Recs – CUI – Name

ID Recommendation All CUI codes
32470 A thorough history and physical examination should be obtained/ performed in patients presenting with Heart Failure to identify cardiac and noncardiac disorders or behaviors that might cause or accelerate the development or progression of Heart Failure. C0004927 Behavior,C0019664 History,C0030705 Patients,C0031809 Physical Examination,C0150618 History and physical examination,C0205485 Physical,C0263955 Thoroughpin,C0420160 History and physical examination, school,C0449258 Progression,C0521110 Accelerated,C0884358 Performed,C1301820 Obtain,C1527148 Development,C1882120 Not Obtained,C4321457 Examination,C0012634 "Disease",C0018799 "Heart Diseases",C0031809 "Physical Examination",C0262926 "Medical History"
32471 In patients with idiopathic dilated cardiomyopathy (DCM), a 3-generational family history should be obtained to aid in establishing the diagnosis of familial DCM. C0007193 Cardiomyopathy, Dilated,C0007930 Chagas Cardiomyopathy,C0011900 Diagnosis,C0015576 Family,C0019664 History,C0030705 Patients,C0241888 Familial,C0241889 Family history,C0264795 Secondary dilated cardiomyopathy,C0340427 Familial dilated cardiomyopathy,C0420612 History not obtained,C0700124 Dilated,C0878544 Cardiomyopathies,C1301820 Obtain,C1837350 No cardiomyopathy,C1882120 Not Obtained,C2364239 Establishing Trust,C3532251 Fetal dilated cardiomyopathy,C0011900 "Diagnosis",C0033141 "Cardiomyopathies, Primary",C0241889 "Family history",C0262926 "Medical History",C0878544 "Cardiomyopathies"
32472 Volume status and vital signs should be assessed at each patient encounter. This includes serial assessment of weight, as well as estimates of jugular venous pressure and the presence of peripheral edema or orthopnea. C0001876 Air Pressure,C0013604 Edema,C0030705 Patients,C0043100 Weight,C0085619 Orthopnea,C0085649 Peripheral edema,C0205100 Peripheral,C0232133 Jugular venous pulse,C0348013 Venous,C0428897 Jugular venous pressure,C0449438 Status,C0449468 Volume,C0582950 Patient encounter status,C0750572 Estimated,C1516048 Assessed,C1882095 No Pressure,C1947978 Encounter,C3146287 Well,C0013604 "Edema",C0085619 "Orthopnea",C0085649 "Peripheral edema",C0311392 "Physical findings",C0392148 "Providing presence (regime/therapy)",C0428897 "Jugular venous pressure",C0460139 "Pressure (finding)",C1261322 "Evaluation procedure"
32474 Initial laboratory evaluation of patients presenting with Heart Failure should include a complete blood cell count, urinalysis, measurement of serum electrolytes (including calcium and magnesium), blood urea nitrogen, serum creatinine, glucose, and thyroid-stimulating hormone, a fasting lipid profile, and liver function tests. C0005767 Blood,C0005771 Blood Cell Count,C0005773 Blood Cells,C0006675 Calcium,C0007584 Cell Count,C0007634 Cells,C0009555 Complete Blood Count,C0010294 Creatinine,C0013832 Electrolytes,C0015663 Fasting,C0017725 Glucose,C0019932 Hormones,C0022877 Laboratory,C0023767 Lipid A,C0023779 Lipids,C0023884 Liver,C0023901 Liver Function Tests,C0024467 Magnesium,C0028158 Nitrogen,C0030705 Patients,C0036792 Copper measurement, serum,C0041942 Urea,C0042014 Urinalysis,C0202004 Estriol measurement, serum,C0202041 Glucose measurement, serum,C0202230 Thyroid stimulating hormone measurement,C0205197 Complete,C0205265 Initially,C0220825 Evaluation,C0229671 Serum,C0232741 Liver function,C0242485 Measurement,C0427433 Serum TIBC measurement,C0428282 Serum creatinine low,C0430044 Fasting lipid profile,C0438244 Serum creatinine normal,C0587355 Electrolytes measurement, serum,C0600061 Serum creatinine level,C0600137 Blood Urea Nitrogen,C0700225 Serum creatinine raised,C0733758 Follicle Stimulating Hormone,C0750480 Count,C0005767 "Blood",C0005771 "Blood Cell Count",C0005773 "Blood Cells",C0005845 "Blood urea nitrogen measurement",C0006675 "Calcium",C0007584 "Cell Count",C0007634 "Cells",C0009555 "Complete Blood Count",C0010294 "Creatinine",C0013832 "Electrolytes",C0015663 "Fasting",C0017725 "Glucose",C0019932 "Hormones",C0023779 "Lipids",C0023884 "Liver",C0023901 "Liver Function Tests",C0024467 "Magnesium",C0028158 "Nitrogen",C0040132 "Thyroid Gland",C0040135 "Thyroid Hormones",C0040160 "Thyrotropin",C0041942 "Urea",C0042014 "Urinalysis",C0201976 "Creatinine measurement, serum (procedure)",C0229671 "Serum",C0430044 "Fasting lipid profile",C0587355 "Electrolytes measurement, serum",C0600137 "Blood Urea Nitrogen",C1261322 "Evaluation procedure",C1269647 "Entire cell",C1278929 "Entire liver",C1291218 "Carbonyldiamide"
32475 Serial monitoring, when indicated, should include serum electrolyte levels and renal function. C0013832 Electrolytes,C0229671 Serum,C0232804 Renal function,C0428284 Electrolyte levels - finding,C1287347 Finding of serum electrolyte levels,C1444656 Indicated,C3536863 Electrolyte [EPC],C0013832 "Electrolytes",C0181904 "Monitor Device",C0229671 "Serum",C1287347 "Finding of serum electrolyte levels",C2946261 "Level"
32476 A 12-lead electrocardiogram should be performed initially on all patients presenting with Heart Failure C0013798 Electrocardiogram,C0023175 Lead,C0030705 Patients,C0179504 Electrocardiogram lead (device),C0199557 Electrocardiogram, single lead,C0205265 Initially,C0444868 All,C0884358 Performed,C2960418 12 lead electrocardiogram at rest,C0013798 "Electrocardiogram",C0023175 "Lead",C1623258 "Electrocardiography"
32477 Screening for hemochromatosis or HIV is reasonable in selected patients who present with Heart Failure. C0018995 Hemochromatosis,C0019682 HIV,C0030705 Patients,C0150312 Present,C1303095 Hemochromatosis gene screening test,C1710032 Screening,C0018995 "Hemochromatosis",C0220908 "Screening procedure"
32478 Diagnostic tests for rheumatological diseases, amyloidosis, or pheochromocytoma are reasonable in patients presenting with Heart Failure in whom there is a clinical suspicion of these diseases. C0002726 Amyloidosis,C0012634 Disease,C0030705 Patients,C0031511 Pheochromocytoma,C0205210 Clinical,C0242114 Suspicion,C0348026 Diagnostic,C0002726 "Amyloidosis",C0012634 "Disease",C0031511 "Pheochromocytoma"
32479 For patients at risk of developing Heart Failure, natriuretic peptide biomarker–based screening followed by team-based care, including a cardiovascular specialist optimizing GDMT, can be useful to prevent the development of left ventricular dysfunction (systolic or diastolic) or new-onset Heart Failure. C0006558 C-Peptide,C0007226 Cardiovascular system,C0030705 Patients,C0030956 Peptides,C0035647 Risk,C0081880 Natriuretic Peptide, C-Type,C0205091 Left,C0205314 New,C0332283 Followed by,C0388060 peptide A,C0442709 end diastolic,C0489485 end systolic,C0597421 natriuretic,C0749225 Systolic dysfunction,C0871489 Team,C1273070 Left ventricular diastolic dysfunction,C1277187 Left ventricular systolic dysfunction,C1522565 Ventricular,C1527148 Development,C1562095 Right ventricular systolic dysfunction,C1611835 Specialist,C1710032 Screening,C1997351 Left ventricular cardiac dysfunction,C3266750 Mild left ventricular systolic dysfunction,C3266752 Moderate left ventricular systolic dysfunction,C3266753 Severe left ventricular systolic dysfunction,C3532309 Fetal ventricular dysfunction,C3532310 Fetal right ventricular dysfunction,C3532311 Fetal left ventricular dysfunction,C3827682 Useful,C3887460 Cardiovascular,C3887504 Dysfunction,C0030956 "Peptides",C0220908 "Screening procedure",C1273070 "Left ventricular diastolic dysfunction",C1277187 "Left ventricular systolic dysfunction"
