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Cardiology Guidelines and Reviews
ACC/AHA/AHRQ/CMS/JCAHO PRACTICE ADVISORY September 7, 2006 Response to COMMIT/CCS-2 Trial Results:Beta Blocker Use for Myocardial Infarction (MI)Within 24 Hours of Hospital Arrival http://www.acc.org/qualityandscience/clinical/practice_advisory/pdfs/COMMITPracticeAdvisory040105.pdf
Framingham CHD Risk Score: www.nhlbi.nih.gov/about/framingham/riskabs.htm
ACC Guidelines
ACC / AHA Guidelines
AHA Guidelines A-Z
ESC Guidelines (European Society of Cardiology) (id and password needed for guideline access - free - takes less than 5 minutes to register)
ICSI Cardiac Guidelines (Institute for Clinical Systems Improvement)
National Heart Lung and Blood Instit/NIH (Includes JNC 7-HTN, NCEP/ATP 3-Cholesterol)
Acute Coronary Syndromes: see Acute Mi below ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction Full Text 2007 http://content.onlinejacc.org/cgi/content/full/50/7/e1 Summary 2007 http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.107.185752 ACC/AHA 2002 Unstable Angina and Non-ST Elevation MI Summary 2002 http://circ.ahajournals.org/cgi/content/full/106/14/1893 Full Text 2002 http://www.americanheart.org/presenter.jhtml?identifier=3001260 DEAD LINK (link removed by AHA)
Acute Myocardial Infarction (ST-Elevation)- also see Acute Coronary Syndromes above: 2007 Focused Update of the ACC/AHA2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction http://content.onlinejacc.org/cgi/content/full/j.jacc.2007.10.001v1 ACC/AHA 2004 ST-Elevation MI Summary: http://www.americanheart.org/presenter.jhtml?identifier=3023107 (DEAD LINK - deleted by AHA) 2007 ACC/AHA Non-ST Elevation MI and USA Guidelines (Summary) http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.107.185752
Alcohol and Heart Disease Wine and Your Heart (2001) “there is little current justification to recommend alcohol (or wine specifically) as a cardioprotective strategy.”
Amyloidosis
NEJM Review 1997 http://content.nejm.org/cgi/content/extract/337/13/898
Anticoagulation
ICIS Anticoagulation Guidelines
Aneurysm
Brain Aneurysm: AHA 2002 Guidelines for Management http://circ.ahajournals.org/cgi/content/full/102/18/2300
Arrhythmias & Antiarrhytmic Drugs (see specific arrhythmias)
JAMA Collection of Arrhythmia Articles: http://jama.ama-assn.org/cgi/collection/arrhythmias some articles with restricted access to subscribers only
Atrial Fibrillation:
ACC/AHA/ESC Atrial FIbrillation 2006 Summary 2006 http://circ.ahajournals.org/cgi/content/full/114/7/700 SEE PAGE 723 RISK FACTORS FOR CVA - RECOMMENDATIONS ASPIRIN VERSUS WARFARIN Full Text 2006 http://circ.ahajournals.org/cgi/content/full/114/7/e257
ICIS 2008 Atrial Fibrillation Guidelines
Cardiac CT ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 Appropriateness Guidelines for Cardiac CT and MR http://content.onlinejacc.org/cgi/reprint/48/7/1475
ACC/AHA 2007 Calcuim Scoring and Risk http://www.americanheart.org/presenter.jhtml?identifier=3044629
ACC/AHA 2005 Cardiac CT and MR Clinical competence www.acc.org/qualityandscience/clinical/competence/imaging/index.pdf
Cholesterol / Lipids 2004 ATP/NCEP Chlesterol Guidelines Update. abstract: http://circ.ahajournals.org/cgi/content/abstract/110/2/227 2004 Statins After Stroke and TIA: http://stroke.ahajournals.org/cgi/content/full/35/4/1023 2009 Current Diagnosis and Treatment in Cardiology/Google Books Chapter 2 Lipid Disorders (start page 15) http://books.google.com/books?id=z_RMq9eFj5AC&printsec=frontcover&source=gbs_v2_summary_r&cad=0#v=onepage&q=&f=false
Congestive Heart Failure (CHF)
2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines http://circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.109.192064v1 PDF: http://click.jwatch.org/cts/click?q=227%3B67167257%3BZJaD7tNmiX%2Bpy23ndRj4l5ps4UzUsTHzRErX0wkUXVk%3D Circulation article with full guidelines (Free PDF) http://click.jwatch.org/cts/click?q=227%3B67167257%3BZJaD7tNmiX%2Bpy23ndRj4l3QIKQT4cA67RErX0wkUXVk%3D
ACC/AHA 2005 CHF Update Full Text 2005 http://circ.ahajournals.org/cgi/content/full/112/12/e154 Summary 2005 http://circ.ahajournals.org/cgi/content/full/112/12/1825
