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GUIDELINES A-Z
 
Acute Coronary Syndromes: see Acute MI below
2007 ACC/AHA Unstable Angina/Non–ST-Elevation Myocardial Infarction
2007 Full Text 2007 Full PDF 2007 Summary
 
2002 ACC/AHA Unstable Angina and Non-ST Elevation MI
2002 Summary 2002 Summary
Acute Myocardial Infarction (ST-Elevation)- also see Acute Coronary Syndromes above:
ST-Elevation
2009 Focused Updates: ACC/AHA Guidelines ST-Elevation Myocardial Infarction
2009 ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention
2009 Update 2007 Update
2004 ACC/AHA ST-Elevation MI Summary:
http://www.americanheart.org/presenter.jhtml?identifier=3023107 (DEAD LINK - deleted by AHA)
Non-ST-Elevation
2007 ACC/AHA Non-ST Elevation MI and USA Guidelines
2007 Summary
Alcohol: Heart Disease and Cancer
Alcohol For Prevention of CAD
2001 AHA Wine and Your Heart (2001)
“there is little current justification to recommend alcohol (or wine specifically) as a cardioprotective strategy.”
Alcohol Linked to Cancer Risk in Women
“Study Shows Even Low-to-Moderate Drinking Raises Risk of Cancer
Amyloidosis
1997 NEJM Review 1997 http://content.nejm.org/cgi/content/extract/337/13/898
Anticoagulation /Antithrombotic / Antiplatelet
2008 ACCP Antithrombotic and Thrombolytic Therapy http://chestjournal.chestpubs.org/content/133/6_suppl
(topics include Afib, Acute MI, CAD, Valvular Heart Disease, PAD, DVT/PE Prevention and Treatment, CVA, Periop)
2008 ACCP Antithrombotic Therapy Executive Summary http://chestjournal.chestpubs.org/content/133/6_suppl
2008 ACCP Antithrombotic Therapy in Atrial Fibrillation http://chestjournal.chestpubs.org/content/133/6_suppl/546S.full.pdf+html
ICIS Anticoagulation Guidelines
Aneurysm
Abdominal Aneurysm
2005 USPSTF Abdominal Aortic Aneurysm Screening: Recommendations
“The USPSTF recommends one-time screening for abdominal aortic aneurysm (AAA) by ultrasonography in men aged 65 to 75 who have ever smoked. ”
“The USPSTF makes no recommendation for or against screening for AAA in men aged 65 to 75 who have never smoked. ”
“The USPSTF recommends against routine screening for AAA in women. ”
Brain (cerebral) Aneurysm
2002 AHA Brain Aneurysm: Guidelines for Management
Thoracic Aneurysm
2010 ACCF/AHA Thoracic Aneurysm Guidelines
2010 Summary 2010 Summary 2010 Full
Aortic Stenosis (also see Valvular Heart Disease)
2009 EAE/ASE Echocardiographic Assessment of Valve Stenosis: EAE/ASE Recommendations for Clinical Practice
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
2009 Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound
http://www.asecho.org/files/public/PVText.pdf
Arrhythmias & Antiarrhythmic Drugs (see specific arrhythmias)
Circulation Collection of Arrhythmia and Electrophysiology Articles: http://circep.ahajournals.org/
JAMA Collection of Arrhythmia Articles: http://jama.ama-assn.org/cgi/collection/arrhythmias
some articles with restricted access to subscribers only
Atrial Fibrillation:
   
2008 ACCP Antithrombotic Therapy in Atrial Fibrillation
2006 ACC/AHA/ESC Atrial FIbrillation
2006 Summary 2006 Full
ICIS 2008 Atrial Fibrillation Guidelines
Beta Blockers
2009 ACCF/AHA Focused Update on Perioperative Beta Blockade
http://content.onlinejacc.org/cgi/content/full/j.jacc.2009.07.004
PDF: Print pages 2-14
2006 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
Cancer / Cancer Screening
Breast Cancer Screening
American Cancer Society Breast Cancer Screening Guidelines
“Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health”
http://www.cancer.org/docroot/PED/content/PED_2_3X_ACS_Cancer_Detection_Guidelines_36.asp?sitearea=PED
2009 USPSTF Breast Cancer Screening (The ACS Guidelines above remain unchanged as of Dec 2009)
Summary of Recommendations
· The USPSTF recommends biennial screening mammography for women aged 50 to 74 years.
· The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account,
including the patient's values regarding specific benefits and harms.
