- 1、原创力文档(book118)网站文档一经付费(服务费),不意味着购买了该文档的版权,仅供个人/单位学习、研究之用,不得用于商业用途,未经授权,严禁复制、发行、汇编、翻译或者网络传播等,侵权必究。。
- 2、本站所有内容均由合作方或网友上传,本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺!文档内容仅供研究参考,付费前请自行鉴别。如您付费,意味着您自己接受本站规则且自行承担风险,本站不退款、不进行额外附加服务;查看《如何避免下载的几个坑》。如果您已付费下载过本站文档,您可以点击 这里二次下载。
- 3、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等,请点击“版权申诉”(推荐),也可以打举报电话:400-050-0827(电话支持时间:9:00-18:30)。
- 4、该文档为VIP文档,如果想要下载,成为VIP会员后,下载免费。
- 5、成为VIP后,下载本文档将扣除1次下载权益。下载后,不支持退款、换文档。如有疑问请联系我们。
- 6、成为VIP后,您将拥有八大权益,权益包括:VIP文档下载权益、阅读免打扰、文档格式转换、高级专利检索、专属身份标志、高级客服、多端互通、版权登记。
- 7、VIP文档为合作方或网友上传,每下载1次, 网站将根据用户上传文档的质量评分、类型等,对文档贡献者给予高额补贴、流量扶持。如果你也想贡献VIP文档。上传文档
查看更多
心脏瓣膜病动态监测和手术转诊
Valvular Heart Disease: Ambulatory Monitoring and Surgical Referral Dr. Shane Shapera Previous version: Dr. Wassim Saad for AIMGP October 2006 Valvular Heart Disease Focus on: Aortic stenosis Chronic mitral regurgitation Mitral Stenosis (extra slides if time permits) Who should have an Echo? At first contact? Follow up? How do we interpret the results? How should we follow patients? How often should they be seen in clinic? Are there options for medical management? When should we refer to a surgeon? References New ACC/AHA Practice Guidelines: ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease) JACC. 2006;48(3):598-675. Reminder Class I: There is evidence and/or general agreement that a given procedure or treatment is useful and effective Class II: There is conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of a procedure or treatment IIa: Weight of evidence/opinion is in favor of usefulness/efficacy IIb: Usefulness/efficacy is less well established by evidence/opinion. Class III: There is evidence and/or general agreement that the procedure/treatment is not useful and in some cases may be harmful. A new referral 62 year old man RFR: Family MD “heard a murmer” PMH: HTN and obesity Meds: ASA and Norvasc HPI: Told he has a murmer 2 years ago No symptoms of CVS or respiratory nature Limited physical activity, but no limitations A new referral O/E: HR: 88 BP: 150/85 JVP normal Harsh midsystolic ejection murmer (3/6) over aortic area – radiates to the clavicle Normal pulses Remainder of physical exam normal Questions to think about: Is a 2D-Echo appropriate in this patient? Which patients require an echo? Are there any symptoms that need to be considered when deciding whether to ord
文档评论(0)