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Assessment of Physical Function

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2661. Guidelines on Diagnosis and Management of Syncope

. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2640 1.3.1 Prevalence of syncope in the general population. . . 2640 1.3.2 Referral from the general population to medical settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2640 1.3.3 Prevalence of the causes of syncope . . . . . . . . . . 2641 1.4 Prognosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2641 1.4.1 Risk of death and life-threatening events . . . . . . . 2641 1.4.2 Recurrence of syncope and risk of physical injury . 2641 1.5 Impact on quality of life (...) electrophysiological study ESC European Society of Cardiology FASS Falls and Syncope Service FDA Food and Drug Administration HF heart failure HOCM hypertrophic obstructive cardiomyopathy HR heart rate HV His-ventricle ICD implantable cardioverter de?brillator ILR implantable loop recorder ISSUE International Study on Syncope of Unknown Etiology LBBB left bundle branch block LOC loss of consciousness LVEF left ventricular ejection fraction MRI magnetic resonance imaging OH orthostatic hypotension PCM physical

2009 European Society of Cardiology

2662. Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis

assessment at admission . . . . . . . . . . . . . . . . 2383 H. Antimicrobial therapy: principles and methods . . . . . . . . . 2383 General principles . . . . . . . . . . . . . . . . . . . . . . . . . . 2383 Penicillin-susceptible oral streptococci and group D streptococci . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2384 Penicillin-resistant oral streptococci and group D streptococci . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2384 Streptococcus pneumoniae, b-haemolytic (...) to the user. The recommendations for for- mulating and issuing ESC Guidelines and Expert Consensus Docu- ments can be found on the ESC website (http://www.escardio.org/ knowledge/guidelines/rules). In brief, experts in the ?eld are selected and undertake a com- prehensive review of the published evidence for management and/ or prevention of a given condition. A critical evaluation of diagnos- tic and therapeutic procedures is performed including assessment of the risk/ bene?t ratio. Estimates of expected

2009 European Society of Cardiology

2663. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

4. Clinical presentations of patients with ventricular arrhythmias and sudden cardiac death 760 4.1. Asymptomatic 760 4.2. Symptoms potentially related to ventricular arrhythmias 760 4.2.1. Hemodynamically stable ventricular tachycardia . . 760 4.2.2. Hemodynamically unstable ventricular tachycardia . . 761 4.3. Sudden cardiac arrest 761 5. General evaluationofpatientswith documentedor suspected ventricular arrhythmias 761 5.1. History and physical examination. 761 5.2. Noninvasive evaluation (...) 761 5.2.1. Resting electrocardiogram. 761 5.2.2. Exercise testing 761 5.2.3. Ambulatory electrocardiography 762 5.2.4. Electrocardiographic techniques and measurements. 762 5.2.5. Left ventricular function and imaging . 763 5.2.5.1. Echocardiograph . 763 5.2.5.2. Cardiac magnetic resonance imaging 764 5.2.5.3. Cardiac computed tomography 764 5.2.5.4. Radionuclide techniques 764 5.2.5.5. Coronary angiography 764 5.3. Electrophysiological testing 764 5.3.1. Electrophysiological testing in patients

2006 European Society of Cardiology

2664. Occupational therapy for people with Parkinson's disease

the benefi ts that occupational therapy, physiotherapy, and speech and language therapy can bring to their functional status and quality of life, and appreciate the way in which interventions are tailored to their specifi c activity and participation needs. This individual approach, while valued by people with Parkinson’s, has also presented obstacles to widespread recognition of the benefi ts of occupational therapy. Each individual with Parkinson’s is unique; the combination of a range of physical (...) . Deane et al (2003a, 2003b) concluded from their surveys that current UK practice emphasises functional goals ‘centred on independence, safety and confi dence, including activities such as transfers, mobility and self- care’ (Deane et al 2003b, p. 252). The principles of occupational therapy for Parkinson’s include: Early intervention to establish rapport, prevent activities and roles being restricted or • lost and, where needed, to develop appropriate coping strategies. Client- centred assessment

