Renal artery stenosis resident survival guide: Difference between revisions
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==Clinical Clues to the Diagnosis of RAS== | ==Clinical Clues to the Diagnosis of RAS== | ||
{{familytree/start}} | {{familytree/start}} | ||
{{familytree | | | A01 | | | A01= ❑ '''Determine if one or more of the above is present'''}} | {{familytree | | | | | A01 | | | A01= ❑ '''Determine if one or more of the above is present'''}} | ||
{{familytree | | | |!| | | | | | | | | | | }} | {{familytree | | | |!| | | | | | | | | | | }} | ||
{{familytree | | | A02 | | A02= <table class="wikitable"> | {{familytree | | | | | A02 | | A02= <table class="wikitable"> | ||
<tr class="v-firstrow"><th>Scenario</th><th>Level of evidence</th></tr> | <tr class="v-firstrow"><th>Scenario</th><th>Level of evidence</th></tr> | ||
<tr><td>'''1.'''Onset of hypertension before the age of 30 years or severe hypertension after the age of 55</td><td>Class I; LOE B</td></tr> | <tr><td>'''1.'''Onset of hypertension before the age of 30 years or severe hypertension after the age of 55</td><td>Class I; LOE B</td></tr> | ||
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<tr><td>'''9.''' Refractory angina</td><td>Class IIb; LOE C</td></tr> | <tr><td>'''9.''' Refractory angina</td><td>Class IIb; LOE C</td></tr> | ||
</table>}} | </table>}} | ||
{{familytree | | | |!| | | | | | | | | | | }} | {{familytree | | | | | |!| | | | | | | | | | | }} | ||
{{familytree | | | A01 | | | A01= ❑'''If one or more of the above are present, proceed to further diagnostic testing'''}} | {{familytree | | | | | A01 | | | A01= ❑'''If one or more of the above are present, proceed to further diagnostic testing'''}} | ||
{{familytree | | | |!| | | | | | | | | | | }} | {{familytree | | | | | |!| | | | | | | | | | | }} | ||
{{familytree | |,|-|^|-|.| | }} | {{familytree | | | |,|-|^|-|.| | }} | ||
{{familytree | B01 | | B02 | B01=<div style="height: 1em; width: 25em; padding:1em;">'''Noninvasive Imaging''' | {{familytree | | | B01 | | B02 | B01=<div style="height: 1em; width: 25em; padding:1em;">'''Noninvasive Imaging''' | ||
</div>| B02= <div style="height: 1em; width: 25em; padding:1em;">'''Invasive Imaging''' | </div>| B02= <div style="height: 1em; width: 25em; padding:1em;">'''Invasive Imaging''' | ||
</div>}} | </div>}} | ||
{{familytree | |!| | | |!| | }} | {{familytree | | | |!| | | |!| | }} | ||
{{familytree | C01 | | C02 | C01= <div style="float: left; text-align: left; height: 5em; width: 25em; padding:1em;">❑ Duplex ultrasound | {{familytree | | | C01 | | C02 | C01= <div style="float: left; text-align: left; height: 5em; width: 25em; padding:1em;">❑ Duplex ultrasound | ||
❑ Gadolinium enhanced MRA | ❑ Gadolinium enhanced MRA | ||
❑ CT angiography </div>| C02= <div style="height: 3em; width: 25em; padding:1em;">❑ Abdominal aortography to assess the renal arteries during coronary and peripheral angiography</div>}} | ❑ CT angiography </div>| C02= <div style="height: 3em; width: 25em; padding:1em;">❑ Abdominal aortography to assess the renal arteries during coronary and peripheral angiography</div>}} | ||
{{familytree | | | {{familytree | | | |!| | | | | | | | | | | }} | ||
{{familytree |,|^|. | {{familytree | |,|-|^|-|.| | }} | ||
{{familytree |!| | {{familytree | |!| | | |!| | | | | | | | | }} | ||
{{familytree | C01 | | C02 | C01= <div style="float: left; text-align: left; height: 5em; width: 25em; padding:1em;">Negative noninvasive test but with high clinical suspicion </div>| C02= <div style="height: 3em; width: 25em; padding:1em;">Evidence of RAS</div>}} | {{familytree | C01 | | C02 | C01= <div style="float: left; text-align: left; height: 5em; width: 25em; padding:1em;">Negative noninvasive test but with high clinical suspicion </div>| C02= <div style="height: 3em; width: 25em; padding:1em;">Evidence of RAS</div>}} | ||
{{familytree/end}} | {{familytree/end}} |
Revision as of 06:45, 6 January 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karol Gema Hernandez, M.D. [2]
Definition
This section provides a short and straight to the point definition of the disease or symptom in one sentence.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Clinical Clues to the Diagnosis of RAS
❑ Determine if one or more of the above is present | |||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||
❑If one or more of the above are present, proceed to further diagnostic testing | |||||||||||||||||||||||||||||||||||
Noninvasive Imaging
| Invasive Imaging
| ||||||||||||||||||||||||||||||||||
❑ Duplex ultrasound
❑ Gadolinium enhanced MRA ❑ CT angiography | ❑ Abdominal aortography to assess the renal arteries during coronary and peripheral angiography | ||||||||||||||||||||||||||||||||||
Negative noninvasive test but with high clinical suspicion | Evidence of RAS | ||||||||||||||||||||||||||||||||||
Algorithm based on the 2013 AHA Guidelines Recommendations for Management of Patients with PAD.[1]
References
- ↑ Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH; et al. (2013). "Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA guideline recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 127 (13): 1425–43. doi:10.1161/CIR.0b013e31828b82aa. PMID 23457117.