ICSI Pre-printed CHF Orders http://www.icsi.org/heart_failure__admission_for__order_set_/heart_failure__admission_for__order_set___ms_word_.html
JAMA Collection of CHF Articles (some articles restricted access) http://jama.ama-assn.org/cgi/collection/congestive_heart_failure_cardiomyopathy
CPR / ACLS AHA 2005 Guidelines http://circ.ahajournals.org/content/vol112/24_suppl/
Defibrillators (see Pacemakers and Ventricualr Arrhyhthmias below)
Diabetes ADA 2008 Diabetes Guidelines Screening for CAD in Diabetes ADA 2007: “Although the CAD asymptomatic patient with diabetes is by definition at least at intermediate risk for CVD events, it is difficult to support routine CAD screening for these patients.” http://care.diabetesjournals.org/cgi/content/abstract/30/10/2729?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=30&firstpage=2729&resourcetype=HWCIT
DVT/PE Venous Thromboembolism 2007 ACP/AAFP Venous Thromboembolism Guidelines http://www.annfammed.org/cgi/content/abstract/5/1/74 ICSI Venous Thromboembolism Guidelines ICIS Venous Thromboembolism Prevention Guidelines ATS 1999 Diagnosis of Acute Venous Thromboembolism (PDF) http://www.thoracic.org/sections/publications/statements/pages/respiratory-disease-adults/venous1-24.html
Endocarditis
2007 American Heart Association Guidelines/ACC: Endocarditis Prophylaxis : http://www.americanheart.org/presenter.jhtml?identifier=3004539
AHA Prevention Endocarditis 1997 (see update 2007 above)
DIRECT LINK TABLE ANTBX REGIMEN ORAL/ESOPH PROCEDURES: http://www.circ.ahajournals.org/cgi/content/full/96/1/358/T4
DIRECT LINK TABLE ANTBX REGIMEN GI/GU PROCEDURES: http://www.circ.ahajournals.org/cgi/content/full/96/1/358/T5
AHA 2005 Infective Endocarditis (endorsed by IDSA) http://circ.ahajournals.org/cgi/content/full/111/23/e394
AHA Dx and Management Endocarditis 1998 (see more current 2005 Guideline above)
Framingham CHD Risk Score: http://hp2010.nhlbihin.net/atpiii/calculator.asp?usertype=prof
Heart Failure (see CHF above)
Hypertension JNC 7 Hypertension Guidelines
Hypertrophic Cardiomyopathy:
ASC/ESC Hypertrophic Cardiomyopathy 2003 http://www.acc.org/qualityandscience/clinical/consensus/cardiomyopathy/index.htm
Recommendations and Considerations Related to Preparticipation Screening for Cardiovascular Abnormalities in Competitive Athletes: 2007 Update
NEJM Review HCM: March 13, 1997 vol 336 p775-85 www.nejm.org
NEJM Clinical Practice HCM: March 25, 2004 vol 350 p1320 www.nejm.org
2007 Septal myectomy and alcohol septal ablation for HCM http://www.cardiosource.com/cjrpicks/CJRPick.asp?cjrID=3032
Myocardial Infarction (see Acute Coronary Syndrome and Acute Myocardial Infarction)
Omega 3 Fish Oils
AHA 2002 Recommendations: http://www.americanheart.org/presenter.jhtml?identifier=4632 2002 AHA Statement: http://circ.ahajournals.org/cgi/content/full/106/21/2747
Pacemakers and Defibrillators ACC/AHA/NAPSE 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities http://content.onlinejacc.org/cgi/content/full/j.jacc.2008.02.032 ACC/AHA/NAPSE 2002 Pacemakers and Defbrillators Summary 2002 http://circ.ahajournals.org/cgi/content/full/106/16/2145 Full Text 2002 http://www.americanheart.org/presenter.jhtml?identifier=3005415 (DEAD LINK)
NEJM Review ICDs: Nov 6, 2003 vol 349 p1836-47 http://content.nejm.org/cgi/content/extract/349/19/1836 requires subscription for access
Pre-op Evaluation for Non-Cardiac Surgery
ACC/AHA Guideline Update for Perioperative Cardiovascular Evaluation for Noncardiac Surgery (2007) ACC/AHA Periop Evaluation for Non-Cardiac Surgery 2002 (see more recent version above) Summary 2002 http://circ.ahajournals.org/cgi/content/full/105/10/1257?ck=nck DIRECT LINK: http://circ.ahajournals.org/cgi/content/full/105/10/1257/FIG1?ck=nck (2002 ONE PAGE FLOW DIAGRAM - PRINT PDF)
Pulmonary Embolism (PE) - see DVT/PE above
Stress Testing ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging http://content.onlinejacc.org/cgi/content/full/j.jacc.2009.02.013 PDF: http://content.onlinejacc.org/cgi/reprint/53/23/2201.pdf QUICK LINKS/Tables Periop Cardiac Assessment: http://content.onlinejacc.org/content/vol53/issue23/images/large/09005853.gra1.jpeg Applications for Chest Pain http://content.onlinejacc.org/cgi/content/full/53/23/2201/FIG2 Asymptomatic Patients http://content.onlinejacc.org/cgi/content/full/53/23/2201/FIG3 (Note: in contrast, ADA 2008 Guidelines no longer advocate stress testing in asymptomatic diabetics) Prior Revacularization (CABG or PCI) http://content.onlinejacc.org/cgi/content/full/53/23/2201/FIG6
