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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor: Cafer Zorkun, M.D., Ph.D. [2]

Any recommendations found on these pages are for education use only. Wikidoc is not a substitute for a licensed healthcare provider. Please see the disclaimers page for important information regarding limitations of the information found here. In suggesting edits to the guidelines, Wikidoc suggests that the following classification scheme be used. Read more about the classification scheme used by the ACC / AHA Guidelines Committee here.

v • d • e Circulatory system pathology (I, 390-459)
Hypertension	Hypertensive heart disease - Hypertensive nephropathy - Secondary hypertension (Renovascular hypertension)
Ischaemic heart disease	Angina pectoris (Prinzmetal's angina) - Myocardial infarction (heart attack) - Dressler's syndrome
Pulmonary circulation	Pulmonary embolism - Cor pulmonale
Pericardium	Pericarditis - Pericardial effusion - Cardiac tamponade
Endocardium/heart valves	Endocarditis - mitral valve (regurgitation, prolapse, stenosis) - aortic valve (stenosis, insufficiency) - pulmonary valve (stenosis, insufficiency) - tricuspid valve (stenosis, insufficiency)
Myocardium	Myocarditis - Cardiomyopathy (Dilated cardiomyopathy, Hypertrophic cardiomyopathy, Loeffler endocarditis, Restrictive cardiomyopathy) - Arrhythmogenic right ventricular dysplasia
Electrical conduction system of the heart	Heart block: AV block (First degree, Second degree, Third degree) - Bundle branch block (Left, Right) - Bifascicular block - Trifascicular block Pre-excitation syndrome (Wolff-Parkinson-White, Lown-Ganong-Levine) - Long QT syndrome - Adams-Stokes syndrome - Cardiac arrest - Sudden cardiac death Arrhythmia: Paroxysmal tachycardia (Supraventricular, AV nodal reentrant, Ventricular) - Atrial flutter - Atrial fibrillation (Familial) - Ventricular fibrillation - Premature contraction (Atrial, Ventricular) - Ectopic pacemaker - Sick sinus syndrome
Other heart conditions	Heart failure - Cardiovascular disease - Cardiomegaly - Ventricular hypertrophy (Left, Right)
Cerebrovascular diseases	Stroke - Transient ischemic attack - Intracranial hemorrhage/cerebral hemorrhage: Extra-axial hemorrhage (Epidural hemorrhage, Subdural hemorrhage, Subarachnoid hemorrhage) Intra-axial hematoma (Intraventricular hemorrhages, Intraparenchymal hemorrhage) - Anterior spinal artery syndrome - Binswanger's disease - Moyamoya disease
Arteries, arterioles and capillaries	Atherosclerosis (Renal artery stenosis) - Aortic dissection/Aortic aneurysm (Abdominal aortic aneurysm) - Aneurysm - Raynaud's phenomenon/Raynaud's disease - Buerger's disease - Vasculitis/Arteritis (Aortitis) - Intermittent claudication - Arteriovenous fistula - Hereditary hemorrhagic telangiectasia - Spider angioma - Dissection (Carotid artery, Vertebral artery)
Veins, lymphatic vessels and lymph nodes	Thrombosis/Phlebitis/Thrombophlebitis (Deep vein thrombosis, May-Thurner syndrome, Portal vein thrombosis, Venous thrombosis, Budd-Chiari syndrome, Renal vein thrombosis, Paget-Schroetter disease) - Varicose veins / Portacaval anastomosis (Hemorrhoid, Esophageal varices, Varicocele, Gastric varices, Caput medusae) - Superior vena cava syndrome - Lymph (Lymphadenitis, Lymphedema, Lymphangitis)
Other	Hypotension (Orthostatic hypotension) - Rheumatic fever
See also congenital (Q20-Q28, 745-747)