"So, what does this mean if you are a woman in your 40s?
You should talk to your doctor and make an informed decision about whether mammography is right for you
based on your family history, general health, and personal values."
Diana Petitti, MD, MPH Vice Chair, U.S. Preventive Services Task Force November 19, 2009
· The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years
or older.
· The USPSTF recommends against teaching breast self-examination (BSE).
· The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older.
· The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer.
http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm
Cervical Cancer Screening
2009 ACOG Pap Smear/Cervical Cancer Screening Recommendations:
“Women from ages 21 to 30 be screened every two years instead of annually, using either the standard Pap or liquid-based cytology.
Women age 30 and older who have had three consecutive negative cervical cytology test results may be screened once every
three years with either the Pap or liquid-based cytology.
Women with certain risk factors may need more frequent screening, including those who have HIV, are immunosuppressed,
were exposed to diethylstilbestrol (DES) in utero, and have been treated for cervical intraepithelial neoplasia (CIN) 2, CIN 3, or cervical cancer.”
http://www.acog.org/acog_districts/dist_notice.cfm?recno=13&bulletin=3161
Colon Cancer Screening
2008 ACG Colorectal Cancer Screening Guidelines
http://www.acg.gi.org/physicians/pdfs/CCSJournalPublicationFebruary2009.pdf
Lung Cancer Treatment
2004 ACS / ACCN Lung Cancer Treatment Guidelines for Patients
http://www.cancer.org/downloads/cri/f9495_02.pdf
Cardiac CT
2006 ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR
Appropriateness Guidelines for Cardiac CT and MR http://content.onlinejacc.org/cgi/reprint/48/7/1475
2007 ACC/AHA Calcuim Scoring and Risk http://www.americanheart.org/presenter.jhtml?identifier=3044629
2005 ACC/AHA Cardiac CT and MR Clinical competence www.acc.org/qualityandscience/clinical/competence/imaging/index.pdf
Cholesterol
2008 USPSTF Cholesterol Screening Guidelines http://www.ahrq.gov/CLINIC/uspstf/uspschol.htm
“Screening Men
· The U.S. Preventive Services Task Force (USPSTF) strongly recommends screening men aged 35 and older for lipid disorders.
Grade: A Recommendation..
· The USPSTF recommends screening men aged 20 to 35 for lipid disorders if they are at increased risk for coronary heart disease.
Grade: B Recommendation.
Screening Women at Increased Risk
· The USPSTF strongly recommends screening women aged 45 and older for lipid disorders if they are at increased risk for coronary heart disease.
Grade: A Recommendation.
· The USPSTF recommends screening women aged 20 to 45 for lipid disorders if they are at increased risk for coronary heart disease.
Grade: B Recommendation.
Screening Young Men and All Women Not at Increased Risk
· The USPSTF makes no recommendation for or against routine screening for lipid disorders in men aged 20 to 35, or in women aged 20 and older who are not at increased risk for coronary heart disease.
Grade: C Recommendation”
2004 ATP/NCEP Cholesterol 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
Colon Cancer
See Cancer above
Congestive Heart Failure (CHF)
 
2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults.
2009 Update 2009 Update 2005 Full 2005 Summary
ICSI Pre-printed CHF Orders
http://www.icsi.org/heart_failure__admission_for__order_set_/heart_failure__admission_for__order_set___ms_word_.html
Coronary Stents (see Stents below)
CPR / ACLS
2005 AHA Guidelines http://circ.ahajournals.org/content/vol112/24_suppl/
Defibrillators (see Pacemakers and Ventricular Arrhythmias 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
Drug Coated Cardiac Stents (Drug Eluting Coronary Stents)
see Stents below
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
1999 ATS Diagnosis of Acute Venous Thromboembolism (PDF)
http://www.thoracic.org/sections/publications/statements/pages/respiratory-disease-adults/venous1-24.html
Electrophysiology
Circulation Collection of Arrhythmia and Electrophysiology Articles: http://circep.ahajournals.org/
JAMA Collection of Arrhythmia Articles: http://jama.ama-assn.org/cgi/collection/arrhythmias
some articles with restricted access to subscribers only
Endocarditis
2007 American Heart Association/ACC Guidelines UPDATE: Endocarditis Prophylaxis :
http://www.americanheart.org/presenter.jhtml?identifier=3004539 (SHOULD BE READ IN CONJUNCTION WITH 1997 GUIDELINES)