2010 Publication 1554

2665. Acute Coronary Syndromes (ACS) in patients presenting without persistent ST-segment elevation

because it is rapidly and widely available. LV systolic function is an important prognostic variable in patients with CAD and can be easily and accurately assessed by echocardiography. In experienced hands, transient seg- mental hypokinesia or akinesia may be detected during ischaemia. Furthermore, differential diagnoses such as aortic dissection, pul- monary embolism, aortic stenosis, hypertrophic cardiomyopathy, or pericardial effusion may be identi?ed. 33 Therefore, echocardio- graphy should (...) be routinely available in emergency rooms or chest pain units, and used in all patients. In patients with non-diagnostic 12-lead ECGs and negative cardiac biomarkers but suspected ACS, stress imaging may be performed, provided the patient is free of chest pain. Various studies have used stress echocardiography, showing high negative predictive values and/or excellent outcome in the presence of a normal stress echocardiogram. 34 Cardiac magnetic resonance (CMR) imaging can integrate assessment of function

2011 European Society of Cardiology

2666. Management of Arterial Hypertension

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2164 2.2 De?nition and classi?cation of hypertension . . . . . . . . .2165 2.3 Prevalence of hypertension . . . . . . . . . . . . . . . . . . . .2165 2.4 Hypertension and total cardiovascular risk . . . . . . . . . .2165 2.4.1 Assessment of total cardiovascular risk . . . . . . . . .2165 2.4.2 Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . .2166 2.4.3 Summary of recommendations on total cardiovascular risk assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . .2167 3 (...) exercise and laboratory stress .2171 3.1.6 Central blood pressure . . . . . . . . . . . . . . . . . . .2172 3.2 Medical history . . . . . . . . . . . . . . . . . . . . . . . . . . . .2172 3.3 Physical examination . . . . . . . . . . . . . . . . . . . . . . . .2173 3.4 Summary of recommendations on blood pressure measurement, history, and physical examination . . . . . . . . .2173 3.5 Laboratory investigations . . . . . . . . . . . . . . . . . . . . .2173 3.6 Genetics

2013 European Society of Cardiology

2667. Cardiac Pacing and Cardiac Resynchronization Therapy

. Indications for cardiac resynchronization therapy . . . . . . . . .2299 3.1 Epidemiology, prognosis, and pathophysiology of heart failure suitable for cardiac resynchronization therapy . . . . . .2299 Section 3.2 Patients in sinus rhythm . . . . . . . . . . . . . . . . .2300 3.2.1 Indications for cardiac resynchronization therapy . . .2300 3.2.1.1 Patients in New York Heart Association functional class III–IV . . . . . . . . . . . . . . . . . . . . . . .2300 3.2.1.2 Patients in New York Heart Association (...) functional class I–II . . . . . . . . . . . . . . . . . . . . . . . .2300 3.2.1.3 Patient selection: role of imaging techniques to evaluate mechanical dyssynchrony criteria to select patients for cardiac resynchronization therapy . . . . . . .2303 3.2.2 Choice of pacing mode (and cardiac resynchronization therapy optimization) . . . . . . . . . . . . . . . . . . . . . . . .2306 Section 3.3 Patients in atrial ?brillation . . . . . . . . . . . . . . .2306 3.3.1 Patients with heart failure, wide QRS

2013 European Society of Cardiology

2668. Management of Stable Coronary Artery Disease

by the release of ischaemic metabolites—such as adenosine—that stimu- late sensitive nerve endings, although angina may be absent even with severe ischaemia owing, for instance, to impaired transmission of painful stimuli to the cortex and other as-yet-unde?ned potential mechanisms. 11 The functional severity of coronary lesions can be assessed by measuring coronary ?ow reserve (CFR) and intracoronary artery pressures (fractional ?ow reserve, FFR). More detailed descriptions can be found in the web addenda (...) remains the cornerstone of the diagnosis of chest pain. In the majority of cases, it is possible to make a con?dent diag- nosis on the basis of the history alone, although physical examination and objective tests are often necessary to con?rm the diagnosis, exclude alternative diagnoses, 48 and assess the severity of underlying disease. The characteristics of discomfort-related to myocardial ischaemia (angina pectoris) may be divided into four categories: location, character

