Sandbox:lipid: Difference between revisions
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{{familytree | | | | | | | | | | | | | | | F01 | | | | F02 | F01='''Type A:'''<br> [[Familial hypercholesterolemia]]| F02= '''Type B:'''<br> [[Familial combined hyperlipidemia]]}} | {{familytree | | | | | | | | | | | | | | | F01 | | | | F02 | F01='''Type A:'''<br> [[Familial hypercholesterolemia]]| F02= '''Type B:'''<br> [[Familial combined hyperlipidemia]]}} | ||
{{familytree/end}} | {{familytree/end}} | ||
{| class="wikitable" | |||
! style="background: #4479BA; padding: 5px 5px;" rowspan=1 colspan=3 | {{fontcolor|#FFFFFF}}Functional Asseeement | |||
|- | |||
! style="background: #4479BA; padding: 5px 5px;" rowspan=1 colspan=1 | {{fontcolor|#FFFFFF}}Key Steps | |||
! style="background: #4479BA; padding: 5px 5px;" rowspan=1 colspan=1 | {{fontcolor|#FFFFFF}}Essential Elements | |||
! style="background: #4479BA; padding: 5px 5px;" rowspan=1 colspan=1 | {{fontcolor|#FFFFFF}}Additional Details | |||
|- | |||
|style="padding: 5px 5px; background: #F5F5F5;" |Frailty and Disability | |||
|style="padding: 5px 5px; background: #F5F5F5;" |Symptoms | |||
AS severity | |||
|style="padding: 5px 5px; background: #F5F5F5;" |Intensity, acuity | |||
Echo and other imaging | |||
|- | |||
|style="padding: 5px 5px; background: #F5F5F5;" |Baseline clinical data | |||
|style="padding: 5px 5px; background: #F5F5F5;" |Cardiac history | |||
Physical exam and labs | |||
Chest irradiation | |||
Dental evaluation | |||
Allergies | |||
Social support | |||
|style="padding: 5px 5px; background: #F5F5F5;" | Prior cardiac interventions | |||
Routine blood tests, [[PFTs]] | |||
Access issues, other cardiac effects | |||
Treat dental issues before TAVR | |||
[[Contrast]], [[latex]], medications | |||
Recovery, transportation, post discharge planning | |||
|- | |||
|style="background: #F5F5F5; padding: 5px 5px;" rowspan=6 colspan=1" | Major CV comorbidity | |||
|style="background: #F5F5F5;|Coronary artery disease | |||
|style="background: #F5F5F5;|[[Coronary angiography]] | |||
|- | |||
|style="background: #F5F5F5;|LV systolic dysfunction | |||
|style="background: #F5F5F5;|[[LV ejection fraction]] | |||
|- | |||
|style="background: #F5F5F5;|Concurrent valve disease | |||
|style="background: #F5F5F5;|Severe [[Mitral regurgitation|MR]] or [[Mitral stenosis|MS]] | |||
|- | |||
|style="background: #F5F5F5;|[[Pulmonary hypertension]] | |||
|style="background: #F5F5F5;|Assess pulmonary pressures | |||
|- | |||
|style="background: #F5F5F5;|Aortic disease | |||
|style="background: #F5F5F5;|Porcelain aorta (CT scan) | |||
|- | |||
|style="background: #F5F5F5;|Peripheral vascular disease | |||
|style="background: #F5F5F5;|Prohibitive re-entry after previous open heart | |||
surgery (CT scan) | |||
Hostile chest | |||
|- | |||
| style="background: #F5F5F5; padding: 5px 5px;" rowspan=5 colspan=1" |Major non CV comorbidity | |||
|style="background: #F5F5F5;|[[Malignancy]] | |||
|style="background: #F5F5F5;|Remote or active, life expectancy | |||
|- | |||
|style="background: #F5F5F5;|Gastrointestinal and liver disease | |||
|style="background: #F5F5F5;|[[IBD]], [[cirrhosis]], [[Esophageal varices|varices]], [[Gastrointestinal bleeding|GIB]], ability to take | |||
antiplatelets/anticoagulation | |||
|- | |||
|style="background: #F5F5F5;|Kidney disease | |||
|style="background: #F5F5F5;|[[eGFR]] <30cc/min or [[dialysis]] | |||
|- | |||
|style="background: #F5F5F5;|Pulmonary disease | |||
|style="background: #F5F5F5;|Oxygen requirement, [[FEV1]] <50% predicted or | |||
[[DLCO]]<50% predicted | |||
|- | |||
|style="background: #F5F5F5;|Neurological disorders | |||
|style="background: #F5F5F5;|[[Movement disorder|Movement disorders]], [[dementia]] | |||
|} | |||
Revision as of 15:20, 11 January 2017
| Lipid disorders | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Hypolipoproteinemia | Hyperlipoproteinemia | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Primary | Secondary | Primary | Secondary | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Low LDL | Low HDL | Anemia, Chronic inflammation, Chronic liver disease, Hyperthyroidism Infection, Malabsorption, Malignancy, Criticial illness | Alcohol, Diabetes, Drugs Liver disease, Obesity Renal disease Smoking, Hypothyroidism | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Abetalipoproteinemia, Hypobetalipoproteinemia PCSK9 deficiency, Chylomicron retention disease, Familial combined hypolipidemia | LCAT deficiency, Apolipoprotein 1 deficiency, Familial hypoalphalipoproteinemia, Tangier disease, FISH eye disease, Familial combined hypolipidemia | Type I: Familial hyperchylomicronemia | Type II | Type III: Dysbetalipoproteinemia | Type IV: Primary hypertriglyceridemia | Type V: Mixed hyperlipoproteinemia | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Type A: Familial hypercholesterolemia | Type B: Familial combined hyperlipidemia | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Functional Asseeement | ||
|---|---|---|
| Key Steps | Essential Elements | Additional Details |
| Frailty and Disability | Symptoms
AS severity |
Intensity, acuity
Echo and other imaging |
| Baseline clinical data | Cardiac history
Physical exam and labs Chest irradiation Dental evaluation Allergies Social support |
Prior cardiac interventions
Routine blood tests, PFTs Access issues, other cardiac effects Treat dental issues before TAVR Recovery, transportation, post discharge planning |
| Major CV comorbidity | Coronary artery disease | Coronary angiography |
| LV systolic dysfunction | LV ejection fraction | |
| Concurrent valve disease | Severe MR or MS | |
| Pulmonary hypertension | Assess pulmonary pressures | |
| Aortic disease | Porcelain aorta (CT scan) | |
| Peripheral vascular disease | Prohibitive re-entry after previous open heart
surgery (CT scan) Hostile chest
| |
| Major non CV comorbidity | Malignancy | Remote or active, life expectancy |
| Gastrointestinal and liver disease | IBD, cirrhosis, varices, GIB, ability to take
antiplatelets/anticoagulation | |
| Kidney disease | eGFR <30cc/min or dialysis | |
| Pulmonary disease | Oxygen requirement, FEV1 <50% predicted or
DLCO<50% predicted | |
| Neurological disorders | Movement disorders, dementia | |