ACC/AHA Guidelines for the Clinical Application of Echocardiography

Alpert, Joseph S.; Armstrong, William F.; Aurigemma, Gerard P.; Beller, George A.; Bierman, Fredrick Z.; Davidson, Thomas; Davis, Jack L.; Douglas, Pamela S.; Gillam, Linda D.; Pearlman, Alan S.; Philbrick, John T.; Shah, Pravin M.; Williams, Roberta G.; Ritchie, James L.; Cheitlin, M.D.; Eagle, Kim A.; Gardner, Timothy J.; Garson, Arthur; Gibbons, Raymond J.; Lewis, Richard P.; O’Rourke, Robert A.; Ryan, Thomas J.

doi:10.1161/01.cir.95.6.1686

Cited by 554 publications

(166 citation statements)

References 478 publications

Supporting

Mentioning

141

Contrasting

Unclassified

Order By: Relevance

“…For detailed age-specific lists of indications, the reader is referred to prior published guidelines. 14 Children with suggested or known heart disease frequently require serial studies to evaluate the evolution or progression of heart disease. Serial studies may be indicated at routine intervals for monitoring of valve function, growth of cardiovascular structures, ventricular function, and potential sequelae of medical or surgical intervention.…”

Section: Indicationsmentioning

confidence: 99%

Guidelines and Standards for Performance of a Pediatric Echocardiogram: A Report from the Task Force of the Pediatric Council of the American Society of Echocardiography

Lai

Geva²,

Shirali

et al. 2006

Journal of the American Society of Echocardiography

769

468

View full text Add to dashboard Cite

Section: Indicationsmentioning

confidence: 99%

Guidelines and Standards for Performance of a Pediatric Echocardiogram: A Report from the Task Force of the Pediatric Council of the American Society of Echocardiography

Lai

Geva²,

Shirali

et al. 2006

Journal of the American Society of Echocardiography

769

468

View full text Add to dashboard Cite

“…LV ejection fraction was measured quantitatively using the 2-dimensional echocardiography biplane method of discs. 8,9 We defined LV hypertrophy as LV mass index >90 g/m 2 based on the 2-dimensional echocardiography truncated ellipse method. 10 A symptom-limited graded exercise treadmill test was performed, and we used stress echocardiography to seek inducible ischemia, defined as the presence of cardiac wall motion abnormality at peak exercise that was not present at rest.…”

Section: Other Characteristicsmentioning

confidence: 99%

Prevalence and Prognosis of Asymptomatic Left Ventricular Diastolic Dysfunction in Ambulatory Patients With Coronary Heart Disease

Ren

Ristow

et al. 2007

The American Journal of Cardiology

View full text Add to dashboard Cite

The association of asymptomatic left ventricular (LV) diastolic dysfunction with cardiovascular outcomes in ambulatory patients with coronary heart disease (CHD) and no history of heart failure (HF) was examined. LV diastolic HF predicts adverse cardiovascular outcomes. However, the prevalence and prognosis of asymptomatic LV diastolic dysfunction in patients with established CHD in the absence of clinical HF is unknown. Six hundred ninety-three patients with stable CHD, normal systolic function (LV ejection fraction ≥50%), and no history of HF were evaluated. Echocardiography was used to classify LV diastolic function, and Cox proportional hazards models were used to evaluate the association of LV diastolic dysfunction with cardiovascular outcomes during 3 years of follow-up. Of 693 subjects with normal systolic function and no history of HF, 455 (66%) had normal LV diastolic function, 166 (24%) had mild LV diastolic dysfunction, and 72 (10%) had moderate to severe LV diastolic dysfunction. After multivariable adjustment, the presence of moderate to severe LV diastolic dysfunction was strongly predictive of incident hospitalization for HF (hazard ratio 6.3, 95% confidence interval 2.4 to 16.1, p = 0.0003) and death from heart disease (HR 3.9, 95% confidence interval 1.0 to 14.8, p = 0.05). In conclusion, moderate to severe LV diastolic dysfunction was present in 10% of patients with stable CHD with normal ejection fraction and no history of HF and predicts subsequent hospitalization for HF and death from heart disease. Patients with asymptomatic LV diastolic dysfunction may benefit from more aggressive therapy to prevent or delay the development of HF.Left ventricular (LV) diastolic heart failure (HF) accounts for nearly half of all HF diagnoses and is associated with increased morbidity and mortality. [1][2][3] The prevalence and prognosis of asymptomatic LV diastolic dysfunction is unclear because most studies of the association between LV diastolic dysfunction and adverse outcomes examined patients with clinical HF. 1-3 One previous study examined the association of LV diastolic dysfunction with cardiovascular outcomes in patients without known heart disease, 4 but the prevalence and *Corresponding author: Tel.: 415-377-1404; fax: 415-563-5939., xiushui@yahoo.com (X. Ren). NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript prognosis of asymptomatic LV diastolic dysfunction in outpatients with stable coronary heart disease (CHD) is unknown. We evaluated the prevalence and prognosis of asymptomatic LV diastolic dysfunction in ambulatory patients with CHD with preserved systolic function and no history of HF. We hypothesized that asymptomatic LV diastolic dysfunction would be an independent predictor of adverse cardiovascular outcomes in these patients. Methods PatientsPatients were enrolled in the Heart and Soul Study, a prospective cohort study investigating the influence of psychosocial factors on cardiovascular events. Methods were described previously. 5 Ad...