32480 In patients presenting with dyspnea, measurement of natriuretic peptide biomarkers is useful to support a diagnosis or exclusion of Heart Failure. C0006558 C-Peptide,C0011900 Diagnosis,C0013404 Dyspnea,C0030705 Patients,C0030956 Peptides,C0081880 Natriuretic Peptide, C-Type,C0242485 Measurement,C0388060 peptide A,C0597421 natriuretic,C1095989 Brain natriuretic peptide measurement,C1446047 Plasma B natriuretic peptide measurement,C2828389 Exclusion,C3827682 Useful,C4518809 Diagnosis of exclusion,C0011900 "Diagnosis",C0013404 "Dyspnea",C0030956 "Peptides"
32481 Measurement of BNP or NT-proBNP is useful for establishing prognosis or disease severity in chronic Heart Failure. C0012634 Disease,C0205191 chronic,C0242485 Measurement,C0278252 Prognosis bad,C2364239 Establishing Trust,C3827682 Useful,C0012634 "Disease",C0033325 "Forecast of outcome"
32482 Measurement of baseline levels of natriuretic peptide biomarkers and/or cardiac troponin on admission to the hospital is useful to establish a prognosis in acutely decompensated Heart Failure. C0006558 C-Peptide,C0019994 Hospitals,C0030956 Peptides,C0041199 Troponin,C0081880 Natriuretic Peptide, C-Type,C0184666 Hospital admission,C0205434 Decompensated,C0242485 Measurement,C0278252 Prognosis bad,C0388060 peptide A,C0443211 Established,C0457453 On admission,C0559269 Pre-admission,C0597421 natriuretic,C1305957 Cardiac troponin I,C1442488 Baseline,C3827682 Useful,C4035588 Hospital-OR,C4533677 at admission,C0030956 "Peptides",C0033325 "Forecast of outcome",C0041199 "Troponin",C0184666 "Hospital admission",C2946261 "Level"
32483 During a Heart Failure hospitalization, a predischarge natriuretic peptide level can be useful to establish a postdischarge prognosis. C0006558 C-Peptide,C0019993 Hospitalization,C0030956 Peptides,C0081880 Natriuretic Peptide, C-Type,C0278252 Prognosis bad,C0347984 During,C0388060 peptide A,C0443211 Established,C0597421 natriuretic,C2946261 Level,C3827682 Useful,C0030956 "Peptides",C0033325 "Forecast of outcome",C2946261 "Level"
32484 In patients with chronic Heart Failure, measurement of other clinically available tests, such as biomarkers of myocardial injury or fibrosis, may be considered for additive risk stratification. C0016059 Fibrosis,C0030705 Patients,C0035647 Risk,C0205191 chronic,C0205394 Other,C0242485 Measurement,C0442796 Additive,C0750591 consider,C1514983 Stratification,C1522564 Myocardial,C0016059 "Fibrosis",C0449210 "OTH tumor staging notation",C3263722 "Traumatic AND/OR non-traumatic injury",C3263723 "Traumatic injury"
32485 Patients with suspected or new-onset Heart Failure, or those presenting with acute decompensated Heart Failure, should undergo a chest x-ray to assess heart size and pulmonary congestion and to detect alternative cardiac, pulmonary, and other diseases that may cause or contribute to the patient’s symptoms. C0012634 Disease,C0018787 Heart,C0030705 Patients,C0205178 acute,C0205314 New,C0205394 Other,C0205434 Decompensated,C0242073 Pulmonary congestion,C0456389 size,C0700148 Congestion,C0817096 Chest,C1330713 EZ Detect,C1457887 Symptoms,C1516048 Assessed,C1523987 Alternative,C1997218 NOT suspected,C0012634 "Disease",C0018787 "Heart",C0018799 "Heart Diseases",C0039985 "Plain chest X-ray",C0242073 "Pulmonary congestion",C0449210 "OTH tumor staging notation",C0700148 "Congestion",C0817096 "Chest",C1281570 "Entire heart",C1306645 "Plain x-ray",C1457887 "Symptoms",C1962945 "Radiographic imaging procedure"
32486 A 2-dimensional echocardiogram with Doppler should be performed during initial evaluation of patients presenting with Heart Failure to assess ventricular function, size, wall thickness, wall motion, and valve function. C0013516 Echocardiography,C0026597 Motion,C0030705 Patients,C0080310 Left Ventricular Function,C0080311 Ventricular Function, Right,C0205265 Initially,C0220825 Evaluation,C0347984 During,C0436484 Echocardiogram normal,C0456389 size,C0588136 Heart valve function,C0743380 echocardiogram result,C0884358 Performed,C1516048 Assessed,C1522565 Ventricular,C1705052 2-Dimensional,C2243117 Echocardiogram (image),C0013516 "Echocardiography",C0554756 "Doppler studies",C1261322 "Evaluation procedure"
32487 Repeat measurement of EF and measurement of the severity of structural remodeling are useful to provide information in patients with Heart Failure who have had a significant change in clinical status; who have experienced or recovered from a clinical event; or who have received treatment, including GDMT, that might have had a significant effect on cardiac function; or who may be candidates for device therapy. C0017366 Structural gene,C0030705 Patients,C0085268 Bone remodeling,C0205210 Clinical,C0205341 Repeat,C0232164 Cardiac function,C0242485 Measurement,C0441471 Event,C0449438 Status,C0449440 Clinical status,C0678594 Structure,C0699733 Devices,C0729795 Fax received,C0746919 NO TREATMENT,C0750502 Significant,C1280500 Effect,C1514756 Receive,C1533716 Information,C1709850 Received By,C3827682 Useful,C0087111 "Therapeutic procedure"
32488 Noninvasive imaging to detect myocardial ischemia and viability is reasonable in patients presenting with de novo Heart Failure, who have known CAD and no angina, unless the patient is not eligible for revascularization of any kind. C0022116 Ischemia,C0030705 Patients,C0151744 Myocardial Ischemia,C0205309 Known,C0472662 Limb revascularization,C0472666 Revascularization of hand,C0472667 Revascularization of thumb,C0472672 Revascularization of foot,C0581603 Revascularization - action,C1330713 EZ Detect,C1522564 Myocardial,C1548635 Eligible,C1552551 Any,C2986496 Noninvasive,C0002962 "Angina Pectoris",C0011923 "Diagnostic Imaging",C0022116 "Ischemia",C0151744 "Myocardial Ischemia",C0581603 "Revascularization - action"
32489 Viability assessment is reasonable in select situations when planning revascularization in Heart Failure patients with CAD. C0030705 Patients,C0472662 Limb revascularization,C0472666 Revascularization of hand,C0472667 Revascularization of thumb,C0472672 Revascularization of foot,C0581603 Revascularization - action,C1651012 Select-OB,C0581603 "Revascularization - action",C1261322 "Evaluation procedure"
32490 Radionuclide ventriculography or magnetic resonance imaging can be useful to assess LVEF and volume when echocardiography is inadequate. C0013516 Echocardiography,C0024485 Magnetic Resonance Imaging,C0034610 Radionuclide Ventriculography,C0449468 Volume,C0596683 Cardiac ventriculography,C0846023 Right ventriculography,C1516048 Assessed,C3827682 Useful,C0011923 "Diagnostic Imaging",C0013516 "Echocardiography",C0024485 "Magnetic Resonance Imaging",C0034610 "Radionuclide Ventriculography",C0231881 "Pulmonary resonance"
