Sandbox:Mitra: Difference between revisions

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(Replaced content with "==Diagnosis== Shown below is an algorithm summarizing the diagnosis of <nowiki>disease name</nowiki> according the the [...] guidelines. {{familytree/start |summary=PE...")
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==Diagnosis==
Shown below is an algorithm summarizing the diagnosis of <nowiki>[[disease name]]</nowiki> according the the [...] guidelines.
{{familytree/start |summary=PE diagnosis Algorithm.}}
{{familytree | | | | A01 | | | A01= }}
Acute Inferior wall Myocardial Infarction
{{familytree | | | | |!| | | | }}
{{familytree | | | | B01 | | | B01= }}
{{familytree | | |,|-|^|-|.| | }}
{{familytree | | C01 | | C02 | C01= | C02= }}


<small>
{{familytree/end}}
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="2" |<small>Diseases</small>
! colspan="3" |<small>Symptoms</small>
! colspan="3" |<small>Physical Examination</small>
! colspan="4" |<small>Diagnostic tests
! rowspan="2" |<small>Other Findings</small>
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!<small>Dyspnea on Exertion</small>
!<small>Chest Pain</small>
!<small>Hemoptysis</small>
!<small>Fever</small>
!<small>Tachypnea</small>
!<small>Tachycardia</small>
!<small>Chest X-ray</small> 
!<small>EKG</small>
!<small>Echocardiography>
!<small>CT scan and MRI</small>
|-style="background: #DCDCDC; padding: 5px; text-align: center;" |[[COVID-associated heart failure]]
| style="background: #F5F5F5; padding: 5px; text-align:center"|
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |
*Cardiomegaly
* Pulmonary edema (interstitial, alveolar)
| style="background: #F5F5F5; padding: 5px;" |
*LVH
*Low-voltage
*Non-specific ST-T change
| style="background: #F5F5F5; padding: 5px;" |
*systoloic dysfunction
*Diastoic dysfunction
*Stress Cardiomyopathy (apical ballooning)
| style="background: #F5F5F5; padding: 5px;" |
*CT: Cardiomegaly, pulmonary edema
*MRI: Signs of underlying myocarditis may be seen
| style="background: #F5F5F5; padding: 5px;" |
*Hypercoagulating conditions ([[Factor V Leiden]], [[thrombophilia]], [[deep vein thrombosis]], immobilization, [[malignancy]], [[pregnancy]])
| style="background: #F5F5F5; padding: 5px;" |
* May be associated with [[metabolic alkalosis]] and [[syncope]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" | [[Congestive heart failure]]
| style="background: #F5F5F5; padding: 5px;" |
*On [[Computed tomography|CT scan]]:
** [[Mediastinal lymphadenopathy]]
** Hazy [[mediastinal]] fat
*On [[Magnetic resonance imaging|MRI]]:
** Abnormality of [[cardiac]] chambers ([[Hypertrophy (medical)|hypertrophy]], dilation)
** Delayed enhancement [[MRI]] may help characterize the [[myocardial]] [[Tissue (biology)|tissue]] ([[fibrosis]])
** Late enhancement of contrast in conditions such as [[myocarditis]], [[sarcoidosis]], [[amyloidosis]], [[Anderson-Fabry disease|Anderson-Fabry]]'s disease, [[Chagas disease]])
| style="background: #F5F5F5; padding: 5px;" |
*Goldberg's criteria may aid in diagnosis of left ventricular dysfunction: (High specificity)
**[[S wave|S]]V1 or [[S wave|S]]V2 + [[R wave|R]]V5 or [[R wave|R]]V6 ≥3.5 mV
**Total [[QRS complex|QRS]] amplitude in each of the limb leads ≤0.8 mV
** [[R wave|R]]/[[S wave|S]] ratio <1 in lead V4
| style="background: #F5F5F5; padding: 5px;" |
*[[Cardiomegaly]]
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*Previous [[myocardial infarction]]
*[[Hypertension]] ([[Systemic hypertension|systemic]] and [[Pulmonary hypertension|pulmonary]])
*[[Cardiac arrhythmia|Cardiac arrythmias]]
*[[Viral]] infections ([[myocarditis]])
*[[Congenital heart disease|Congenital heart defects]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Right heart failure]] associated with:
**[[Hepatomegaly]]
**Positive hepato-jugular reflex
**Increased [[jugular venous pressure]]
**[[Peripheral edema]]
*[[Left heart failure]] associated with:
**[[Pulmonary edema]]
**Eventual [[right heart failure]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Percarditis]]
| style="background: #F5F5F5; padding: 5px;" |
*On contrast enhanced [[Computed tomography|CT scan]]:
**Enhancement of the [[pericardium]] (due to [[inflammation]])
**[[Pericardial effusion]]
**[[Pericardial calcification]]
*On [[gadolinium]]-enhanced fat-saturated [[Magnetic resonance imaging|T1-weighted MRI]]:
**[[Pericardial]] enhancement (due to [[inflammation]])
**[[Pericardial effusion]]
| style="background: #F5F5F5; padding: 5px;" |
*ST elevation
*PR depression
| style="background: #F5F5F5; padding: 5px;" |
*Large collection of fluid inside the pericardial sac (pericardial effusion)
*Calcification of pericardial sac
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔ (Low grade)
| style="background: #F5F5F5; padding: 5px;" |✔ (Relieved by sitting up and leaning forward)
