Recommendations for the Use of Ambulatory Blood-Pressure Monitoring

In addition to the prediction of cardiovascular risk, ambulatory blood-pressure monitoring, when used in conjunction with clinic blood-pressure assessments, is of potential value in a variety of other clinical conditions. Some of these conditions are:
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Perioperative Cardiovascular Evaluation for Noncardiac Surgery

Clinical Predictors of Increased Perioperative Cardiovascular Risk (Myocardial Infarction, Heart Failure, Death)
Major
Unstable coronary syndromes

  • Acute or recent MI* with evidence of important ischemic risk by clinical symptoms or noninvasive study
  • Unstable or severe† angina (Canadian class III or IV) Continue reading

Diagnostic Criteria for Myocarditis

Myocarditis may present with a wide range of symptoms, ranging from mild dyspnea or chest pain that resolves without specific therapy to cardiogenic shock and death. Dilated cardiomyopathy with chronic heart failure is the major long-term sequela of myocarditis. Most often, myocarditis results from common viral infections; less commonly, specific forms of myocarditis may result from other pathogens, toxic or hypersensitivity drug reactions, giant-cell myocarditis, or sarcoidosis.  Continue reading

Indications and Contraindications for Tilt Table Testing

Indications

  • Recurrent syncope or single syncopal episode accompanied by physical injury or motor vehicle crash or occurring in a high risk setting (for example, pilot, surgeon, commercial vehicle driver) and no evidence of structural cardiovascular disease; or presence of structural cardiovascular disease but other causes of syncope ruled out by diagnostic testing

  • Syncope induced by or associated with exercise

  • Further evaluation of patients in whom an apparent specific cause of syncope has been established (for example, asystole, high atrioventricular block) but susceptibility to neurocardiogenic syncope may affect treatment plan

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Diagnostic Criteria for Heparin-Induced Thrombocytopenia (HIT)

Diagnostic Criteria for Heparin-Induced Thrombocytopenia (HIT)

  • Heparin exposure >5 days
  • Relative thrombocytopenia: decrease in platelet count by 50% from baseline OR absolute thrombocytopenia: decrease in platelet count to less than 100 to 150 x 109/L
  • Absence of other causes of thrombocytopenia
  • Development of new thrombosis, or extension of pre-existing thrombosis, while receiving heparin therapy
  • Confirmation by laboratory testing
  • Return to normal platelet count when heparin is discontinued Continue reading

Causes of Syncope

Cardiac causes

    • Structural cardiac or cardiopulmonary disease (aortic stenosis, mitral stenosis, pulmonary stenosis, left atrial myxoma, aortic dissection, acute myocardial infarction, cardiac tamponade, pulmonary embolism, obstructive cardiomyopathy)

    • Cardiac arrhythmias (tachyarrhythmias, bradyarrhythmias)

    • Neurally mediated syncopal syndrome (includes neurocardiogenic or vasovagal syncope, carotid sinus syncope, and situational syncope)

    • Orthostatic (or postural) hypotension

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