32491 Magnetic resonance imaging is reasonable when assessing myocardial infiltrative processes or scar burden. C0024485 Magnetic Resonance Imaging,C1522564 Myocardial,C2828008 Burden,C0011923 "Diagnostic Imaging",C0024485 "Magnetic Resonance Imaging",C0231881 "Pulmonary resonance",C2004491 "Cicatrix"
32492 Routine repeat measurement of LV function assessment in the absence of clinical status change or treatment interventions should NOT be performed. C0205210 Clinical,C0205341 Repeat,C0205547 Routine,C0242485 Measurement,C0442739 No status change,C0445106 Not performed,C0449438 Status,C0449440 Clinical status,C0746919 NO TREATMENT,C0884358 Performed,C2732244 School function assessment,C1261322 "Evaluation procedure",C1273869 "Intervention regimes",C1689985 "Absence (morphologic abnormality)"
32493 Invasive hemodynamic monitoring with a pulmonary artery catheter should be performed to guide therapy in patients who have respiratory distress or clinical evidence of impaired perfusion in whom the adequacy or excess of intracardiac filling pressures cannot be determined from clinical assessment. C0019010 Hemodynamics,C0030705 Patients,C0150264 Invasive hemodynamic monitoring (regime/therapy),C0179732 Pulmonary artery catheter, oximetric,C0183290 Pulmonary artery shunt,C0190658 Pulmonary Artery Catheterization,C0199629 Pulmonary artery pressure monitoring,C0205210 Clinical,C0205281 Invasive,C0221099 Impaired,C0226054 Right pulmonary artery,C0226069 Left pulmonary artery,C0231303 Distress,C0476273 Respiratory distress,C0521095 Determined by,C0521346 respiratory,C0884358 Performed,C0919772 Hemodynamic test,C1827218 Pulmonary artery catheter care,C1828314 Removal of pulmonary artery catheter,C1979886 Excess,C3882333 Pulmonary artery catheter, standard,C3887511 Evidence,C4082936 Hemodynamic Monitoring,C0003842 "Arteries",C0031001 "Perfusion (procedure)",C0034052 "Pulmonary artery structure",C0085590 "catheter device",C0087111 "Therapeutic procedure",C0150264 "Invasive hemodynamic monitoring (regime/therapy)",C0161959 "Cardiovascular monitoring",C0179790 "Swan-Ganz catheter, device",C0181904 "Monitor Device",C0302614 "Guide device",C0460139 "Pressure (finding)",C0476273 "Respiratory distress",C0729936 "Cardiac chamber structure",C1261322 "Evaluation procedure",C1269026 "Entire pulmonary artery"
32494 Invasive hemodynamic monitoring can be useful for carefully selected patients with acute Heart Failure who have persistent symptoms despite empiric adjustment of standard therapies, and: • Whose fluid status, perfusion, or systemic or pulmonary vascular resistance is uncertain; • Whose systolic pressure remains low, or is associated with symptoms, despite initial therapy; • Whose renal function is worsening with therapy; • Who require parenteral vasoactive agents; or • Who may need consideration for mechanical circulatory support (MCS) or transplantation. C0001876 Air Pressure,C0019010 Hemodynamics,C0027552 Needs,C0030705 Patients,C0040732 Transplantation,C0042380 Vascular resistance,C0087130 Uncertainty,C0150264 Invasive hemodynamic monitoring (regime/therapy),C0205178 acute,C0205251 low,C0205265 Initially,C0205281 Invasive,C0205322 Persistent,C0205373 Systemic,C0232804 Renal function,C0332281 Associated with,C0426068 Uncertain lie,C0428971 Circulatory time,C0429119 Vascular resistance (finding),C0449438 Status,C0456261 Pulmonary Vascular Resistance,C0489485 end systolic,C0518609 Consideration,C0871470 Systolic Pressure,C0919772 Hemodynamic test,C1457887 Symptoms,C1801960 Vascular,C1880496 Empiric,C1882095 No Pressure,C1980011 Vasoactive,C3827682 Useful,C4082936 Hemodynamic Monitoring,C4281815 Resistance,C0031001 "Perfusion (procedure)",C0040732 "Transplantation",C0087111 "Therapeutic procedure",C0150264 "Invasive hemodynamic monitoring (regime/therapy)",C0161959 "Cardiovascular monitoring",C0181904 "Monitor Device",C0183683 "Support, device",C0344211 "Supportive care",C0450442 "Agent",C0460139 "Pressure (finding)",C1457887 "Symptoms"
32495 When ischemia may be contributing to Heart Failure, coronary arteriography is reasonable for patients eligible for revascularization. C0003844 Arteriography,C0022116 Ischemia,C0030705 Patients,C0436418 Coronary arteriography awaited,C0436469 Coronary arteriography normal,C0436525 Coronary arteriography abnormal,C0472662 Limb revascularization,C0472666 Revascularization of hand,C0472667 Revascularization of thumb,C0472672 Revascularization of foot,C0565183 Right coronary arteriography,C0565184 Left coronary arteriography,C0581603 Revascularization - action,C1445885 Coronary arteriography declined,C1522318 Coronary,C1548635 Eligible,C1880177 Contribution,C0003844 "Arteriography",C0022116 "Ischemia",C0085532 "Coronary angiography",C0581603 "Revascularization - action"
32496 Endomyocardial biopsy can be useful in patients presenting with Heart Failure when a specific diagnosis is suspected that would influence therapy. C0005558 Biopsy,C0011900 Diagnosis,C0030705 Patients,C0189785 Endomyocardial biopsy (procedure),C1997218 NOT suspected,C3827682 Useful,C4054723 Influence,C0005558 "Biopsy",C0011900 "Diagnosis",C0087111 "Therapeutic procedure",C0189785 "Endomyocardial biopsy (procedure)"
32497 Routine use of invasive hemodynamic monitoring is NOT recommended in normotensive patients with acute decompensated Heart Failure and congestion with symptomatic response to diuretics and vasodilators. C0012798 Diuretics,C0019010 Hemodynamics,C0030705 Patients,C0150264 Invasive hemodynamic monitoring (regime/therapy),C0205178 acute,C0205281 Invasive,C0205434 Decompensated,C0205547 Routine,C0231220 Symptomatic,C0700148 Congestion,C0919772 Hemodynamic test,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C4082936 Hemodynamic Monitoring,C4282382 No response,C0012798 "Diuretics",C0042402 "Vasodilator Agents",C0150264 "Invasive hemodynamic monitoring (regime/therapy)",C0161959 "Cardiovascular monitoring",C0181904 "Monitor Device",C0522563 "Acute congestion",C0700148 "Congestion",C2712122 "Normal blood pressure"
32498 Endomyocardial biopsy should NOT be performed in the routine evaluation of patients with Heart Failure. C0005558 Biopsy,C0030705 Patients,C0189785 Endomyocardial biopsy (procedure),C0205547 Routine,C0220825 Evaluation,C0445106 Not performed,C0884358 Performed,C0005558 "Biopsy",C0189785 "Endomyocardial biopsy (procedure)",C1261322 "Evaluation procedure"
32500 Other conditions that may lead to or contribute to Heart Failure, such as obesity, diabetes mellitus, tobacco use, and known cardiotoxic agents, should be controlled or avoided. C0011847 Diabetes,C0011849 Diabetes Mellitus,C0023175 Lead,C0028754 Obesity,C0040329 Tobacco,C0205309 Known,C0205318 Uncontrolled,C0205394 Other,C0332298 Controlled by,C1956032 Cardiotoxins,C3853727 Tobacco user,C0011849 "Diabetes Mellitus",C0028754 "Obesity",C0040329 "Tobacco",C0449210 "OTH tumor staging notation",C0450442 "Agent"