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*Infections:
**[[Viral]] (Coxsackie virus, [[Herpes simplex virus|Herpes virus]], [[Mumps virus]], [[Human Immunodeficiency Virus (HIV)|HIV]])
**[[Bacteria]] ([[Mycobacterium tuberculosis]]-common in developing countries)
**[[Fungal]] ([[Histoplasmosis]])
*Idiopathic in a large number of cases
*[[Autoimmune]]
*[[Uremia]]
*[[Malignancy]]
*Previous [[myocardial infarction]]
| style="background: #F5F5F5; padding: 5px;" |
*May be clinically classified into:
**Acute (< 6 weeks)
**Sub-acute (6 weeks - 6 months)
**Chronic (> 6 months)
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pneumonia]]
| style="background: #F5F5F5; padding: 5px;" |
*On [[Computed tomography|CT scan]]: (not generally indicated)
**[[Consolidation (medicine)|Consolidation]] ([[alveolar]]/lobar pneumonia)
**Peribronchial [[nodules]] ([[bronchopneumonia]])
**[[Ground glass opacification on CT|Ground-glass opacity]] (GGO)
**[[Abscess]]
**[[Pleural effusion]]
**On [[MRI]]:
*Not indicated
| style="background: #F5F5F5; padding: 5px;" |
*Prolonged [[PR interval]]
*Transient [[T wave]] inversions
| style="background: #F5F5F5; padding: 5px;" |
*[[Consolidation (medicine)|Consolidation]] ([[alveolar]]/lobar [[pneumonia]])
*Peribronchial [[nodules]] (bronchopneumonia)
*Ground-glass opacity (GGO)
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*Ill-contact
*Travelling
*[[Smoking]]
*[[Diabetes mellitus|Diabetic]]
*Recent hospitalization
*[[Chronic obstructive pulmonary disease]]
| style="background: #F5F5F5; padding: 5px;" |
*Requires [[Sputum|sputum stain]] and culture for diagnosis
*[[Empiric therapy|Empiric management]] usually started before [[Culture collection|culture]] results
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vasculitis]]
| style="background: #F5F5F5; padding: 5px;" |
*On [[Computed tomography|CT scan]]: ([[Takayasu's arteritis|Takayasu arteritis]])
**[[Blood vessel|Vessel]] wall thickening
**Luminal narrowing of [[pulmonary artery]]
**Masses or nodules ([[Anti-neutrophil cytoplasmic antibody|ANCA]]-associated granulomatous vasculitis)
*On [[Magnetic resonance imaging|MRI]]:
Homogeneous, circumferential [[Blood vessel|vessel]] wall [[swelling]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Bundle branch block|Right or left bundle-branch block]] ([[Churg-Strauss syndrome]])
*[[Atrial fibrillation]] ([[Churg-Strauss syndrome]])
*Non-specific [[ST interval|ST segment]] and [[T wave]] changes
| style="background: #F5F5F5; padding: 5px;" |
*[[Nodule (medicine)|Nodules]]
*[[Cavitation]]
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |
*[[Takayasu's arteritis|Takayasu arteritis]] usually found in persons aged 4-60 years with a mean of 30
*[[Giant-cell arteritis]] usually occurrs in persons aged > 60 years
*[[Churg-Strauss syndrome]] may present with [[asthma]], [[sinusitis]], transient [[pulmonary]] infiltrates and neuropathy alongwith [[cardiac]] involvement
*Granulomatous vasculitides may present with [[nephritis]] and [[upper airway]] ([[nasopharyngeal]]) destruction
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Chronic obstructive pulmonary disease]] (COPD)
| style="background: #F5F5F5; padding: 5px;" |
*On [[Computed tomography|CT scan]]:
**[[Chronic bronchitis]] may show [[bronchial]] wall thickening, scarring with bronchovascular irregularity, [[fibrosis]]
**[[Emphysema]] may show [[alveolar]] septal destruction and airspace enlargement (Centrilobular- upper lobe, panlobular- lower lobe)
**Giant bubbles
*On [[MRI]]:
**Increased diameter of [[pulmonary arteries]]
**Peripheral [[pulmonary]] [[vasculature]] attentuation
**Loss of retrosternal airspace due to right ventricular enlargement
**Hyperpolarized Helium MRI may show progressively poor ventilation and destruction of lung
| style="background: #F5F5F5; padding: 5px;" |
*[[Multifocal atrial tachycardia]] (atleast 3 distinct [[P waves|P wave]] morphologies)
| style="background: #F5F5F5; padding: 5px;" |
*Enlarged [[lung]] shadows ([[emphysema]])
*Flattening of [[diaphragm]] ([[emphysema]])
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" |✔
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
*[[Smoking]]
*[[Alpha 1-antitrypsin deficiency|Alpha-1 antitrypsin deficiency]]
*Increased [[sputum]] production ([[chronic bronchitis]])
*[[Cough]]
| style="background: #F5F5F5; padding: 5px;" |
*[[Alpha 1-antitrypsin deficiency|Alpha 1 antitrypsin deficiency]] may be associated with [[hepatomegaly]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[COVID-19-associated heart failure]]
| style="background: #F5F5F5; padding: 5px;" |
*
| style="background: #F5F5F5; padding: 5px;" |
*
| style="background: #F5F5F5; padding: 5px;" |
*
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
*
| style="background: #F5F5F5; padding: 5px;" |
*
|}
 
