Eisenmenger’s syndrome ACC/AHA guidelines for evaluation of patients: Difference between revisions
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==ACC / AHA Guidelines- Recommendations for Evaluation of the Patient With Congenital Heart Disease– Pulmonary Arterial Hypertension (DO NOT EDIT)== | ==ACC / AHA Guidelines- Recommendations for Evaluation of the Patient With Congenital Heart Disease– Pulmonary Arterial Hypertension (DO NOT EDIT)== | ||
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]= | {| class="wikitable" | ||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Care of adult patients with CHD-related PAH should be performed in centers that have shared expertise and training in both ACHD and PAH. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' The evaluation of all ACHD patients with suspected PAH should include noninvasive assessment of cardiovascular anatomy and potential shunting, as detailed below: | |||
a. Pulse oximetry, with and without administration of supplemental oxygen, as appropriate. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | |||
b. Chest x-ray. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | |||
C) | |||
c. ECG. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | |||
d. Diagnostic cardiovascular imaging via TTE, TEE, MRI, or CT as appropriate. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | |||
e. Complete blood count and nuclear lung scintigraphy. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' If PAH is identified but its causes are not fully recognized, additional testing should include the following: | |||
a. Pulmonary function tests with volumes and diffusion capacity (diffusing capacity of the lung for carbon monoxide). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | |||
b. Pulmonary embolism–protocol CT with parenchymal lung windows. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | |||
c. Additional testing as appropriate to rule out contributing causes of PAH. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | |||
d. Cardiac catheterization at least once, with potential for vasodilator testing or anatomic intervention, at a center with expertise in catheterization, PAH, and management of CHD-PAH. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |||
|} | |||
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]= | {| class="wikitable" | ||
1. It is reasonable to include a 6-minute walk test or | |- | ||
similar nonmaximal cardiopulmonary exercise test as | | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | ||
part of the functional assessment of patients with | |- | ||
CHD-PAH. (Level of Evidence: C) | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' It is reasonable to include a 6-minute walk test or similar nonmaximal cardiopulmonary exercise test as part of the functional assessment of patients with CHD-PAH. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
|} | |||
==References== | ==References== | ||
Revision as of 15:56, 9 October 2012
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Eisenmenger’s syndrome ACC/AHA Guidelines for Evaluation of Patients |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Priyamavada Singh, MBBS [[2]] Assistant Editor-In-Chief: Kristin Feeney, B.S. [[3]]
Overview
ACC / AHA Guidelines- Recommendations for Evaluation of the Patient With Congenital Heart Disease– Pulmonary Arterial Hypertension (DO NOT EDIT)
| Class I |
| "1. Care of adult patients with CHD-related PAH should be performed in centers that have shared expertise and training in both ACHD and PAH. (Level of Evidence: C) " |
| "2. The evaluation of all ACHD patients with suspected PAH should include noninvasive assessment of cardiovascular anatomy and potential shunting, as detailed below:
a. Pulse oximetry, with and without administration of supplemental oxygen, as appropriate. (Level of Evidence: C) b. Chest x-ray. (Level of Evidence: C) c. ECG. (Level of Evidence: C) d. Diagnostic cardiovascular imaging via TTE, TEE, MRI, or CT as appropriate. (Level of Evidence: C) e. Complete blood count and nuclear lung scintigraphy. (Level of Evidence: C) " |
| "3. If PAH is identified but its causes are not fully recognized, additional testing should include the following:
a. Pulmonary function tests with volumes and diffusion capacity (diffusing capacity of the lung for carbon monoxide). (Level of Evidence: C) b. Pulmonary embolism–protocol CT with parenchymal lung windows. (Level of Evidence: C) c. Additional testing as appropriate to rule out contributing causes of PAH. (Level of Evidence: C) d. Cardiac catheterization at least once, with potential for vasodilator testing or anatomic intervention, at a center with expertise in catheterization, PAH, and management of CHD-PAH. (Level of Evidence: C) " |
| Class IIa |
| "1. It is reasonable to include a 6-minute walk test or similar nonmaximal cardiopulmonary exercise test as part of the functional assessment of patients with CHD-PAH. (Level of Evidence: C) " |