32501 In all patients with a recent or remote history of MI or acute coronary syndrome and reduced EF, angiotensin-converting enzyme (ACE) inhibitors should be used to prevent symptomatic Heart Failure and reduce mortality. In patients intolerant of ACE inhibitors, angiotensin-receptor blockers are appropriate unless contraindicated. C0003006 Angiotensin I,C0003009 angiotensin II,C0003012 Angiotensin III,C0003015 Angiotensin-Converting Enzyme Inhibitors,C0003018 Angiotensins,C0014442 Enzymes,C0019664 History,C0030705 Patients,C0034787 Angiotensin Receptor,C0039082 Syndrome,C0201888 Angiotensin converting enzyme measurement,C0205157 Remote,C0205178 acute,C0231200 intolerant,C0231220 Symptomatic,C0243077 inhibitors,C0332185 Recent,C0340678 Coronary steal syndrome,C0392756 Reduced,C0444868 All,C0597357 receptor,C0948089 Acute Coronary Syndrome,C1272105 CSF: angiotensin-converting enzyme level,C1444657 Contraindicated,C1522318 Coronary,C1548787 Appropriate,C1873000 angiotensin A,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0003018 "Angiotensins",C0014442 "Enzymes",C0022709 "Peptidyl-Dipeptidase A",C0034787 "Angiotensin Receptor",C0039082 "Syndrome",C0262926 "Medical History",C0597357 "receptor",C0948089 "Acute Coronary Syndrome"
32503 In all patients with a recent or remote history of MI or acute coronary syndrome and reduced EF, evidence-based beta blockers should be used to reduce mortality. C0019664 History,C0030705 Patients,C0039082 Syndrome,C0205157 Remote,C0205178 acute,C0332185 Recent,C0340678 Coronary steal syndrome,C0392756 Reduced,C0444868 All,C0948089 Acute Coronary Syndrome,C1522318 Coronary,C3887511 Evidence,C0039082 "Syndrome",C0262926 "Medical History",C0948089 "Acute Coronary Syndrome"
32504 In all patients with a recent or remote history of MI or acute coronary syndrome, statins should be used to prevent symptomatic Heart Failure and cardiovascular events. C0007226 Cardiovascular system,C0019664 History,C0030705 Patients,C0039082 Syndrome,C0205157 Remote,C0205178 acute,C0231220 Symptomatic,C0332185 Recent,C0340678 Coronary steal syndrome,C0441471 Event,C0444868 All,C0948089 Acute Coronary Syndrome,C1522318 Coronary,C3887460 Cardiovascular,C0039082 "Syndrome",C0262926 "Medical History",C0360714 "Hydroxymethylglutaryl-CoA Reductase Inhibitors",C0948089 "Acute Coronary Syndrome",C1320716 "Cardiovascular event"
32505 In patients with structural cardiac abnormalities, including LV hypertrophy, in the absence of a history of MI or ACS, blood pressure should be controlled in accordance with clinical practice guidelines for hypertension to prevent symptomatic Heart Failure. C0001876 Air Pressure,C0005767 Blood,C0005823 Blood Pressure,C0015393 Eye Abnormalities,C0017366 Structural gene,C0019664 History,C0020564 Hypertrophy,C0030705 Patients,C0162791 Guidelines,C0205210 Clinical,C0205318 Uncontrolled,C0231220 Symptomatic,C0332298 Controlled by,C0445199 Pressure controlled method,C0564627 Pressure controlled SIMV,C0678594 Structure,C1882095 No Pressure,C1963138 Hypertension, CTCAE,C2748577 No hypertension,C3809765 No abnormalities,C0005767 "Blood",C0020538 "Hypertensive disease",C0020564 "Hypertrophy",C0149721 "Left Ventricular Hypertrophy",C0262926 "Medical History",C0460139 "Pressure (finding)",C1272641 "Systemic arterial pressure",C1689985 "Absence (morphologic abnormality)"
32506 ACE inhibitors should be used in all patients with a reduced EF to prevent symptomatic Heart Failure, even if they do not have a history of MI. C0019664 History,C0030705 Patients,C0231220 Symptomatic,C0243077 inhibitors,C0392756 Reduced,C0444868 All,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0262926 "Medical History"
32507 Beta blockers should be used in all patients with a reduced EF to prevent symptomatic Heart Failure, even if they do not have a history of MI. C0019664 History,C0030705 Patients,C0231220 Symptomatic,C0392756 Reduced,C0444868 All,C0262926 "Medical History"
32508 To prevent sudden death, placement of an implantable cardioverterdefibrillator (ICD) is reasonable in patients with asymptomatic ischemic cardiomyopathy who are ?40 days post-MI, have an LVEF of ?30%, are on appropriate medical therapy, and have a reasonable expectation of survival with a good functional status for >1 year. C0007930 Chagas Cardiomyopathy,C0011071 Sudden death,C0030705 Patients,C0205170 Good,C0205245 Functional,C0205476 Medical,C0231221 Asymptomatic,C0349782 Ischemic cardiomyopathy,C0418981 Medical therapy,C0439234 year,C0439509 /40,C0449438 Status,C0451175 Functional status index,C0475224 Ischemic,C0679138 Expectations,C0687676 Post,C0878544 Cardiomyopathies,C1524072 Placement,C1548787 Appropriate,C1837350 No cardiomyopathy,C3842587 40%,C3842588 30%,C0011071 "Sudden death",C0087111 "Therapeutic procedure",C0231221 "Asymptomatic",C0349782 "Ischemic cardiomyopathy",C0418981 "Medical therapy",C0441587 "Clinical act of insertion",C0878544 "Cardiomyopathies",C1306577 "Death (finding)",C1533810 "Placement action"
32509 Nondihydropyridine calcium channel blockers with negative inotropic effects may be harmful in asymptomatic patients with low LVEF and no symptoms of Heart Failure after MI. C0006675 Calcium,C0030705 Patients,C0205160 Negative,C0205251 low,C0231221 Asymptomatic,C0231918 Nose symptoms,C0439799 Channel,C0573229 Overdose of calcium-channel blockers,C1280500 Effect,C1457887 Symptoms,C1704420 effects of,C0006675 "Calcium",C0006684 "Calcium Channel Blockers",C0231221 "Asymptomatic",C1457887 "Symptoms"
32510 Patients with Heart Failure should receive specific education to facilitate Heart Failure self-care. C0030705 Patients,C0036588 Self,C1514756 Receive,C0013658 "Educational Status",C0039401 "Educational process of instructing",C0424927 "Details of education"
32511 Sodium restriction is reasonable for patients with symptomatic Heart Failure to reduce congestive symptoms. C0030705 Patients,C0037473 Sodium,C0150136 Area restriction,C0231220 Symptomatic,C0430141 Sodium restriction test,C0742742 Congestive,C1457887 Symptoms,C0037473 "Sodium",C1457887 "Symptoms"
32512 Exercise training (or regular physical activity) is recommended as safe and effective for patients with Heart Failure who are able to participate to improve functional status. C0015259 Exercise,C0026606 Physical activity,C0030705 Patients,C0184511 Improved,C0205245 Functional,C0205272 Regular,C0205485 Physical,C0220931 Training,C0449438 Status,C0451175 Functional status index,C1704419 Effective,C1820977 Recommended diet,C3845261 No activity,C3846195 Not Recommended,C3846199 Chem recommended,C0220931 "Training"
32513 Cardiac rehabilitation can be useful in clinically stable patients with Heart Failure to improve functional capacity, exercise duration, health-related quality of life (HRQOL), and mortality. C0015259 Exercise,C0018684 Health,C0026643 Mouth Rehabilitation,C0030705 Patients,C0184511 Improved,C0205245 Functional,C0332306 Quality,C0376558 Life,C0700431 Cardiac rehabilitation,C1516240 Capacity,C1998319 Functional capacity,C2926735 Duration,C3827682 Useful,C0034991 "Rehabilitation therapy",C0518214 "Perceived quality of life",C0700431 "Cardiac rehabilitation",C1998319 "Functional capacity",C2926735 "Duration"
32516 Heart FailurerEF NYHA class I?IV (Stage C) ACEI or ARB AND GDMT beta blocker; diuretics as needed (COR I) C0012798 Diuretics,C0456387 Class,C1306673 Stage,C1883728 As Needed,C0012798 "Diuretics",C0028778 "Obstruction"
