Sandbox Rim: Difference between revisions

Revision as of 12:08, 22 July 2014

Mitral Stenosis

Abbreviations: AF: atrial fibrillation; MS: mitral stenosis; MR: mitral regurgitation; MVA: ; MVR: ;PCWP: ;PMBC: ;T_1/2:

Determine the severity of mitral stenosis (MS)

Very severe MS
❑ MVA ≤1 cm2
❑ T1/2 ≥220 ms

Severe MS
❑ MVA ≤1.5 cm2
❑ T_1/2 ≥150 ms

Progressive MS
MVA >1.5 cm2
T_1/2 <150 ms

Is the patient symptomatic?

No
( Stage C)

Yes
(Stage D)

No
(Stage C)

Yes
With no other cause for the symptoms

Does the patient have:
❑ Favorable valve morphology
AND
❑ No left appendage clot

AND
❑ No or mild MR

Does the patient have:
❑ Favorable valve morphology

AND
❑ No left appendage clot

AND
❑ No or mild MR

Is there a new onset of AF?

Order an exercise stress test

No

Yes

No

Yes

No

Is PCWP> 25 mm Hg?

Does the patient have:
❑ NYHA class III-IV symptoms
AND
❑ High surgical risk

Does the patient have:
❑ Favorable valve morphology

AND
❑ No left appendage clot

AND
❑ No or mild MR

No

Yes

No

Yes

No

Periodic monitoring

PMBC (Class IIa)

PMBC (Class I)

MVR (Class I)

PMBC (Class IIb)

Periodic monitoring

PMBC (Class IIb)

