DVT complete diagnostic approach resident survival guide: Difference between revisions

Revision as of 22:02, 8 March 2014

Probability of infective endocaritis	Characteristics
Definite diagnosis by pathological criteria	❑ Microorganisms demonstrated by culture or histological examination of a vegetation, OR ❑ Pathological lesions; vegetation or intracardiac abscess confirmed by histological examination showing active endocarditis
Definite diagnosis by clinical criteria	❑ 2 major criteria; OR ❑ 1 major criterion and 3 minor criteria; OR ❑ 5 minor criteria
Possible diagnosis	❑ 1 major criterion and 1 minor criterion; OR ❑ 3 minor criteria
Rejected diagnosis	❑ Firm alternative diagnosis explaining evidence of IE, OR ❑ Resolution of IE syndrome with antibiotic therapy for 4 days, OR ❑ No pathological evidence of IE at surgery or autopsy, with antibiotic therapy for 4 days, OR ❑ Does not meet criteria for possible IE as above

Criteria	Definite Infective Endocarditis According to Modified Duke Criteria
Pathological Criteria	Microorganisms demonstrated by culture or histological examination of a vegetation Pathological lesions; vegetation or intracardiac abscess confirmed by histological examination showing active endocarditis
Clinical Criteria	2 major criteria; or 1 major criterion and 3 minor criteria; or 5 minor criteria
Possible IE	1 major criterion and 1 minor criterion; or 3 minor criteria
Rejected	Firm alternative diagnosis explaining evidence of IE; or Resolution of IE syndrome with antibiotic therapy for 4 days; or No pathological evidence of IE at surgery or autopsy, with antibiotic therapy for 4 days; or Does not meet criteria for possible IE as above

Management of focal atrial tachycardia
Acute treatment
Conversion
Hemodynamically unstable patient
▸ DC cardioversion (Class I, level of evidence B)
Hemodynamically stable patient
▸ Adenosine (Class IIa, level of evidence C) OR ▸ Verapamil (Class IIa, level of evidence C) OR ▸ Diltiazem (Class IIa, level of evidence C) OR ▸ Beta blocker (Class IIa, level of evidence C) OR ▸ Amiodarone (Class IIa, level of evidence C) OR ▸ Sotalol (Class IIa, level of evidence C) OR ▸ Procainamide (Class IIa, level of evidence C) OR ▸ Flecainide (Class IIa, level of evidence C) OR ▸ Propafenone (Class IIa, level of evidence C)
Rate control
▸ Verapamil (Class I, level of evidence C) OR ▸ Diltiazem (Class I, level of evidence C) OR ▸ Beta blocker (Class I, level of evidence C) OR ▸ Digoxin (Class IIb, level of evidence C)

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 | style="padding: 0 5px; font-size: 90%; background: #DCDCDC;" align=left | '''''Rate control'''''
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-| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Verapamil]]''''' ([[ACC AHA guidelines classification scheme|Class I, level of evidence C]])<BR>''OR''<BR>▸ '''''[[Diltiazem]]''''' ([[ACC AHA guidelines classification scheme|Class I, level of evidence C]])<BR>''OR''<BR>▸ '''''[[Beta blocker]]''''' ([[ACC AHA guidelines classification scheme|Class I, level of evidence C]])<BR>''OR''<BR>▸ '''''[[Digoxin]]''''' ([[ACC AHA guidelines classification scheme|Class I, level of evidence C]])
+| style="font-size: 90%; padding: 0 5px; background: #DCDCDC" align=left | ▸ '''''[[Verapamil]]''''' ([[ACC AHA guidelines classification scheme|Class I, level of evidence C]])<BR>''OR''<BR>▸ '''''[[Diltiazem]]''''' ([[ACC AHA guidelines classification scheme|Class I, level of evidence C]])<BR>''OR''<BR>▸ '''''[[Beta blocker]]''''' ([[ACC AHA guidelines classification scheme|Class I, level of evidence C]])<BR>''OR''<BR>▸ '''''[[Digoxin]]''''' ([[ACC AHA guidelines classification scheme|Class IIb, level of evidence C]])
 |-
 |}