32517 NYHA class II?IV, provided est. CrCl >30 mL/min & K+ <5.0 mEq/L implement Aldosterone antagonist (COR I) C0002006 Aldosterone,C0002007 Aldosterone Antagonists,C0439152 mEq,C0439445 mL/min,C0439526 /mL,C0456387 Class,C3661900 Not provided,C3842588 30%,C0002006 "Aldosterone",C0002007 "Aldosterone Antagonists"
32520 NYHA class II?III, LVEF ?35%; (caveat: >1 y survival, >40 d post MI) implement implantable cardioverter-defibrillator C0180307 Defibrillators,C0439509 /40,C0456387 Class,C0687676 Post,C1289801 Implantable cardioverter leads,C1960586 Cardioverter defibrillator procedure,C3842587 40%,C4319605 35,C0162589 "Implantable defibrillator",C0180307 "Defibrillators"
32522 NYHA class II?III, NSR, heart rate ?70 bpm on maximally tolerated dose beta blocker C0018787 Heart,C0018810 heart rate,C0456387 Class,C1521828 Rate,C3842584 70%,C0018787 "Heart",C0028778 "Obstruction",C1281570 "Entire heart"
32523 patients are Stage D refractory NYHA class III-IV consider additional therapy of palliative care (COR I) or transplant (COR I) or left ventricular assist device (COR IIa) or Investigational studies C0030231 Palliative Care,C0030705 Patients,C0181598 Left ventricular assist device,C0205091 Left,C0456387 Class,C0699733 Devices,C0750591 consider,C1285530 Palliative,C1306673 Stage,C1517586 Investigational,C1522565 Ventricular,C1524062 Additional,C1960585 Removal of ventricular assist device,C3841811 Transplant,C0030231 "Palliative Care",C0040732 "Transplantation",C0085842 "Artificial Ventricle",C0087111 "Therapeutic procedure",C0181598 "Left ventricular assist device",C0332835 "Transplanted tissue"
32524 Diuretics are recommended in patients with Heart FailurerEF with fluid retention C0012798 Diuretics,C0030705 Patients,C0268000 Body fluid retention,C1820977 Recommended diet,C3532160 Fetal fluid retention,C3846195 Not Recommended,C3846199 Chem recommended,C0012798 "Diuretics",C0268000 "Body fluid retention"
32525 ACE inhibitors are recommended for all patients with Heart FailurerEF C0030705 Patients,C0243077 inhibitors,C0444868 All,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0003015 "Angiotensin-Converting Enzyme Inhibitors"
32526 ARBs are recommended in patients with Heart FailurerEF who are ACE inhibitor–intolerant C0030705 Patients,C0231200 intolerant,C1820977 Recommended diet,C1999216 Inhibitor,C3846195 Not Recommended,C3846199 Chem recommended,C0003015 "Angiotensin-Converting Enzyme Inhibitors"
32529 Routine combined use of an ACE inhibitor, ARB, and aldosterone antagonist is potentially harmful for patients with Heart FailurerEF. C0002006 Aldosterone,C0002007 Aldosterone Antagonists,C0030705 Patients,C0205195 Combined,C0205547 Routine,C1999216 Inhibitor,C0002006 "Aldosterone",C0002007 "Aldosterone Antagonists",C0003015 "Angiotensin-Converting Enzyme Inhibitors"
32531 Aldosterone receptor antagonists are recommended in patients with NYHA class II–IV Heart Failure who have LVEF ?35% C0002006 Aldosterone,C0030705 Patients,C0243076 antagonists,C0456387 Class,C0522271 Aldosterone receptor site,C0597357 receptor,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C4319605 35,C0002006 "Aldosterone",C0002007 "Aldosterone Antagonists",C0597357 "receptor"
32532 Aldosterone receptor antagonists are recommended to reduce morbidity and mortality following an acute MI in patients who have LVEF of ?40% who develop symptoms of Heart Failure or who have a history of diabetes mellitus, unless contraindicated. C0002006 Aldosterone,C0009488 Comorbidity,C0011847 Diabetes,C0011849 Diabetes Mellitus,C0019664 History,C0030705 Patients,C0205178 acute,C0243076 antagonists,C0332282 Following,C0439509 /40,C0522271 Aldosterone receptor site,C0597357 receptor,C1313937 Family history of diabetes mellitus,C1444657 Contraindicated,C1457887 Symptoms,C1820977 Recommended diet,C3532488 History of diabetes mellitus type 2,C3532489 History of diabetes mellitus type 1,C3842587 40%,C3846195 Not Recommended,C3846199 Chem recommended,C0002006 "Aldosterone",C0002007 "Aldosterone Antagonists",C0011849 "Diabetes Mellitus",C0262926 "Medical History",C0597357 "receptor",C1457887 "Symptoms"
32533 Inappropriate use of aldosterone receptor antagonists is potentially harmful because of life-threatening hyperkalemia or renal insufficiency when serum creatinine is >2.5 mg/dL in men or >2.0 mg/dL in women (or estimated glomerular filtration rate <30 mL/min/1.73 m2), and/or potassium >5.0 mEq/L. C0002006 Aldosterone,C0010294 Creatinine,C0016107 filtration,C0017654 Glomerular Filtration Rate,C0020461 Hyperkalemia,C0032821 Potassium,C0229671 Serum,C0231179 Insufficiency,C0232809 Glomerular filtration,C0243076 antagonists,C0376558 Life,C0428282 Serum creatinine low,C0438244 Serum creatinine normal,C0439152 mEq,C0439269 mg/dL,C0439445 mL/min,C0439526 /mL,C0522271 Aldosterone receptor site,C0597357 receptor,C0600061 Serum creatinine level,C0700225 Serum creatinine raised,C0750572 Estimated,C1301862 Min 1,C1521828 Rate,C1548788 Inappropriate,C2826244 Life Threatening,C3842588 30%,C4321396 MG,C0002006 "Aldosterone",C0002007 "Aldosterone Antagonists",C0010294 "Creatinine",C0017654 "Glomerular Filtration Rate",C0020461 "Hyperkalemia",C0032821 "Potassium",C0035078 "Kidney Failure",C0201976 "Creatinine measurement, serum (procedure)",C0229671 "Serum",C0597357 "receptor"
32534 The combination of hydralazine and isosorbide dinitrate is recommended for African Americans with NYHA class III–IV Heart FailurerEF on GDMT C0020223 Hydralazine,C0022251 Isosorbide,C0022252 Isosorbide Dinitrate,C0052142 AP combination,C0054603 CAP combination,C0456387 Class,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0020223 "Hydralazine",C0022251 "Isosorbide",C0022252 "Isosorbide Dinitrate"
32535 A combination of hydralazine and isosorbide dinitrate can be useful in patients with Heart FailurerEF who cannot be given ACE inhibitors or ARBs C0020223 Hydralazine,C0022251 Isosorbide,C0022252 Isosorbide Dinitrate,C0030705 Patients,C0052142 AP combination,C0054603 CAP combination,C0243077 inhibitors,C1442162 GIVEN,C3827682 Useful,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0020223 "Hydralazine",C0022251 "Isosorbide",C0022252 "Isosorbide Dinitrate"
32536 Digoxin can be beneficial in patients with Heart FailurerEF, unless contraindicated, to decrease hospitalizations for Heart Failure. C0012265 Digoxin,C0019993 Hospitalization,C0030705 Patients,C0547047 Decrease,C1444657 Contraindicated,C0012265 "Digoxin"
32537 Patients with chronic Heart Failure with permanent/persistent/paroxysmal AF and an additional risk factor for cardioembolic stroke (history of hypertension, diabetes mellitus, previous stroke or transient ischemic attack, or ?75 years of age) should receive chronic anticoagulant therapy (in the absence of contraindications to anticoagulation). C0001779 Age,C0003280 Anticoagulants,C0007787 Transient Ischemic Attack,C0011847 Diabetes,C0011849 Diabetes Mellitus,C0019664 History,C0030705 Patients,C0035647 Risk,C0035648 risk factors,C0079164 contraindications aspect,C0150457 Anticoagulant therapy,C0205156 Previous,C0205191 chronic,C0205311 Paroxysmal,C0205322 Persistent,C0205355 Permanent,C0341425 Transient ischemic colitis,C0439234 year,C0449867 Use of anticoagulation,C0475224 Ischemic,C0852649 Contraindications, Surgery,C1317264 Contraindications section,C1446238 Stroke / transient ischemic attack referral,C1514756 Receive,C1521761 Factor,C1524062 Additional,C1531624 Cardioembolic stroke,C1963138 Hypertension, CTCAE,C1998164 History of cardioembolic stroke,C2748577 No hypertension,C3173979 Contraindications for test,C3536711 Anti-coagulant [EPC],C3843647 > 2 years,C4319621 75,C4505286 Contraindications, Drug,C0003280 "Anticoagulants",C0007787 "Transient Ischemic Attack",C0011849 "Diabetes Mellitus",C0020538 "Hypertensive disease",C0038454 "Cerebrovascular accident",C0087111 "Therapeutic procedure",C0150457 "Anticoagulant therapy",C0262926 "Medical History",C1304680 "Observation of attack",C1531624 "Cardioembolic stroke"