2013 European Society of Cardiology

2669. Diabetes, Pre-Diabetes and Cardiovascular Diseases

resistance in type 2 diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3047 4.3 Endothelial dysfunction, oxidative stress and vascular in?ammation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3047 4.4 Macrophage dysfunction . . . . . . . . . . . . . . . . . . . . . .3047 4.5 Atherogenic dyslipidaemia . . . . . . . . . . . . . . . . . . . .3048 4.6 Coagulation and platelet function . . . . . . . . . . . . . . . .3048 4.7 Diabetic cardiomyopathy (...) . . . . . . . . . . . . . . . . . . . . .3049 4.8 The metabolic syndrome . . . . . . . . . . . . . . . . . . . . .3049 4.9 Endothelial progenitor cells and vascular repair . . . . . . .3049 4.10 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3049 5. Cardiovascular risk assessment in patients with dysglycaemia . .3049 5.1 Risk scores developed for people without diabetes . . . .3049 5.2 Evaluation of cardiovascular risk in people with pre- diabetes

2013 European Society of Cardiology

2670. Acute Myocardial Infarction in patients presenting with ST-segment elevation

4.1.3. Ambulation . . . . . . . . . . . . . . . . . . . . . . . . . . 2593 4.1.4. Length of stay . . . . . . . . . . . . . . . . . . . . . . . . . 2593 4.2. Risk assessment and imaging . . . . . . . . . . . . . . . . . . 2594 4.2.1. Indications and timing . . . . . . . . . . . . . . . . . . . .2594 4.3. Assessment of myocardial viability . . . . . . . . . . . . . . 2595 4.4. Long-term therapies for ST-segment elevation myocardial infarction . . . . . . . . . . . . . . . . . . . . . . . . . . 2595 (...) tenecteplase TRANSFER Trial of Routine ANgioplasty and Stenting after Fibrinolysis to Enhance Reperfusion in acute myocardial infarction TRITON—TIMI 38 TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet InhibitioN with prasugrel—Thrombolysis in Myocardial Infarction 38 UFH unfractionated heparin VALIANT VALsartan In Acute myocardial iNfarction Trial VF ventricular ?brillation VT ventricular tachycardia 1. Preamble Guidelines summarize and evaluate all available evidence—at the time

2012 European Society of Cardiology

2671. CVD Prevention in clinical practice

-- -- --- -- -- --- -- --- -- -- --- -- -- --- -- -- --- -- -- --- -- -- --- -- --- -- -- --- -- -- --- --- - - - - - - --- -- -- --- -- -- --- -- --- -- -- --- -- -- --- -- -- --- -- -- --- -- -- --- -- --- -- -- -- Keywords Cardiovascular disease † Prevention † Risk assessment † Risk management † Smoking † Nutrition † Physical activity † Psychosocial factors Table of Contents Abbreviations and acronyms . . . . . . . . . . . . . . . . . . . . . . . .1638 1. What is cardiovascular disease prevention? . . . . . . . . . . . . .1638 1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1638 1.2 Development of guidelines . . . . . . . . . . . . . . . . . . . .1639 1.3 Evaluation methods (...) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1664 4.3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . .1665 4.3.2 Nutrients . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1665 4.3.3 Foods and food groups . . . . . . . . . . . . . . . . . . .1666 4.3.4 Functional foods . . . . . . . . . . . . . . . . . . . . . . . .1667 4.3.5 Dietary patterns . . . . . . . . . . . . . . . . . . . . . . . .1667 4.4 Physical activity . . . . . . . . . . . . . . . . . . . . . . . . . . . .1668 4.4.1 Introduction

2012 European Society of Cardiology

2672. Acute and Chronic Heart Failure

damage), whereas certain features, particularly previous myocardial infarction, greatly increase the likelihood of HF in a Table 2 New York Heart Association functional classi?cation based on severity of symptoms and physical activity Class I No limitation of physical activity. Ordinary physical activity does not cause undue breathlessness, fatigue, or palpitations. Class II Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in undue breathlessness (...) & Rehabilitation (EACPR), European Association of Echocardiography (EAE), European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI) Working Groups: Acute Cardiac Care, Cardiovascular Pharmacology and Drug Therapy, Cardiovascular Surgery, Grown-up Congenital Heart Disease, Hypertension and the Heart, Myocardial and Pericardial Diseases, Pulmonary Circulation and Right Ventricular Function, Thrombosis, Valvular Heart Disease Councils: Cardiovascular

