Paroxysmal AV block echocardiography and ultrasound: Difference between revisions
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==Overview== | ==Overview== | ||
[[Echocardiography]] has a highler yield where [[diagnosing]] [[syncope]] and [[presyncope]] is concerned, in patients with [[structural]] heart disease. | |||
==2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Recommendations for Cardiac Imaging== | |||
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| colspan="1" style="text-align:center; background: LightBlue"|[[2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay| Recommendations for Cardiac Imaging]] | |||
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| bgcolor="LightBlue"|<nowiki>"</nowiki>'''1.''' In patients with newly identified LBBB, seconddegree Mobitz type II atrioventricular block,high-grade atrioventricular block, or hirddegree atrioventricular block with or without apparent structural heart disease or coronary artery disease, transthoracic echocardiography is recommended. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B-NR]]<ref name="pmid30412710">{{cite journal| author=Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR | display-authors=etal| title=2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2019 | volume= 74 | issue= 7 | pages= 932-987 | pmid=30412710 | doi=10.1016/j.jacc.2018.10.043 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30412710 }} </ref>'' | |||
'''2.''' In selected patients presenting with bradycardia or conduction disorders other than LBBB, second-degree Mobitz type II atrioventricular block, high-grade atrioventricular block, or third-degree atrioventricular block, transthoracic echocardiography is reasonable if structuralheart disease is suspected. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B-NR]])<ref name="pmid30412710">{{cite journal| author=Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR | display-authors=etal| title=2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2019 | volume= 74 | issue= 7 | pages= 932-987 | pmid=30412710 | doi=10.1016/j.jacc.2018.10.043 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30412710 }} </ref>'' | |||
'''3.''' In selected patients with bradycardia or bundle branch block, disease-specific advanced imaging (eg, transesophageal echocardiography, computed tomography,cardiac magnetic resonance imaging [MRI], or nuclear imaging) is reasonable if structural heart disease is suspected yet not confirmed by other diagnostic modalities. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C-LD]])<ref name="pmid30412710">{{cite journal| author=Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR | display-authors=etal| title=2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2019 | volume= 74 | issue= 7 | pages= 932-987 | pmid=30412710 | doi=10.1016/j.jacc.2018.10.043 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30412710 }} </ref>'' | |||
'''4.''' In the evaluation of patients with asymptomatic sinus bradycardia or firstdegree atrioventricular block and no clinical evidence of structural heart disease, routine | |||
cardiac imaging is not indicated. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B-NR]])<ref name="pmid30412710">{{cite journal| author=Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR | display-authors=etal| title=2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2019 | volume= 74 | issue= 7 | pages= 932-987 | pmid=30412710 | doi=10.1016/j.jacc.2018.10.043 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30412710 }} </ref>''<nowiki>"</nowiki> | |||
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== | *[[Echocardiography]] has a highler yield where [[diagnosing]] [[syncope]] and [[presyncope]] in patients with [[structural]] heart disease. | ||
*Thransthroacic/ [[Transesophagal echocardiography]] may highlight [[endocarditis]] with or without [[perivalvular]] [[complications]], [[aortic dissection]], or unruptured [[sinus of Valsalva]] [[aneurysm]] which have all been occasionally associated with [[bradycardia]] or [[conduction block]]. <ref name="pmid30412710">{{cite journal| author=Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR | display-authors=etal| title=2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. | journal=J Am Coll Cardiol | year= 2019 | volume= 74 | issue= 7 | pages= 932-987 | pmid=30412710 | doi=10.1016/j.jacc.2018.10.043 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30412710 }} </ref> | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akash Daswaney, M.B.B.S[2]
Overview
Echocardiography has a highler yield where diagnosing syncope and presyncope is concerned, in patients with structural heart disease.
2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Recommendations for Cardiac Imaging
| Recommendations for Cardiac Imaging |
| "1. In patients with newly identified LBBB, seconddegree Mobitz type II atrioventricular block,high-grade atrioventricular block, or hirddegree atrioventricular block with or without apparent structural heart disease or coronary artery disease, transthoracic echocardiography is recommended. (Level of Evidence: B-NR[1]
2. In selected patients presenting with bradycardia or conduction disorders other than LBBB, second-degree Mobitz type II atrioventricular block, high-grade atrioventricular block, or third-degree atrioventricular block, transthoracic echocardiography is reasonable if structuralheart disease is suspected. (Level of Evidence: B-NR)[1] 3. In selected patients with bradycardia or bundle branch block, disease-specific advanced imaging (eg, transesophageal echocardiography, computed tomography,cardiac magnetic resonance imaging [MRI], or nuclear imaging) is reasonable if structural heart disease is suspected yet not confirmed by other diagnostic modalities. (Level of Evidence: C-LD)[1] 4. In the evaluation of patients with asymptomatic sinus bradycardia or firstdegree atrioventricular block and no clinical evidence of structural heart disease, routine cardiac imaging is not indicated. (Level of Evidence: B-NR)[1]" |
- Echocardiography has a highler yield where diagnosing syncope and presyncope in patients with structural heart disease.
- Thransthroacic/ Transesophagal echocardiography may highlight endocarditis with or without perivalvular complications, aortic dissection, or unruptured sinus of Valsalva aneurysm which have all been occasionally associated with bradycardia or conduction block. [1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR; et al. (2019). "2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society". J Am Coll Cardiol. 74 (7): 932–987. doi:10.1016/j.jacc.2018.10.043. PMID 30412710.