32538 The selection of an anticoagulant agent (warfarin, dabigatran, apixaban, or rivaroxaban) for permanent/persistent/paroxysmal AF should be individualized on the basis of risk factors, cost, tolerability, patient preference, potential for drug interactions, and other clinical characteristics, including time in the international normalized ratio therapeutic range if the patient has been taking warfarin. ( C0003280 Anticoagulants,C0030705 Patients,C0035647 Risk,C0040223 Time,C0043031 Warfarin,C0205210 Clinical,C0205311 Paroxysmal,C0205322 Persistent,C0205355 Permanent,C0205394 Other,C0242784 Food Interactions,C0302350 Therapeutic,C0332310 Has patient,C0450442 Agent,C0455939 A/N risk factors,C0456603 Ratio,C0460096 Above therapeutic range,C0460097 Within therapeutic range,C0460099 Below therapeutic range,C0525032 International Normalized Ratio,C0558295 preference,C0687133 Drug Interactions,C1512888 International,C1514721 Range,C1521970 Characteristics,C1739768 rivaroxaban,C1831808 apixaban,C1874451 Basis,C1881197 Individualized,C1882115 Normalize,C2348066 dabigatran,C2986790 Normalized Time,C3245505 Potential,C3274448 Tolerability Study,C3536711 Anti-coagulant [EPC],C0003280 "Anticoagulants",C0013227 "Pharmaceutical Preparations",C0043031 "Warfarin",C0449210 "OTH tumor staging notation",C0450442 "Agent",C0525032 "International Normalized Ratio",C1739768 "rivaroxaban",C1831808 "apixaban",C1874451 "Basis"
32539 Chronic anticoagulation is reasonable for patients with chronic Heart Failure who have permanent/persistent/paroxysmal AF but are without an additional risk factor for cardioembolic stroke (in the absence of contraindications to anticoagulation). ( C0030705 Patients,C0035647 Risk,C0035648 risk factors,C0079164 contraindications aspect,C0205191 chronic,C0205311 Paroxysmal,C0205322 Persistent,C0205355 Permanent,C0332288 Without,C0449867 Use of anticoagulation,C0852649 Contraindications, Surgery,C1317264 Contraindications section,C1521761 Factor,C1524062 Additional,C1531624 Cardioembolic stroke,C3173979 Contraindications for test,C4505286 Contraindications, Drug,C0038454 "Cerebrovascular accident",C1531624 "Cardioembolic stroke"
32540 Anticoagulation is NOT recommended in patients with chronic Heart FailurerEF without AF, a prior thromboembolic event, or a cardioembolic source C0030705 Patients,C0205191 chronic,C0332288 Without,C0333214 thromboembolic,C0441471 Event,C0449416 Source,C0449867 Use of anticoagulation,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0449416 "Source"
32541 Statins are NOT beneficial as adjunctive therapy when prescribed solely for Heart Failure C0278329 Prescribed,C1292783 Adjunctive care,C0087111 "Therapeutic procedure",C0360714 "Hydroxymethylglutaryl-CoA Reductase Inhibitors"
32543 Nutritional supplements as treatment for Heart Failure are NOT recommended in patients with current or prior symptoms of Heart FailurerEF. ( C0030705 Patients,C0746919 NO TREATMENT,C1457887 Symptoms,C1521739 Nutritional,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C1457887 "Symptoms"
32545 Drugs known to adversely affect the clinical status of patients with current or prior symptoms of Heart FailurerEF are potentially harmful and should be avoided or withdrawn whenever possible (eg, most antiarrhythmic drugs, most calcium channel–blocking drugs [except amlodipine], nonsteroidal anti-inflammatory drugs, or thiazolidinediones). C0006675 Calcium,C0030705 Patients,C0051696 Amlodipine,C0205210 Clinical,C0205309 Known,C0205393 Most,C0332149 Possible,C0332206 Blocking,C0333348 Inflammatory,C0424092 Withdrawn,C0439799 Channel,C0449438 Status,C0449440 Clinical status,C1257987 Thiazolidinediones,C1457887 Symptoms,C3537142 Antiarrhythmic [EPC],C0003195 "Anti-Arrhythmia Agents",C0006675 "Calcium",C0013227 "Pharmaceutical Preparations",C0051696 "Amlodipine",C1257987 "Thiazolidinediones",C1457887 "Symptoms"
32546 Long-term use of infused positive inotropic drugs is potentially harmful for patients with Heart FailurerEF, except as palliation for patients with end-stage disease who cannot be stabilized with standard medical treatment C0012634 Disease,C0030705 Patients,C0205088 End-stage,C0205166 Long,C0205476 Medical,C0444930 End,C0746919 NO TREATMENT,C0849833 Fear of medical treatment,C1306673 Stage,C1446409 Positive,C0012634 "Disease",C0013227 "Pharmaceutical Preparations",C0354668 "Positive inotropic drug"
32548 The clinical strategy of inhibition of the renin-angiotensin system with ACE inhibitors OR ARBs in conjunction with evidence-based beta blockers, and aldosterone antagonists in selected patients, is recommended for patients with chronic Heart FailurerEF to reduce morbidity and mortality. C0002006 Aldosterone,C0003006 Angiotensin I,C0003009 angiotensin II,C0003012 Angiotensin III,C0003018 Angiotensins,C0009488 Comorbidity,C0030705 Patients,C0035094 Renin,C0205191 chronic,C0205210 Clinical,C0243076 antagonists,C0243077 inhibitors,C0449913 System,C0679199 Strategy,C1820977 Recommended diet,C1873000 angiotensin A,C2699427 Conjunction,C3463820 Inhibition,C3846195 Not Recommended,C3846199 Chem recommended,C3887511 Evidence,C0002006 "Aldosterone",C0002007 "Aldosterone Antagonists",C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0003018 "Angiotensins",C0035094 "Renin",C1960108 "Renin inhibitor"
32549 The clinical strategy of inhibition of the renin-angiotensin system with ARNI in conjunction with evidence-based beta blockers, and aldosterone antagonists in selected patients, is recommended for patients with chronic Heart FailurerEF to reduce morbidity and mortality. C0002006 Aldosterone,C0003006 Angiotensin I,C0003009 angiotensin II,C0003012 Angiotensin III,C0003018 Angiotensins,C0009488 Comorbidity,C0030705 Patients,C0035094 Renin,C0205191 chronic,C0205210 Clinical,C0243076 antagonists,C0449913 System,C0679199 Strategy,C1820977 Recommended diet,C1873000 angiotensin A,C2699427 Conjunction,C3463820 Inhibition,C3846195 Not Recommended,C3846199 Chem recommended,C3887511 Evidence,C0002006 "Aldosterone",C0002007 "Aldosterone Antagonists",C0003018 "Angiotensins",C0035094 "Renin"
32550 The use of ACE inhibitors is beneficial for patients with prior or current symptoms of chronic Heart FailurerEF to reduce morbidity and mortality. C0009488 Comorbidity,C0030705 Patients,C0205191 chronic,C0243077 inhibitors,C1457887 Symptoms,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C1457887 "Symptoms"
