help)