show abstract

“…É fundamental que a equipe multidisciplinar envolvida no atendimento esteja treinada para o registro dessa derivação, que deve ser realizado em todos os pacientes com infarto inferior na admissão hospitalar. A ecocardiografia Doppler pode ser útil em pacientes com suspeita clínica de isquemia do ventrículo direito e achados não diagnósticos 379 . Dilatação ventricular direita, assinergia da contração ventricular e movimentação anômala dos septos interventricular e interatrial são os achados mais comuns 380-382 .…”

Section: -Diagnóstico Clínicounclassified

Diretrizes

2009

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

-Atendimento pré-hospitalarO interesse no atendimento pré-hospitalar do infarto agudo do miocárdio (IAM) teve início na década de 1960, devido ao grande número de óbitos que ocorriam antes que os paciente chegassem ao hospital.A maioria das mortes por IAM ocorre nas primeiras horas de manifestação da doença, sendo 40%-65% dos casos na primeira hora e, aproximadamente, 80% nas primeiras 24 horas [1][2][3] . Assim, a maior parte das mortes por IAM acontece fora do ambiente hospitalar, geralmente desassistidas pelos médicos 4 . A modalidade mais frequente de parada cardiorrespiratória nas primeiras horas do IAM é a fibrilação ventricular 3 . -Período pré-hospitalar.O período pré-hospitalar compreende dois momentos: a) do início dos sintomas (geralmente dor torácica aguda) até a decisão de procurar atendimento; b) da decisão de procurar atendimento até a chegada ao hospital.No infarto agudo do miocárdio com elevação do segmento ST (IAMCST), o tempo desde o início dos sintomas (oclusão da artéria coronária) até a instituição do tratamento (reperfusão química ou mecânica) é diretamente proporcional à ocorrência de eventos clinicamente relevantes. Esse tempo é fator fundamental para o benefício do tratamento, tanto imediato quanto tardio 5 .No entanto, sabe-se que a fase pré-hospitalar (em ambos os momentos descritos) é caracterizada por ser demorada, especialmente em pacientes idosos, do sexo feminino e com baixa condição socioeconômica 4 . Alguns fatores estão relacionados ao aumento desse tempo tão precioso (Quadro 1.1.1.1) 6 . O componente pré-hospitalar no atraso do atendimento ao paciente com dor torácica é de tal magnitude que, na prática clínica, apenas cerca de 20% destes pacientes chegam ao setor de emergência com até duas horas após o início dos sintomas 7 . -Medidas na fase pré-hospitalarApesar da significativa redução da mortalidade hospitalar do IAM nas últimas décadas 8,9 , houve pouco avanço no conhecimento sobre a epidemiologia e o tratamento na fase pré-hospitalar. É notória a necessidade de mudanças nesse cenário, embora poucas sejam as evidências geradas para este fim.A abordagem do paciente com suspeita de síndrome coronária aguda em ambiente extra-hospitalar deve, idealmente, ser feita por profissional de saúde, com realização de uma história clínica direcionada, investigando as características dos sintomas atuais (momento do início, tempo de duração, qualidade, intensidade, relação com o esforço e repouso) e a presença de doença coronária estabelecida (angina prévia). Algumas características são reconhecidamente determinantes para a manifestação atípica de um evento coronariano e devem ser lembradas quando um indivíduo for abordado na fase pré-hospitalar, por mascararem o quadro de IAM (Tabela 1.1.2.1) [10][11][12] .O eletrocardiograma executado no local de atendimento e interpretado por um médico habilitado (na ambulância ou em local remoto) mostrou ser um método que reduz em 34% o tempo porta-agulha e em 18% o tempo porta-balão, além de proporcionar maiores taxas de tempo porta-balão ideal (men...

show abstract

ACC/AHA Guidelines for the Clinical Application of Echocardiography

Cited by 554 publications

References 478 publications

Guidelines and Standards for Performance of a Pediatric Echocardiogram: A Report from the Task Force of the Pediatric Council of the American Society of Echocardiography

Guidelines and Standards for Performance of a Pediatric Echocardiogram: A Report from the Task Force of the Pediatric Council of the American Society of Echocardiography

Prevalence and Prognosis of Asymptomatic Left Ventricular Diastolic Dysfunction in Ambulatory Patients With Coronary Heart Disease

Diretrizes

Contact Info

Product

Resources

About