32551 The use of ARBs to reduce morbidity and mortality is recommended in patients with prior or current symptoms of chronic Heart FailurerEF who are intolerant to ACE inhibitors because of cough or angioedema. C0002994 Angioedema,C0009488 Comorbidity,C0030705 Patients,C0205191 chronic,C0231200 intolerant,C0243077 inhibitors,C1457887 Symptoms,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0002994 "Angioedema",C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0010200 "Coughing",C1457887 "Symptoms"
32552 In patients with chronic symptomatic Heart FailurerEF NYHA class II or III who tolerate an ACE inhibitor or ARB, replacement by an ARNI is recommended to further reduce morbidity and mortality. C0009488 Comorbidity,C0030705 Patients,C0205191 chronic,C0231220 Symptomatic,C0456387 Class,C0559956 Replacement,C1517331 Further,C1820977 Recommended diet,C1999216 Inhibitor,C3846195 Not Recommended,C3846199 Chem recommended,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0035139 "Surgical Replantation"
32553 Angiotensin receptor-neprilysin inhibitor should not be administered concomitantly with ACE inhibitors or within 36 hours of the last dose of an ACE inhibitor. C0003006 Angiotensin I,C0003009 angiotensin II,C0003012 Angiotensin III,C0003018 Angiotensins,C0025250 Neprilysin,C0034787 Angiotensin Receptor,C0243077 inhibitors,C0332285 Within,C0439227 Hour,C0564385 /hour,C0597357 receptor,C1517741 Last,C1548562 Not Administered,C1873000 angiotensin A,C1999216 Inhibitor,C4319606 36,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0003018 "Angiotensins",C0034787 "Angiotensin Receptor",C0597357 "receptor"
32554 Angiotensin receptor-neprilysin inhibitor should not be administered to patients with a history of angioedema. C0002994 Angioedema,C0003006 Angiotensin I,C0003009 angiotensin II,C0003012 Angiotensin III,C0003018 Angiotensins,C0019664 History,C0025250 Neprilysin,C0030705 Patients,C0034787 Angiotensin Receptor,C0597357 receptor,C1548562 Not Administered,C1873000 angiotensin A,C1999216 Inhibitor,C3266719 History of angioedema,C0002994 "Angioedema",C0003018 "Angiotensins",C0034787 "Angiotensin Receptor",C0262926 "Medical History",C0597357 "receptor"
32555 Ivabradine can be beneficial to reduce Heart Failure hospitalization for patients with symptomatic (NYHA class II-III) stable chronic Heart FailurerEF (LVEF ?35%) who are receiving GDEM, including a beta blocker at maximum tolerated dose, and who are in sinus rhythm with a heart rate of ?70 bpm at rest. C0018787 Heart,C0018810 heart rate,C0019993 Hospitalization,C0030705 Patients,C0035253 Rest,C0205191 chronic,C0231220 Symptomatic,C0232201 Sinus rhythm,C0257190 ivabradine,C0456387 Class,C0806909 Maximum,C0871269 Rhythm,C1319902 Patient on maximum tolerated dose,C1521828 Rate,C3842584 70%,C4319605 35,C0016169 "pathologic fistula",C0018787 "Heart",C0028778 "Obstruction",C0232201 "Sinus rhythm",C0257190 "ivabradine",C0423772 "Cutaneous Fistula",C1281570 "Entire heart"
32556 Diuretics are recommended in patients with Heart FailurerEF who have evidence of fluid retention, unless contraindicated, to improve symptoms. C0012798 Diuretics,C0030705 Patients,C0184511 Improved,C0268000 Body fluid retention,C1444657 Contraindicated,C1457887 Symptoms,C1820977 Recommended diet,C3532160 Fetal fluid retention,C3846195 Not Recommended,C3846199 Chem recommended,C3887511 Evidence,C0012798 "Diuretics",C0268000 "Body fluid retention",C1457887 "Symptoms"
32557 ACE inhibitors are recommended in patients with Heart FailurerEF and current or prior symptoms, unless contraindicated, to reduce morbidity and mortality. C0009488 Comorbidity,C0030705 Patients,C0243077 inhibitors,C1444657 Contraindicated,C1457887 Symptoms,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C1457887 "Symptoms"
32558 ARBs are recommended in patients with Heart FailurerEF with current or prior symptoms who are ACE inhibitor–intolerant, unless contraindicated, to reduce morbidity and mortality. C0009488 Comorbidity,C0030705 Patients,C0231200 intolerant,C1444657 Contraindicated,C1457887 Symptoms,C1820977 Recommended diet,C1999216 Inhibitor,C3846195 Not Recommended,C3846199 Chem recommended,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C1457887 "Symptoms"
32559 ARBs are reasonable to reduce morbidity and mortality as alternatives to ACE inhibitors as first-line therapy for patients with Heart FailurerEF, especially for patients already taking ARBs for other indications, unless contraindicated. C0009488 Comorbidity,C0030705 Patients,C0205394 Other,C0243077 inhibitors,C1444657 Contraindicated,C2093656 PTCA indications:,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0087111 "Therapeutic procedure",C0449210 "OTH tumor staging notation"
32560 Addition of an ARB may be considered in persistently symptomatic patients with Heart FailurerEF who are already being treated with an ACE inhibitor and a beta blocker in whom an aldosterone antagonist is not indicated or tolerated. C0002006 Aldosterone,C0002007 Aldosterone Antagonists,C0030705 Patients,C0231220 Symptomatic,C0750508 persistently,C0750591 consider,C1444655 Not indicated,C1444656 Indicated,C1999216 Inhibitor,C0002006 "Aldosterone",C0002007 "Aldosterone Antagonists",C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0028778 "Obstruction"
32562 Use of 1 of the 3 beta blockers proven to reduce mortality (ie, bisoprolol, carvedilol, and sustained-release metoprolol succinate) is recommended for all patients with current or prior symptoms of Heart FailurerEF, unless contraindicated, to reduce morbidity and mortality. C0009488 Comorbidity,C0025859 Metoprolol,C0030705 Patients,C0038617 Succinates,C0053799 Bisoprolol,C0054836 carvedilol,C0220918 succinate,C0443318 Sustained,C0444868 All,C0724633 metoprolol succinate,C1444657 Contraindicated,C1457887 Symptoms,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0025859 "Metoprolol",C0053799 "Bisoprolol",C0054836 "carvedilol",C0220918 "succinate",C0724633 "metoprolol succinate",C1457887 "Symptoms",C1963578 "Release (procedure)",C2732140 "Sustain"
32563 Aldosterone receptor antagonists (or mineralocorticoid receptor antagonists) are recommended in patients with NYHA class II–IV and who have LVEF of ?35%, unless contraindicated, to reduce morbidity and mortality. Patients with NYHA class II should have a history of prior cardiovascular hospitalization or elevated plasma natriuretic peptide levels to be considered for aldosterone receptor antagonists. Creatinine levels should be ?2.5 mg/dL in men or ?2.0 mg/dL in women (or estimated glomerular filtration rate >30 mL/min/1.73 m2) 2) and potassium levels should be <5.0 mEq/L. Careful monitoring of potassium levels, renal function, and diuretic dosing should be performed at initiation and closely followed thereafter to minimize risk of hyperkalemia and renal insufficiency. C0002006 Aldosterone,C0006558 C-Peptide,C0007226 Cardiovascular system,C0009488 Comorbidity,C0010294 Creatinine,C0012798 Diuretics,C0016107 filtration,C0017654 Glomerular Filtration Rate,C0019664 History,C0019993 Hospitalization,C0020461 Hyperkalemia,C0026160 Mineralocorticoids,C0030705 Patients,C0030956 Peptides,C0032105 Plasma,C0032821 Potassium,C0035647 Risk,C0081880 Natriuretic Peptide, C-Type,C0231179 Insufficiency,C0232804 Renal function,C0232809 Glomerular filtration,C0243076 antagonists,C0332283 Followed by,C0388060 peptide A,C0439152 mEq,C0439269 mg/dL,C0439445 mL/min,C0439526 /mL,C0456387 Class,C0522271 Aldosterone receptor site,C0597357 receptor,C0597421 natriuretic,C0750572 Estimated,C0750591 consider,C0884358 Performed,C1301862 Min 1,C1444657 Contraindicated,C1521828 Rate,C1704686 Initiation,C1820977 Recommended diet,C3163633 Elevated,C3842588 30%,C3846195 Not Recommended,C3846199 Chem recommended,C3887460 Cardiovascular,C4319605 35,C4321396 MG,C0002006 "Aldosterone",C0002007 "Aldosterone Antagonists",C0010294 "Creatinine",C0012798 "Diuretics",C0017654 "Glomerular Filtration Rate",C0020461 "Hyperkalemia",C0030956 "Peptides",C0032105 "Plasma",C0032821 "Potassium",C0035078 "Kidney Failure",C0181904 "Monitor Device",C0262926 "Medical History",C0597357 "receptor",C2946261 "Level"