2012 European Society of Cardiology

2673. Valvular Heart Disease

should include a comprehensive evaluation of all valves, looking for associated valve diseases, and the aorta. Indices of left ventricular (LV) enlargement and function are strong prognostic factors. While diameters allow a less complete assessment of LV size than volumes, their prognostic value has been studied more extensively. LV dimensions should be indexed to bodysurface area(BSA).Theuseof indexedvaluesisofparticu- lar interest in patients with a small body size but should be avoided in patients (...) -dimensional echocardiography and is useful for the assessment of complex valve problems or for monitoring surgery and percutaneous intervention. 3.1.3 Other non-invasive investigations 3.1.3.1 Stress testing Stress testing is considered here for the evaluation of VHD and/or its consequences, but not for the diagnosis of associated CAD. Predictive values of functional tests used for the diagnosis of CAD may not apply in the presence of VHD and are generally not used in this setting. 20 Exercise ECG

2012 European Society of Cardiology

2674. Sugars intake for adult and children

confidenc e interval CVD cardiovascular disease eLENA WHO e-Library of Evidence for Nutrition Actions FAO Food and Agriculture Organization of the United Nations GINA WHO Global database on the Implementation of Nutrition Action GRADE Grading of Recommendations Assessment, Development and Evaluation NCD noncommunicable disease NGO nongovernmental organization NHD WHO Department of Nutrition for Health and Development NUGAG WHO Nutrition Guidance Expert Advisory Group OR odds ratio PICO population (...) quarters of all NCD deaths (28 million), and the majority of premature deaths (82%), occurred in low- and middle-income countries. Modifiable risk factors such as poor diet and physical inactivity are some of the most common causes of NCDs; they are also risk factors for obesity 1 – an independent risk factor for many NCDs – which is also rapidly increasing globally (2). A high level of free sugars 2 intake is of concern, because of its association with poor dietary quality, obesity and risk of NCDs (3

2015 World Health Organisation Guidelines

2675. Optimal serum and red blood cell folate concentrations in women of reproductive age for prevention of neural tube defects

DFE = µg food folate + 1.7 × µg synthetic folate.17 WHO I Guideline: Optimal serum and red blood cell folate concentrations in women of reproductive age for prevention of neural tube defects WHO I Guideline: Optimal serum and red blood cell folate concentrations in women of reproductive age for prevention of neural tube defects indices and functional tests, may be more informative. Most methods used to assess nutritional status have not yet been standardized, which can lead to considerable (...) Performance of laboratory assays for assessment of folate concentrations 16 Recommendations 17 Remarks 17 Implications for future research 18vi WHO I Guideline: Optimal serum and red blood cell folate concentrations in women of reproductive age for prevention of neural tube defects Dissemination, adaptation and implementation 19 Dissemination 19 Adaptation and implementation 19 Monitoring and evaluation of guideline implementation 20 A harmonization programme for folate microbiological assays 20 Ethical

2015 World Health Organisation Guidelines

2676. Diagnosis and Management of Acute Pulmonary Embolism

& Rehabilitation (EACPR), European Association of Cardio- vascular Imaging (EACVI), Heart Failure Association (HFA), ESC Councils: Council on Cardiovascular Nursing and Allied Professions (CCNAP), Council for Cardiology Practice (CCP), Council on Cardiovascular Primary Care (CCPC) ESC Working Groups: Cardiovascular Pharmacology and Drug Therapy, Nuclear Cardiology and Cardiac Computed Tomography, Peripheral Circulation, Pulmonary Circulation and Right Ventricular Function, Thrombosis. Disclaimer: The ESC (...) classi?cation of pulmonary embolism severity . . .3039 3. Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3039 3.1 Clinical presentation . . . . . . . . . . . . . . . . . . . . . . . .3039 3.2 Assessment of clinical probability . . . . . . . . . . . . . . . .3040 3.3 D-dimer testing . . . . . . . . . . . . . . . . . . . . . . . . . . .3040 3.4 Computed tomographic pulmonary angiography . . . . . .3042 3.5 Lung scintigraphy

