Showing 1-20 of 74 for: Essential Evidence Topics > Cardiovascular 
- Aneurysm (abdominal aorta)
Essential Evidence Topics, 18-Nov-2022
Overall Bottom Line: One-time screening for abdominal aortic aneurysm is recommended in men between the ages of 65 and 75 years who have ever smoked and may also be useful in nonsmoking men in that age range. There is insufficent evidence to recommend s
- Aneurysm (cerebral)
Essential Evidence Topics, 21-Jun-2019
Overall Bottom Line: Screen for cerebral aneurysm with MRA if 2 first-degree relatives have an intracranial aneurysm and in patients with autosomal dominant polycystic kidney disease. A cerebral aneurysm of 7 mm or less has a 5-year risk of rupture of l
- Aneurysm (thoracic aorta)
Essential Evidence Topics, 25-Apr-2022
Overall Bottom Line: Most patients are asymptomatic, but patients may complain of midback pain or chest pain. Transthoracic echocardiography (TTE) is indicated in patients with an enlarged aortic root to assess the severity of aortic dilatation. Elect
- Angina (unstable)
Essential Evidence Topics, 19-Sep-2022
Overall Bottom Line: Perform a 12-lead ECG and obtain cardiac biomarkers promptly in all patients with chest discomfort consistent with possible acute coronary syndrome (ACS). Give 165 to 325 mg of non-enteric-coated aspirin to all patients with possibl
- Anticoagulation management
Essential Evidence Topics, 28-Mar-2023
Background: OVERALL BOTTOM LINE Per ACC/AHA guidelines, for patients with non-valvular atrial fibrillation (NVAF) with a CHA2DS2VASc score of 2 or greater in men and 3 or greater in women, oral anticoagulation with warfarin, dabigatran, rivaroxaban, apixa
- Aortic insufficiency
Essential Evidence Topics, 17-Jan-2022
Overall Bottom Line: Most patients with chronic aortic insufficiency (AI) remain asymptomatic for many years; symptoms of heart failure develop with the gradual decline in the function of the left ventricle. Diagnosis is usually made clinically on the b
- Aortic stenosis
Essential Evidence Topics, 13-Apr-2023
Overall Bottom Line: Patients with a late systolic murmur should undergo echocardiography. Once aortic stenosis is diagnosed, transthoracic echo should be performed in asymptomatic patients at regular intervals. Asymptomatic patients have an excellent
- Arrhythmia (atrioventricular block)
Essential Evidence Topics, 23-Feb-2019
Overall Bottom Line: Routine 12-lead ECG is usually adequate to establish the degree and site of atrioventricular (AV) block. Drug therapy is reserved for treatment of symptomatic high grade AV block in the emergency setting until cardiac pacing can b
- Arrhythmia (ventricular tachycardia and fibrillation)
Essential Evidence Topics, 20-Jun-2022
Overall Bottom Line: Wide-complex tachycardia, in a patient with a history of structural heart disease (especially coronary disease), is highly suggestive of VT. Electrocardiography (ECG) is the standard for the diagnosis for VT and is indicated in all p
- Arterial gas embolism
Essential Evidence Topics, 20-Oct-2021
Overall Bottom Line: Diagnosis of arterial gas embolism is based on clinical history, with support from quantitative EEG, CT, MRI, and echocardiogram. The patient should be placed on supplemental oxygen in the supine position initially, then treated wit
- Atrial fibrillation and flutter
Essential Evidence Topics, 9-Jun-2022
Overall Bottom Line: Transesophageal echocardiogram is important to rule out atrial thrombus prior to pharmacological or electrical cardioversion of atrial flutter or fibrillation that has lasted more than 48 hours or is of unknown duration. In a single
- Bundle branch block
Essential Evidence Topics, 27-Jul-2022
Overall Bottom Line: 12-lead ECG establishes the diagnosis of bundle branch block (BBB). A transthoracic echocardiogram is recommended to exclude structural heart disease in newly detected LBBB . Cardiac resynchronization therapy is recommended for pa
- Cardiac arrest
Essential Evidence Topics, 16-Jun-2022
Bottom line: Four cardiac rhythms result in pulseless cardiac arrest: ventricular fibrillation, ventricular tachycardia, asystole, and pulseless electrical activity. Bystander recognition of sudden cardiac arrest, immediate activation of emergency medical
- Cardiomyopathy (viral)
Essential Evidence Topics, 19-Sep-2022
Overall Bottom Line: Suspect viral myocarditis in patients with flu-like symptoms followed by chest pain, palpitations, syncopal episode, dyspnea on exertion, and pedal edema. Order an echocardiogram if viral cardiomyopathy is clinically suspected. Su
- Cavernous sinus thrombosis
Essential Evidence Topics, 25-Apr-2022
Overall Bottom Line: Suspect cavernous sinus thrombosis in a patient with acute onset of unilateral periorbital swelling, headache, photophobia, chemosis, proptosis, ptosis, and cranial nerve palsies progressing to bilateral involvement (especially within
- Cerebrovascular disease (acute stroke)
Essential Evidence Topics, 24-Mar-2023
Overall Bottom Line: Obtain time of symptom onset. Complete your evaluation and determine treatment within 60 minutes of the patient’s arrival in the emergency department. Obtain CT of the brain before initiating any specific treatment. Thrombolytic t
- Cerebrovascular disease (chronic management)
Essential Evidence Topics, 10-Feb-2023
Overall Bottom Line: The identification and treatment of hypertension is a cornerstone of the prevention and management of cerebrovascular disease (CVD). For the diagnosis of CVD, combined MRA and carotid duplex ultrasound is accurate and less invasive
- Cerebrovascular disease (TIA)
Essential Evidence Topics, 10-Feb-2023
Overall Bottom Line: Transient ischemic attack (TIA) is a short-term neurologic disorder more common in the elderly and normally caused by embolic or occlusive atherosclerotic disease. TIA should be considered a "stroke-prone" state with the majority of
- Chest pain (evaluation)
Essential Evidence Topics, 10-Feb-2023
Overall Bottom Line: Chest pain may represent serious cardiovascular disease or other less serious conditions. Initial evaluation of patients with chest pain should focus on the nature of chest pain (typical, atypical, or non-cardiac, see ), anginal sym
- Congenital hydrocephalus
Essential Evidence Topics, 21-Jan-2022
Overall Bottom Line: Congenital hydrocephalus is rare, and occurs in less than 0.6 per 1000 live births. Over 40% of infants have other associated malformations, most commonly facial clefts, cardiac defects, or renal malformations. Clinical signs may be