=====Other Conditions that Cause Dyspnea that are Emergencies=====
The following emergency conditions should be excluded when diagnosing a patient with heart failure:
* [[Asthma]] or [[bronchospasm]]
* [[Foreign body aspiration]]
* [[H. influenza epiglottitis]]
* [[Spontaneous pneumothorax]]
 
=====Non Cardiac Causes of Dyspnea=====
* [[Abdominal masses]]
* [[Acute bronchitis]]
* [[Acute Chest Syndrome]]
* [[Acute myeloid leukemia]]
* [[Acute promyelocytic leukemia]]
* [[Acute tracheobronchitis]]
* [[AIDS]]
* [[Air pollution]]
* [[Air-conditioner lung]]
* [[Allergy]]
* [[Alpha 1-antitrypsin deficiency]]
* [[Altitude sickness]]
* [[Amniotic fluid embolism]]
* [[Amphotericin B]]
* [[Amyl nitrite]]
* [[Amyotrophic Lateral Sclerosis]] ([[ALS]])
* [[Anaphylactoid reactions]]
* [[Anaphylaxis]]
* [[Anemia]]
* [[Anthrax]]
* [[Anxiety]]
* [[Asbestosis]]
* [[Aspergillus clavatus]]
* [[Aspiration]]
* [[Asthma]]
* [[Atelectasis]]
* [[Atypical pneumonia]]
* [[Barium]]
* [[Beta-blockers]]
* [[Betazole]]
* [[Bird breeder's lung]]
* [[Bird fancier's lung]]
* [[Bland-White-Garland Syndrome]]
* [[Bleomycin]] in [[ABVD]]
* [[Blood transfusion]]
* [[Brain stem infarction]]
* [[Bronchial asthma]]
* [[Bronchial tumors]]
* [[Bronchiolitis]]
* [[Bronchiolitis obliterans]]
* [[Bronchiolitis obliterans organizing pneumonia]]
* [[Bronchitis]]
* [[Bronchogenic carcinoma]]
* [[Bronchoscopy]]
*[[Cardiovascular syphilis]]
* [[Caspofungin]]
* [[Cheese worker's lung]]
* [[Chemical worker's lung]]
* [[Chest trauma]]
* [[Chest tube]]
* [[Cholesterol pericarditis]]
* [[Bronchitis|Chronic bronchitis]]
* [[Chronic fatigue syndrome]]
* [[Chronic Obstructive Pulmonary Disease]] (COPD)
* [[Chylothorax]]
* [[Cirrhosis]]
* [[Cladosporium]]
* [[CMV Pneumonitis]]
* [[Community-acquired pneumonia]]
* [[Croup]]
* [[Cystic Fibrosis]]
* [[Daptomycin]]
* [[Decompression sickness]]
* Decreased thoracic or [[diaphragm]]atic excursion
* [[Diabetic coma]]
* [[Diffuse panbronchiolitis]]
* [[Diverticulosis]]
* [[Drugs]]
* [[Ehrlichiosis (canine)]]
* [[Empty nose syndrome]]
* [[Empyema, pleural]]
* [[Encephalitis]]
* [[Eosinophilic pneumonia]]
* [[Ephedrine]]
* [[Epidemic dropsy]]
* [[Erdheim-Chester disease]]
* [[Esophageal cancer]]
* Esophageal diseases with [[trachea]]l compression
