Congestive heart failure cardiac catheterization: Difference between revisions
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(/* 2021 European Society of Cardiology (DO NOT EDIT) {{cite journal |vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A |title=2021 ESC Guidelines for the diagnosis an...) |
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===2021 European Society of Cardiology (DO NOT EDIT) <ref name="pmid34447992">{{cite journal |vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A |title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure |journal=Eur Heart J |volume=42 |issue=36 |pages=3599–3726 |date=September 2021 |pmid=34447992 |doi=10.1093/eurheartj/ehab368 |url=}}</ref>=== | ====2021 European Society of Cardiology (DO NOT EDIT) <ref name="pmid34447992">{{cite journal |vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A |title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure |journal=Eur Heart J |volume=42 |issue=36 |pages=3599–3726 |date=September 2021 |pmid=34447992 |doi=10.1093/eurheartj/ehab368 |url=}}</ref>==== | ||
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| bgcolor="LightGreen"|<nowiki>"</nowiki> [[Right heart catheterization]] may be considered in selected [[patients]] with [[HFpEF]] to confirm the diagnosis..([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki> [[Right heart catheterization]] may be considered in selected [[patients]] with [[HFpEF]] to confirm the diagnosis..([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
===[[Computed tomography coronary angiography]] ([[CTCA]])=== | ===[[Computed tomography coronary angiography]] ([[CTCA]])=== | ||
Revision as of 19:57, 22 June 2022
 |
Resident Survival Guide |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Sara Zand, M.D.[2] Lakshmi Gopalakrishnan, M.B.B.S. [3] Edzel Lorraine Co, DMD, MD[4]
Overview
Coronary angiography is recommended in patients with heart failure, who have angina pectoris or an angina equivalent despite pharmacological therapy, in order to establish the diagnosis of CAD and its severity. Coronary angiography may also be considered in patients with HFrEF who have an intermediate to high pre-test probability of CAD and who are considered potentially suitable for coronary revascularization.
Cardiac Catheterization
Coronary Angiography
- Invasive coronary angiography is useful to rule out significant CAD in patients with cardiac dysfunction.
- It is recommended in patients with angina despite pharmacological therapy or symptomatic ventricular arrhythmias.
- In patients with HFrEF with an intermediate to high pre-test probability of CAD and the presence of ischaemia in noninvasive stress tests, invasive coronary angiography may be considered.
2021 European Society of Cardiology (DO NOT EDIT) [1]
| Class I |
| "Invasive coronary angiography is recommended in patients with angina despite medical therapy or symptomatic ventricular arrhythmias.(Level of Evidence: B) " |
| Class IIb |
| " Invasive coronary angiography may be considered in patients with HFrEF with an intermediate to high pre-test probability of CAD and the presence of ischemia in non-invasive stress tests.(Level of Evidence: B) " |
| Class I |
| " Right heart catheterization is recommended in patients with severe HF being evaluated for heart transplantation or mechanical circulatory support (Level of Evidence: C) " |
| Class IIa |
| " Right heart catheterization is reasonable in HF patients with suspicion of constrictive pericarditis, restrictive cardiomyopathy, congenital heart disease, and high output states.(Level of Evidence: C) " |
| Class IIb |
| " Right heart catheterization may be considered in selected patients with HFpEF to confirm the diagnosis..(Level of Evidence: C) " |
Computed tomography coronary angiography (CTCA)
- Computed tomography coronary angiography (CTCA) may be considered in patients with a low to intermediate pre-test probability ofCAD, or equivocal result of
non-invasive stress tests in order to exclude the diagnosis of CAD.[2]
2021 European Society of Cardiology (DO NOT EDIT) [1][1]
| Class IIa |
| "Coronary CT angiography should be considered in patients with a low to intermediate pre-test probability of CAD or those with equivocal non-invasive stress tests in order to rule out coronary artery stenosis.(Level of Evidence: C) " |
| The above table adopted from 2021 ESC Guideline |
|---|
| Class IIa |
| "Endomyocardial biopsy should be considered in patients with rapidly progressive HF despite standard therapy when there is a probability of a specific diagnosis, which can be confirmed only in myocardial samples.(Level of Evidence: C) " |
Hemodynamic Assessment
Right Heart Catheterization
Right heart catheterization can be useful to assess the following:
- Pulmonary capillary wedge pressure
- Pulmonary artery pressure to diagnose pulmonary hypertension and respond to therapy
- Right heart catheterization should be considered in patients where HF is thought to be due to constrictive pericarditis, restrictive cardiomyopathy,
congenital heart disease, and high output states.
References
- ↑ 1.0 1.1 1.2 McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland J, Coats A, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam C, Lyon AR, McMurray J, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano G, Ruschitzka F, Kathrine Skibelund A (September 2021). "2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure". Eur Heart J. 42 (36): 3599–3726. doi:10.1093/eurheartj/ehab368. PMID 34447992 Check
|pmid=value (help). Vancouver style error: initials (help) - ↑ Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, Prescott E, Storey RF, Deaton C, Cuisset T, Agewall S, Dickstein K, Edvardsen T, Escaned J, Gersh BJ, Svitil P, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Valgimigli M, Achenbach S, Bax JJ (January 2020). "2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes". Eur Heart J. 41 (3): 407–477. doi:10.1093/eurheartj/ehz425. PMID 31504439.