Download Cardiology for the primary care Physician by Joseph S. Alpert (auth.), Joseph S. Alpert MD (eds.) PDF

By Joseph S. Alpert (auth.), Joseph S. Alpert MD (eds.)

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In valvular stenosis, transvalvular gradients may be determined and valve areas calculated, with a high correlation with data obtained during cardiac catheterization. The degree of valvular incompetence also may be assessed, since Dopper flows demonstrate the extent of regurgitant flow. Radionuclide angiography allows serial assessment of ventricular function and has been used in conjunction with exercise testing for aortic insufficiency to assist in decisions regarding the timing of valve replacement surgery.

The prognostic value of serum troponin T in unstable angina. N Engl] Med 1992, 327:146-150. : Comprehensive strategy for the evaluation and triage of the chest pain patient. Ann Emerg Med1997,29:116-125. 42. : Combining clinical and thallium data optimizes preoperative assessment of cardiac risk before major vascular surgery. Ann Intern Med 1989, 110:859-866. 43. : Dobutamine stress echocardiography for assessment of perioperative cardiac risk in patients undergoing major vascular surgery. Circulation 1993, 87:1506-1512.

However, criteria have been defined to improve the accuracy of the ECG diagnosis for wide complex tachycardias (Table 2) [4]. Chamber Enlargement/ Left Ventricular Hypertrophy Although there are established criteria for diagnosing chamber enlargement, the anatomic correlation tends to be poor. While characterization of ECG abnormalities associated with enlargement or hypertropy of the cardiac chambers is beyond the scope of this text, left ventricular hypertrophy (LVH) is a common and often-discussed entity [5].

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