2014 European Society of Cardiology

2677. ESC/EACTS Guidelines in Myocardial Revascularisation

-making (Heart Team) . . . . . . .2553 4.3 Timing of revascularization andadhoc percutaneous coronary intervention . . . . . . . . . . . . . . . . . . . . . . . . . .2553 5. Strategies for diagnosis: functional testing and imaging . . . . . .2554 5.1 Non-invasive tests . . . . . . . . . . . . . . . . . . . . . . . . .2554 5.2 Invasive tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2554 5.3 Detection of myocardial viability . . . . . . . . . . . . . . . .2555 6. Revascularization (...) Repeat percutaneous coronary intervention . . . . . . . .2583 14.5 Hybrid procedures . . . . . . . . . . . . . . . . . . . . . . . .2583 15. Arrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2585 15.1 Ventricular arrhythmias . . . . . . . . . . . . . . . . . . . . .2585 15.1.1 Revascularization for prevention of sudden cardiac death in patients with stable coronary artery disease and reduced left ventricular function . . . . . . . . . . . . . . . . . .2585 15.1.2

2014 European Society of Cardiology

2678. Aortic Diseases

with the medical care of patients with this pathology.Selectedexpertsinthe?eldundertookacomprehensive reviewofthepublishedevidenceformanagement(includingdiagno- sis, treatment, prevention and rehabilitation) of a given condition accordingto ESC Committee forPractice Guidelines (CPG)policy. A critical evaluation of diagnostic and therapeutic procedures was performed including assessment of the risk-bene?t-ratio. Estimates of expected health outcomes for larger populations wereincluded, where data exist (...) , including the medical, endovascular, and surgical approaches,which areoften combined. In addition, genetic disorders, congenital abnormalities, aortic aneurysms, and AD are discussedinmoredetail. In the following section, the normal- and the ageing aorta are described. Assessment of the aorta includes clinical examination and laboratory testing, but is based mainly on imaging techniques usingultrasound,computedtomography(CT),andMRI.Endovascu- lar therapies are playing an increasingly important role

2014 European Society of Cardiology

2679. Hypertrophic Cardiomyopathy

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .2740 5.2 History and physical examination . . . . . . . . . . . . . . . .2740 5.3 Resting and ambulatory electrocardiography . . . . . . . . .2742 5.4 Echocardiography . . . . . . . . . . . . . . . . . . . . . . . . . .2742 5.4.1 Assessment of left ventricular wall thickness . . . . . .2742 5.4.2 Associated abnormalities of the mitral valve and left ventricular out?ow tract . . . . . . . . . . . . . . . . . . . . . . .2742 5.4.3 Assessment of latent obstruction . . . . . . . . . . . . .2743 5.4.4 (...) Left atrial enlargement . . . . . . . . . . . . . . . . . . . .2743 5.4.5 Assessment of diastolic function . . . . . . . . . . . . . .2744 5.4.6 Systolic function . . . . . . . . . . . . . . . . . . . . . . . .2744 5.4.7 Value of echocardiography in differential diagnosis . .2744 5.4.8 Contrast echocardiography . . . . . . . . . . . . . . . . .2744 5.4.9 Transoesophageal echocardiography . . . . . . . . . . .2744 5.5 Cardiovascular magnetic resonance imaging . . . . . . . . .2745 5.5.1 Assessment

2014 European Society of Cardiology

2680. Guidelines for caring for an infant, child, or young person who requires enteral feeding

of enteral device 11 Disposables required for enteral feeding 15 Enteral Feeds 15 Use of liquidised/blended food: 16 Checking position of enteral feeding devices 17 Flushing enteral devices 18 Administration of enteral feeds 18 Risks assessment for continuous overnight enteral feeding 20 Oral Hygiene 21 Administration of medications via an enteral feeding device 21 Trouble shooting guide for Enteral Devices 24 Glossary 29 APPENDIX 1. 32 APPENDIX 2 33 APPENDIX 3 (...) . Observe dressing on wound site for leakage of gastric contents or bleeding ½ hourly for 4 hours, then hourly To detect any postoperative complications. 12 for 4 hours and then 4 hourly if no concerns are noted. Give regular analgesia as prescribed noting effect. Administration of feed should commence as per Surgeons and Dietetic recommendations – every child is individually assessed. 10 STOP FEED/ MEDICATION DELIVERY IMMEDIATELY IF THERE IS: ? PAIN ON FEEDING ? SIGNS OF DISTRESS/ PHYSIOLOGICAL

2015 Regulation and Quality Improvement Authority

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