ACC/AHA 2002 Exercise Testing Summary 2002 http://circ.ahajournals.org/cgi/content/full/106/14/1883 PDF http://circ.ahajournals.org/cgi/reprint/106/14/1883 QUICK LINKS/Tables TABLE 17A. Summary of Studies Using Exercise ECG Testing in Chest Pain Centers http://circ.ahajournals.org/cgi/content-nw/full/106/14/1883/TBL3A Full Text 2002 http://www.americanheart.org/presenter.jhtml?identifier=3005237
Stress Test Accuracy (sensitivity,specificity, positive/negative predicitive value) PRIMARY CARE MEDICINE/GOOGLE BOOKS (see page 326) http://books.google.com/books?id=bIZvJPcSEXMC&printsec=frontcover#v=onepage&q=&f=false
Stroke ALL AHA Stroke Guidelines http://www.americanheart.org/presenter.jhtml?identifier=3004586 2005 Guidelines for the Treatment of Ischemic Stroke http://stroke.ahajournals.org/cgi/content/full/36/4/916 2006 Secondary Prevention of Ischemic Stroke http://stroke.ahajournals.org/cgi/content/full/37/2/577 2004 Statins After Stroke and TIA: http://stroke.ahajournals.org/cgi/content/full/35/4/1023 Bleeding Stroke (Intracerebral CVA) AHA 1999 Intracerebral Hemorrhage Guidelines: http://stroke.ahajournals.org/cgi/content/full/30/4/905
Syncope
ESC 2004 Syncope Guidelines http://www.escardio.org/knowledge/guidelines/Management_of_Syncope_Guidelines.htm ACC/ACCF 2006 Syncope http://content.onlinejacc.org/cgi/reprint/47/2/473 DIRECT LINK ALGORITHM TO DIAGNOSE SYNCOPE http://content.onlinejacc.org/cgi/content/figsonly/47/2/473 NOTE: this algorithm puts a heavier emphasis on ischemia work-up than other sources and DOES NOT SITE STATISTICAL EVIDENCE FOR THESE RECOMMENDATIONS (stress testing) NEJM Review Syncope: Dec. 21, 2000 vol 343 p1856-62 http://content.nejm.org/cgi/content/extract/343/25/1856 (requires subscription for access)
Valvular Heart Disease:
ACC/AHA Valvular Heart Disease 2006 Summary 2006 http://circ.ahajournals.org/cgi/reprint/114/5/450 Full Text 2006 http://circ.ahajournals.org/cgi/reprint/114/5/e84
Ventricular Arrhythmias ACC/AHA/ESC Ventricular Arrhythmia/Sudden Death 2006 Summary http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.106.178104 Full Text http://www.americanheart.org/presenter.jhtml?identifier=3041764 Pocket Guideline 2006 http://www.americanheart.org/presenter.jhtml?identifier=3041764 Wallet Card 2006 http://www.americanheart.org/presenter.jhtml?identifier=3041765 _
 
FRAUD FILES Doctor gets prison time for fraud August 21, 2009 “McALLEN, Texas (AP) — A federal judge has sentenced a South Texas cardiologist to more than four years in prison for Medicare and Medicaid fraud. Some of the allegations against Dr. Fabian Aurignac include billing for services at his office while he was traveling in Argentina.” http://www.valleymorningstar.com/news/texas-58116-doctor-time.html McAllen Cardiologist forfeits more than $1 million in Medicare fraud case May 9, 2009 http://www.brownsvilleherald.com/news/aurignac-97862-doctor-mcallen.html
Fraud investigation at Redding Medical Center highlights problems with American healthcare system Tue, 12 Aug 2003 19:00:00 | Shelley Wood http://www.theheart.org/article/244417.do New York, NY - A New York Times front-page exposé examining the FBI's investigation of Redding Medical Center's cardiology program takes aim at the "twisted finances of American healthcare," which may have fostered the alleged fraud at Redding.1 Misgivings voiced by physicians at the hospital to administrators were repeatedly ignored, the article notes. Redding has been in the news since October 2002, when the FBI raided the offices of Dr Chae Hyun Moon, chief cardiologist at Redding, and Dr Fidel Realyvasquez, the hospital's "top surgeon" and director of the California Heart Institute at Redding. The two doctors are being investigated for allegedly performing unnecessary invasive coronary procedures on patients, including heart catheterizations, angioplasty, and open-heart surgeries, as reported by heartwire.
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