Pulseless ventricular tachycardia diagnostic study of choice: Difference between revisions

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Latest revision as of 14:25, 10 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]

Overview

The diagnosis of pulseless ventricular tachycardia is based on ECG and physical examination findings. An ECG should be the initial study, and other investigations may be carried out afterwards to determine the underlying aetiology.

Diagnostic Study of Choice

Study of choice

An ECG should be the initial study,^[1] and other investigations may be carried out afterward to determine the underlying etiology.^[2]
In order to evaluate left and right ventricular function in patients with ventricular arrhythmias, echocardiography should be performed.^[3]
If echocardiography fails to determine ventricular function, MRI, cardiac CT scanning, or radionuclide angiography can be useful assessments of structural heart changes.

References

↑ Foglesong A, Mathew D. PMID 32119354 Check |pmid= value (help). Missing or empty |title= (help)
↑ Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, Brooks SC, de Caen AR, Donnino MW, Ferrer JM, Kleinman ME, Kronick SL, Lavonas EJ, Link MS, Mancini ME, Morrison LJ, O'Connor RE, Samson RA, Schexnayder SM, Singletary EM, Sinz EH, Travers AH, Wyckoff MH, Hazinski MF (November 2015). "Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S315–67. doi:10.1161/CIR.0000000000000252. PMID 26472989.
↑ Dalia AA, Essandoh M, Cronin B, Hussain N, Gerstein NS, Schulman P (June 2019). "A Narrative Review for Anesthesiologists of the 2017 American Heart Association/American College of Cardiology/Heart Rhythm Society Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death". J. Cardiothorac. Vasc. Anesth. 33 (6): 1722–1730. doi:10.1053/j.jvca.2019.01.004. PMID 30685157.

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[pmid32119354-1] Foglesong A, Mathew D. PMID 32119354 Check |pmid= value (help). Missing or empty |title= (help)

[pmid26472989-2] Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, Brooks SC, de Caen AR, Donnino MW, Ferrer JM, Kleinman ME, Kronick SL, Lavonas EJ, Link MS, Mancini ME, Morrison LJ, O'Connor RE, Samson RA, Schexnayder SM, Singletary EM, Sinz EH, Travers AH, Wyckoff MH, Hazinski MF (November 2015). "Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S315–67. doi:10.1161/CIR.0000000000000252. PMID 26472989.

[pmid30685157-3] Dalia AA, Essandoh M, Cronin B, Hussain N, Gerstein NS, Schulman P (June 2019). "A Narrative Review for Anesthesiologists of the 2017 American Heart Association/American College of Cardiology/Heart Rhythm Society Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death". J. Cardiothorac. Vasc. Anesth. 33 (6): 1722–1730. doi:10.1053/j.jvca.2019.01.004. PMID 30685157.

[1]

[2]

[3]

@@ Line 3: / Line 3: @@
 {{CMG}}; {{AE}}{{Aisha}}
 == Overview ==
+The diagnosis of pulseless ventricular tachycardia is based on ECG and physical examination findings. An ECG should be the initial study, and other investigations may be carried out afterwards to determine the underlying aetiology.
 == Diagnostic Study of Choice ==
 === Study of choice ===
-[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
+*An ECG should be the initial study,<ref name="pmid32119354">{{cite journal |vauthors=Foglesong A, Mathew D |title= |journal= |volume= |issue= |pages= |date= |pmid=32119354 |doi= |url=}}</ref> and other investigations may be carried out afterward to determine the underlying etiology.<ref name="pmid26472989">{{cite journal |vauthors=Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, Brooks SC, de Caen AR, Donnino MW, Ferrer JM, Kleinman ME, Kronick SL, Lavonas EJ, Link MS, Mancini ME, Morrison LJ, O'Connor RE, Samson RA, Schexnayder SM, Singletary EM, Sinz EH, Travers AH, Wyckoff MH, Hazinski MF |title=Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care |journal=Circulation |volume=132 |issue=18 Suppl 2 |pages=S315–67 |date=November 2015 |pmid=26472989 |doi=10.1161/CIR.0000000000000252 |url=}}</ref>
+*In order to evaluate left and right ventricular function in patients with ventricular arrhythmias, echocardiography should be performed.<ref name="pmid30685157">{{cite journal |vauthors=Dalia AA, Essandoh M, Cronin B, Hussain N, Gerstein NS, Schulman P |title=A Narrative Review for Anesthesiologists of the 2017 American Heart Association/American College of Cardiology/Heart Rhythm Society Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death |journal=J. Cardiothorac. Vasc. Anesth. |volume=33 |issue=6 |pages=1722–1730 |date=June 2019 |pmid=30685157 |doi=10.1053/j.jvca.2019.01.004 |url=}}</ref>
-OR
+*If echocardiography fails to determine ventricular function, MRI, cardiac CT scanning, or radionuclide angiography can be useful assessments of structural heart changes.
-The following result of [gold standard test] is confirmatory of [disease name]:
-* [Result 1]
-* [Result 2]
-OR
-[Name of the investigation] must be performed when:
-* The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
-* A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
-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
-| 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
-| 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==