AHA Prevention Endocarditis 1997 (see update 2007 above which significantly reduces the number of cardiac conditions requiring prophylaxis)
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
2005 AHA 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
2007 ESC Hypertension Guidelines
http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-AH-FT.pdf
Hypertrophic Cardiomyopathy:
2003 ASC/ESC Hypertrophic Cardiomyopathy http://www.acc.org/qualityandscience/clinical/consensus/cardiomyopathy/index.htm
2007 Hypertrophic Cardiomyopathy and Athletes:
Recommendations and Considerations Related to Preparticipation Screening for Cardiovascular Abnormalities in Competitive Athletes: 2007 Update
1997 NEJM Review HCM: March 13, 1997 vol 336 p775-85 www.nejm.org
2004 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)
Obesity and Fitness
BMI (Body Mass Index)
NHLBI BMI Table http://www.nhlbi.nih.gov/guidelines/obesity/bmi_tbl.htm
NHLBI BMI Table PDF http://www.nhlbi.nih.gov/guidelines/obesity/bmi_tbl.pdf
NHLBI BMI Calculator http://www.nhlbisupport.com/bmi/
Child Obesity Page
Obesity Guidelines
1998 Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report
PDF (228 pages) http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf
2000 NHLBI The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (88 pages)
http://www.nhlbi.nih.gov/guidelines/obesity/practgde.htm
Obesity CME
NHLBI Overweight and Obese Patients: What Providers Need to Know
http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/cont_ed.htm
Omega 3 Fish Oils
2002 AHA 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
2008 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
2002 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)
2003 NEJM Review ICDs: Nov 6, 2003 vol 349 p1836-47 http://content.nejm.org/cgi/content/extract/349/19/1836
requires subscription for access
Pneumonia
Hospital Acquired Pneumonia
2005 ATS/IDSA Guidelines for the Management of Adults with Hospital-Acquired Ventilator-Associated and Healthcare-associated Pneumonia
http://www.thoracic.org/sections/publications/statements/pages/mtpi/guide1-29.html
Community Acquired Pneumonia
2007 IDSA Community Acquired Pneumonia Guidelines
Pre-op /Periop
Evaluation for Non-Cardiac Surgery
2009 ACCF/AHA Focused Update on Perioperative Beta Blockade
http://content.onlinejacc.org/cgi/content/full/j.jacc.2009.07.004
ACC/AHA Guideline Update for Perioperative Cardiovascular Evaluation for Noncardiac Surgery (2007)
2002 ACC/AHA Periop Evaluation for Non-Cardiac Surgery (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)
Pre-op /Periop
Antithrombotic Therapy
2008 ACCP Peri-op Antithrombotic Management http://chestjournal.chestpubs.org/content/133/6_suppl/299S.full.pdf+html
Pulmonary Embolism (PE) - see DVT/PE above
Pulmonary Fibrosis / Idiopathic Pulmonary Fibrosis (IPF)
Medline Plus Pulmonary Fibrosis Page http://www.nlm.nih.gov/medlineplus/pulmonaryfibrosis.html
NHLBI Information for Patients and Families http://www.nhlbi.nih.gov/health/dci/Diseases/ipf/ipf_whatis.html
1999 American Thoracic Society Guidelines: Idiopathic Pulmonary Fibrosis Diagnosis and Treatment
http://www.thoracic.org/sections/publications/statements/pages/respiratory-disease-adults/idiopathic1-19.html
Stents: Coronary
2009 ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention
(Updating the 2005 Guideline and 2007 Focused Update)
Cardiac Stents: FDA Statement on Drug Eluting Cardiac Stents March 2007
http://content.nejm.org/cgi/content/full/356/10/984
AHA/ACC/SCAI/ACS/ADA SCIENCE ADVISORY Jan 2007
Prevention of Premature Discontinuation of Dual Antiplatelet Therapy in Patients With Coronary Artery Stents
http://content.onlinejacc.org/cgi/content/full/j.jacc.2007.01.003v1
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
DIRECT 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 and 144)
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
2009 ESC Syncope Guidelines
http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-syncope-FT.pdf
2004 ESC Syncope Guidelines
http://www.escardio.org/knowledge/guidelines/Management_of_Syncope_Guidelines.htm
2006 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
2009 Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound
http://www.asecho.org/files/public/PVText.pdf
2009 Echocardiographic Assessment of Valve Stenosis: EAE/ASE Recommendations for Clinical Practice
http://www.asecho.org/files/VSGuideline.pdf
2009 ASE Diastolic Function
http://www.asecho.org/files/DF.pdf
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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