* [[Exercise-induced asthma]]
* [[Extrinsic allergic alveolitis]]
* [[Fat embolism]]
* [[Fibrosing alveolitis, cryptogenic]]
* [[Gamma-Hydroxybutyric acid]]
* [[Gastroesophageal reflux]]
* [[Gemeprost]]
* [[Glatiramer acetate]]
* Glottal edema
* [[Goiter]]
* [[Goodpasture syndrome]]
* [[Grain handler's lung]]
* Gram-negative [[sepsis]]
* [[Guillain-Barre Syndrome]]
* [[Hemochlyothorax]]
* [[Hemothorax]]
* [[Histiocytosis X]]
* [[Hoose (disease)]]
* [[Humidifier lung]]
* [[Hydrochlyothorax]]
* [[Hypersensitivity Pneumonitis]]
* [[Hyperthyroidism]]
* [[Hypoxia]]
* [[Hysteria]]
* [[Idiopathic pulmonary fibrosis]]
* [[Iloprost]]
* [[Interstitial lung disease]]
* [[Intoxication]] ([[carbon monoxide]], [[cyanide]])
* Intrapulmonary receptor stimulation
* [[Intussusception (medical disorder)]]
* [[Iron deficiency anemia]]
* [[Irregular Heart Rhythms]]
* [[Ketorolac]]
* [[Kyphoscoliosis]]
* [[Laryngeal]]/[[bronchospasm]]
* [[Leukemia]]
* [[Lung cancer]]
* [[Lymphangitic metastases]]
* [[Lymphocytic interstitial pneumonia]]
* [[Lymphoma]]
* [[Malignant Mesothelioma]]
* [[Malt worker's lung]]
* [[Mediastinal tumors]]
* [[Megaloblastic Anemias]]
* [[Mercury (element)]]
* [[Metabolic acidosis]]
* [[Methyl isocyanate]]
* [[Micropolyspora faeni]]
* [[Miliary tuberculosis]]
* [[Mollusk shell hypersensitivity]]
* [[Mucor stolonifer]]
* Multiple [[rib fractures]]
* [[Myasthenia Gravis]]
* [[Myxoma]]
* [[Neuromuscular disease]]
* [[Obesity]]
* [[Phrenic nerve paralysis]]
* Pleural callosity
* [[Pneumoconiosis]]
* [[Pneumonia]]
* [[Pneumochlyothorax]]
* [[Pneumothorax]]
* [[Pleural Effusion]]
* Pleural fibrosis
* [[Polyradiculitis]]
* Pulmonary [[arteriovenous malformation]]
* [[Pulmonary Emphysema]]
* [[Pulmonary fibrosis]]
* [[Quincke's Edema]]
* [[Radiation]] pneumonitis
* [[Respiratory tract infection]]
* [[Sarcoidosis]]
* [[Shock]]
* [[Shock lung]]
* [[Sleep Apnea Syndrome]]
* [[Trauma]]
* [[Tracheal stenosis]]
* [[Tracheal tumors]]
* [[Tracheomalacia]]
* [[Tracheobronchial collapse]]
* [[Uremia]]

Revision as of 17:41, 1 August 2020

Diagnosis

Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.

Acute Inferior wall Myocardial Infarction

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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