v • d • e Electrocardiography
Overview	History of the EKG • EKG interpretation basics • Normal sinus rhythm
EKG Complexes	P wave • QRS complex • ST Segment • T wave • T wave alternans • Tombstone T wave • U wave Osborn wave • H wave • K wave • Delta wave NSSTW changes
EKG Intervals	PR Interval • QRS Interval • ST Interval • QT Interval
Conduction System & Bradycardia	Cardiac pacemaker • SA node • AV node• Bundle of His • Purkinje fibers • Sinus bradycardia • First Degree AV Block • Second Degree AV Block • Complete or Third-Degree AV Block • Concealed conduction • AV Junctional Rhythms • LBBB • LAHB • LPHB • RBBB • Trifascicular block
Atrial Arrhythmias	Sinus tachycardia • Premature Atrial Contractions (PACs) • Ectopic Atrial Rhythm • Paroxysmal Atrial Tachycardia (PAT) • Paroxysmal Atrial Tachycardia (PAT) with Block • Multifocal Atrial Tachycardia (MAT) • Atrial Flutter • Atrial Fibrillation • Wandering atrial pacemaker
Ventricular Arrhythmias	Differential Diagnosis of Tachycardia with a Wide QRS Complex • Accelerated Idioventricular Rhythm • Ventricular Parasystole • Premature Ventricular Contractions (PVCs) • Ventricular tachycardia • Ventricular Fibrillation • Sudden cardiac death
EKG Abnormalities in Disease States	Hypertrophy & Dilatation • Right atrial enlargement • Left atrial enlargement • Biatrial enlargement • Left Ventricular Hypertrophy • Right Ventricular Hypertrophy • Biventricular Hypertrophy • Acute myocardial infarction • NSTEMI • STEMI • Tombstone ST elevation • Right ventricular myocardial infarction • Atrial infarction Pre-excitation Syndromes • Wolff-Parkinson-White Syndrome • Lown Ganong Levine Syndrome • Mahaim Type Preexcitation Cardiomyopathies • Arrhythmogenic Right Ventricular Dysplasia • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy Drug Effects on the EKG • Adenosine • β-blockers • Digitalis • Quinidine • Procainamide • Disopyramide • Lidocaine • Tocainide and Mexiletine • Phenytoin • Encainide, Flecainide and Propafenone • Amiodarone • Bretylium • Ca Channel Blockers • Phenothiazines • Tricyclic Antidepressants • Lithium Congenital Heart Disease • Dextrocardia • Atrial Septal Defect • Ventricular Septal Defect • Tetralogy of Fallot • Conjoined Twins or Siamese Twins • Congenital heart block Electrolyte Disturbances • Hyperkalemia • Hypokalemia • Hypercalcemia • Hypocalcemia • Nonspecific Changes Other Heart Diseases • Pericarditis • Myocarditis • Tamponade • Heart Transplantation • Sick Sinus Syndrome • Long QT Syndrome Inherited Disease • Brugada Syndrome Systemic Diseases • CNS Disease • Cardiac Tumors Heart Transplantation • EKG Changes in patient with Heart Transplantation Exogenous Effects • Hypothermia • Chest Trauma • Insect Bites • Electric Injuries
Technical Issues and Potential Errors in Interpretation	Artifacts • Lead Placement Errors • The EKG in a Patient with a Pacemaker • EKG in athletes

The Living Guidelines: STEMI

Pharmacotherapy

Recommendations for Antiplatelet Agents / Anticoagulants Therapy: Aspirin [1]

CLASS I

CLASS IIa

Recommendations for Antiplatelet Agents / Anticoagulants Therapy: Clopidogrel [1]

CLASS I

CLASS IIa

Recommendations for Antiplatelet Agents / Anticoagulants Therapy: Warfarin [1]

CLASS I

Recommendations for Beta Blocker Therapy [1]

CLASS I

CLASS IIa

CLASS III

Recommendations for ACE Inhibitors Therapy

CLASS I

CLASS IIa

Recommendations for Angiotensin Receptor Blockers Therapy

CLASS I [1]

CLASS IIb [1]

Recommendations for Aldosterone Blockers Therapy

CLASS I [1]

Recommendations for Inhibition of the Renin-Angiotensin-Aldosterone System

CLASS I [1]

CLASS IIa [1]

CLASS IIb [1]

Recommendations for Influenza Vaccination [1]

CLASS I

Reperfusion

Primary Invasive or Pharmacological Approach [1]

CLASS I

Facilitated PCI [1]

CLASS IIb

CLASS III

Immediate (or Emergency) Invasive Strategy and Rescue PCI [1]

Class I

Class IIa

Class IIb

Class III

PCI after Successful Fibrinolysis or for Patients not Undergoing Primary Reperfusion [1]

Class IIb

Class III

Anticoagulants as Ancillary Therapy [1]

Class I

Anticoagulants for STEMI patients who do not undergo reperfusion therapy [1]

Class IIa

Class III

Thienopyridines [1]

Class I

Class IIa

Reference

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Recommendations for Antiplatelet Agents / Anticoagulants Therapy: Aspirin ^[1]

Recommendations for Antiplatelet Agents / Anticoagulants Therapy: Clopidogrel ^[1]

Recommendations for Antiplatelet Agents / Anticoagulants Therapy: Warfarin ^[1]

Recommendations for Beta Blocker Therapy ^[1]

CLASS I ^[1]

CLASS IIb ^[1]

CLASS I ^[1]

CLASS I ^[1]

CLASS IIa ^[1]

CLASS IIb ^[1]

Recommendations for Influenza Vaccination ^[1]

Primary Invasive or Pharmacological Approach ^[1]

Facilitated PCI ^[1]

Immediate (or Emergency) Invasive Strategy and Rescue PCI ^[1]

PCI after Successful Fibrinolysis or for Patients not Undergoing Primary Reperfusion ^[1]

Anticoagulants as Ancillary Therapy ^[1]

Anticoagulants for STEMI patients who do not undergo reperfusion therapy ^[1]

Thienopyridines ^[1]