Periodic monitoring

@@ Line 1: / Line 1: @@
 ==Mitral Stenosis==
-<span style="font-size:85%">'''Abbreviations:''' '''AF''': [[atrial fibrillation]]; '''MS:''' [[mitral stenosis]]; '''MR:''' [[mitral regurgitation]]; MVA: ; MVR: ;PCWP: ;PMBC: ;T<sub>1/2</sub>:
+<span style="font-size:85%">'''Abbreviations:''' '''AF''': [[atrial fibrillation]]; '''MS:''' [[mitral stenosis]]; '''MR:''' [[mitral regurgitation]]; MVA: ; MVR: ;PCWP: ;PMBC: ;T<sub>1/2</sub>: </span>
 {{Familytree/start}}
-{{Family tree | | | | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | A01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Determine the severity of mitral stenosis (MS)</div>}}
+{{Family tree | | | | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | A01= <div style="float: left; text-align: left; width: 8em; padding:1em;">'''Determine the severity of [[mitral stenosis]] (MS)'''</div>}}
 {{Family tree | | | | | | | | |,|-|-|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|-|-|-|-|-|.| | | | }}
-{{Family tree | | | | | | | | B01 | | | | | | | | B02 | | | | | | | | | | | B03 | | | B01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Very severe MS <br> MVA ≤1 cm2 <br> T1/2 ≥220 ms </div>| B02=  <div style="float: left; text-align: left; width: 8em; padding:1em;">Severe MS <br> MVA ≤1.5 cm2 <br> T<sub>1/2</sub> ≥150 ms </div>| B03= <div style="float: left; text-align: left; width: 8em; padding:1em;">Progressive MS <br> MVA >1.5 cm2 <br> T<sub>1/2</sub> <150 ms </div>}}
+{{Family tree | | | | | | | | B01 | | | | | | | | B02 | | | | | | | | | | | B03 | | | B01= <div style="float: left; text-align: left; width: 8em; padding:1em;">'''Very severe MS''' <br> ❑ MVA ≤1 cm2 <br> ❑ T1/2 ≥220 ms </div>| B02=  <div style="float: left; text-align: left; width: 8em; padding:1em;">'''Severe MS''' <br> ❑ MVA ≤1.5 cm2 <br> ❑ T<sub>1/2</sub> ≥150 ms </div>| B03= <div style="float: left; text-align: left; width: 8em; padding:1em;">'''Progressive MS''' <br> MVA >1.5 cm2 <br> T<sub>1/2</sub> <150 ms </div>}}
 {{Family tree | | | | | | | | |!| | | | | | | | | |!| | | | | | | | | | | | |!| | }}
 {{Family tree | | | | | | | | B04 | | | | | | | | B05 | | | | | | | | | | | B06 | B04= <div style="float: left; text-align: left; width: 8em; padding:1em;">Is the patient symptomatic? </div>| B05= <div style="float: left; text-align: left; width: 8em; padding:1em;">Is the patient symptomatic?</div>| B06=<div style="float: left; text-align: left; width: 8em; padding:1em;">Is the patient symptomatic? </div>}}
 {{Family tree | | | |,|-|-|-|-|^|-|-|.| |,|-|-|-|-|^|-|-|-|-|-|-|.| | | | | |!| | | | }}
-{{Family tree | | | C01 | | | | | | | C02 | | | | | | | | | | | C03 | | | | C04 | | | C01= No <br> (Stage C)| C02= Yes <br> (Stage D)| C03= No <br> (Stage C)| C04= <div style="float: left; text-align: left; width: 8em; padding:1em;">Yes <br> With no other cause for the symptoms </div>}}
+{{Family tree | | | C01 | | | | | | | C02 | | | | | | | | | | | C03 | | | | C04 | | | C01= No <br> ([[Mitral stenosis resident survival guide#Classification| Stage C]])| C02= Yes <br> ([[Mitral stenosis resident survival guide#Classification|Stage D]])| C03= No <br> ([[Mitral stenosis resident survival guide#Classification|Stage C]])| C04= <div style="float: left; text-align: left; width: 8em; padding:1em;">Yes <br> With no other cause for the symptoms </div>}}
 {{Family tree | | | |!| | | | | | | | |!| | | | | | | | | | | | |!| | | | | |!| | | | }}
-{{Family tree | | | D01 | | | | | | | D02 | | | | | | | | | | | |!| | | | | |!| | | | D01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ Favorable valve morphology <br> AND <br>❑ No left appendage clot <br> <br> AND <br>❑ No or mild MR </div>| D02= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ Favorable valve morphology <br> <br> AND <br>❑ No left appendage clot <br><br> AND <br> ❑ No or mild MR </div>}}
+{{Family tree | | | D01 | | | | | | | D02 | | | | | | | | | | | |!| | | | | |!| | | | D01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ Favorable valve morphology <br> AND <br>❑ No [[left appendage]] clot <br> <br> AND <br>❑ No or mild [[MR]] </div>| D02= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ Favorable valve morphology <br> <br> AND <br>❑ No [[left appendage]] clot <br><br> AND <br> ❑ No or mild [[MR]] </div>}}
 {{Family tree | | | |!| | | | | | | | |!| | | | | | | | | | | | |!| | | | | |!| | | | }}
-{{Family tree | | | |!| | | | | | | | |!| | | | | | | | | | | | D03 | | | | D04 | | | | D03= <div style="float: left; text-align: left; width: 8em; padding:1em;">Is there a new onset of AF? </div>| D04= <div style="float: left; text-align: left; width: 8em; padding:1em;">Order an exercise stress test </div>}}
+{{Family tree | | | |!| | | | | | | | |!| | | | | | | | | | | | D03 | | | | D04 | | | | D03= <div style="float: left; text-align: left; width: 8em; padding:1em;">Is there a new onset of [[AF]]? </div>| D04= <div style="float: left; text-align: left; width: 8em; padding:1em;">Order an exercise stress test </div>}}
 {{Family tree | |,|-|^|-|.| | | |,|-|-|^|-|-|.| | | | | | | |,|-|^|-|.| | | |!| | | | }}
-{{Family tree | E01 | | E02 | | E03 | | | | E04 | | | | | | E05 | | E06 | | E07 | | | E01= No| E02= Yes| E03= Yes| E04= No| E05= Yes| E06= No| E07= Is PCWP> 25 mm Hg?}}
+{{Family tree | E01 | | E02 | | E03 | | | | E04 | | | | | | E05 | | E06 | | E07 | | | E01= No| E02= Yes| E03= Yes| E04= No| E05= Yes| E06= No| E07= Is [[PCWP]]> 25 mm Hg?}}
 {{Family tree | |!| | | |!| | | |!| | | | | |!| | | | | | | |!| | | |!| |,|-|^|-|.| | }}
-{{Family tree | |!| | | |!| | | |!| | | | | F01 | | | | | | F02 | | |!| |!| | | |!| F01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ NYHA class III-IV symptoms <br> AND <br> ❑ High surgical risk </div>| F02= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ Favorable valve morphology <br> <br> AND <br>❑ No left appendage clot <br> <br> AND <br>❑ No or mild MR </div>}}
+{{Family tree | |!| | | |!| | | |!| | | | | F01 | | | | | | F02 | | |!| |!| | | |!| F01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ [[NYHA class]] III-IV symptoms <br> AND <br> ❑ High surgical risk </div>| F02= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ Favorable valve morphology <br> <br> AND <br>❑ No [[left appendage]] clot <br> <br> AND <br>❑ No or mild [[MR]] </div>}}
 {{Family tree | |!| | | |!| | | |!| | | |,|-|^|-|.| | | |,|-|^|-|.| |!| |!| | | |!| | }}
 {{Family tree | |!| | | |!| | | |!| | | G01 | | G02 | | G03 | | G04 |!| G05 | | G06 | | G01= No| G02= Yes| G03= Yes| G04= No| G05= Yes| G06= No}}
 {{Family tree | |!| | | |!| | | |!| | | |!| | | | |!| |!| | | | |!| |!| |!| | | |!| | }}
-{{Family tree | H01 | | H02 | | H03 | | H04 | | | | H05 | | | | | H06 | | H07 | | H08 | H01= Periodic monitoring| H02= PMBC (Class IIa)| H03= PMBC (Class I)| H04= MVR (Class I)| H05= PMBC (Class IIb)| H06= Periodic monitoring| H07= PMBC (Class IIb)| H08= Periodic monitoring}}
+{{Family tree | H01 | | H02 | | H03 | | H04 | | | | H05 | | | | | H06 | | H07 | | H08 | H01= Periodic monitoring| H02= [[PMBC]] (Class IIa)| H03= [[PMBC]] (Class I)| H04= [[MVR]] (Class I)| H05= [[PMBC]] (Class IIb)| H06= Periodic monitoring| H07= [[PMBC]] (Class IIb)| H08= Periodic monitoring}}
 {{Familytree/end}}

Sandbox Rim: Difference between revisions

Revision as of 12:08, 22 July 2014

Mitral Stenosis

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