32566 The combination of hydralazine and isosorbide dinitrate is recommended to reduce morbidity and mortality for patients selfdescribed as African Americans with NYHA class III–IV Heart FailurerEF receiving optimal therapy with ACE inhibitors and beta blockers, unless contraindicated. C0009488 Comorbidity,C0020223 Hydralazine,C0022251 Isosorbide,C0022252 Isosorbide Dinitrate,C0030705 Patients,C0052142 AP combination,C0054603 CAP combination,C0243077 inhibitors,C0456387 Class,C1444657 Contraindicated,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0020223 "Hydralazine",C0022251 "Isosorbide",C0022252 "Isosorbide Dinitrate",C0087111 "Therapeutic procedure"
32567 A combination of hydralazine and isosorbide dinitrate can be useful to reduce morbidity or mortality in patients with current or prior symptomatic Heart FailurerEF who cannot be given an ACE inhibitor or ARB because of drug intolerance, hypotension, or renal insufficiency, unless contraindicated. C0009269 Cold intolerance,C0009488 Comorbidity,C0020223 Hydralazine,C0020649 Hypotension,C0022251 Isosorbide,C0022252 Isosorbide Dinitrate,C0030705 Patients,C0052142 AP combination,C0054603 CAP combination,C0231179 Insufficiency,C0231220 Symptomatic,C0277585 Intolerance to drug,C1442162 GIVEN,C1444657 Contraindicated,C1999216 Inhibitor,C3827682 Useful,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0013227 "Pharmaceutical Preparations",C0020223 "Hydralazine",C0020649 "Hypotension",C0022251 "Isosorbide",C0022252 "Isosorbide Dinitrate",C0035078 "Kidney Failure",C0277585 "Drug intolerance"
32570 The selection of an anticoagulant agent (warfarin, dabigatran, apixaban, or rivaroxaban) for permanent/persistent/paroxysmal AF should be individualized on the basis of risk factors, cost, tolerability, patient preference, potential for drug interactions, and other clinical characteristics, including time in the international normalized ratio therapeutic range if the patient has been taking warfarin. C0003280 Anticoagulants,C0030705 Patients,C0035647 Risk,C0040223 Time,C0043031 Warfarin,C0205210 Clinical,C0205311 Paroxysmal,C0205322 Persistent,C0205355 Permanent,C0205394 Other,C0242784 Food Interactions,C0302350 Therapeutic,C0332310 Has patient,C0450442 Agent,C0455939 A/N risk factors,C0456603 Ratio,C0460096 Above therapeutic range,C0460097 Within therapeutic range,C0460099 Below therapeutic range,C0525032 International Normalized Ratio,C0558295 preference,C0687133 Drug Interactions,C1512888 International,C1514721 Range,C1521970 Characteristics,C1739768 rivaroxaban,C1831808 apixaban,C1874451 Basis,C1881197 Individualized,C1882115 Normalize,C2348066 dabigatran,C2986790 Normalized Time,C3245505 Potential,C3274448 Tolerability Study,C3536711 Anti-coagulant [EPC],C0003280 "Anticoagulants",C0013227 "Pharmaceutical Preparations",C0043031 "Warfarin",C0449210 "OTH tumor staging notation",C0450442 "Agent",C0525032 "International Normalized Ratio",C1739768 "rivaroxaban",C1831808 "apixaban",C1874451 "Basis"
32571 Chronic anticoagulation is reasonable for patients with chronic Heart Failure who have permanent/persistent/paroxysmal AF but are without an additional risk factor for cardioembolic stroke (in the absence of contraindications to anticoagulation). C0030705 Patients,C0035647 Risk,C0035648 risk factors,C0079164 contraindications aspect,C0205191 chronic,C0205311 Paroxysmal,C0205322 Persistent,C0205355 Permanent,C0332288 Without,C0449867 Use of anticoagulation,C0852649 Contraindications, Surgery,C1317264 Contraindications section,C1521761 Factor,C1524062 Additional,C1531624 Cardioembolic stroke,C3173979 Contraindications for test,C4505286 Contraindications, Drug,C0038454 "Cerebrovascular accident",C1531624 "Cardioembolic stroke"
32572 Anticoagulation is NOT recommended in patients with chronic Heart FailurerEF without AF, a prior thromboembolic event, or a cardioembolic source. (III-B: No Benefit) C0030705 Patients,C0205191 chronic,C0332288 Without,C0333214 thromboembolic,C0441471 Event,C0449416 Source,C0449867 Use of anticoagulation,C0814225 Benefit,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0449416 "Source"
32573 Statins are NOT beneficial as adjunctive therapy when prescribed solely for the diagnosis of Heart Failure in the absence of other indications for their use. C0011900 Diagnosis,C0205394 Other,C0278329 Prescribed,C1292783 Adjunctive care,C2093656 PTCA indications:,C0011900 "Diagnosis",C0087111 "Therapeutic procedure",C0360714 "Hydroxymethylglutaryl-CoA Reductase Inhibitors",C0449210 "OTH tumor staging notation",C1689985 "Absence (morphologic abnormality)"
32574 Omega-3 polyunsaturated fatty acid (PUFA) supplementation is reasonable to use as adjunctive therapy in patients with NYHA class II–IV symptoms and Heart FailurerEF or Heart FailurepEF, unless contraindicated, to reduce mortality and cardiovascular hospitalizations. C0001128 Acids,C0007226 Cardiovascular system,C0015684 Fatty Acids,C0019993 Hospitalization,C0030705 Patients,C0032615 Polyunsaturated Fatty Acids,C0242296 Food Supplementation,C0452290 High polyunsaturated fatty acid diet,C0452291 High n-3 polyunsaturated fatty acid diet,C0452293 High n-6 polyunsaturated fatty acid diet,C0456387 Class,C0556056 Polyunsaturated fatty acid requirement,C0556077 Energy supplementation,C0556088 Fat supplementation,C0556095 Polyunsaturated fatty acid supplementation,C0556123 Polyunsaturated fatty acid intake,C1292783 Adjunctive care,C1444657 Contraindicated,C1457887 Symptoms,C1719844 Omega,C2362518 Polyunsaturated fat,C3887460 Cardiovascular,C0001128 "Acids",C0015684 "Fatty Acids",C0015689 "Omega-3 Fatty Acids",C0032615 "Polyunsaturated Fatty Acids",C0087111 "Therapeutic procedure",C1457887 "Symptoms"
32575 Nutritional supplements as treatment for Heart Failure are NOT recommended in patients with current or prior symptoms of Heart FailurerEF. C0030705 Patients,C0746919 NO TREATMENT,C1457887 Symptoms,C1521739 Nutritional,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C1457887 "Symptoms"
32576 Hormonal therapies other than to correct deficiencies are NOT recommended for patients with current or prior symptoms of Heart FailurerEF. C0030705 Patients,C0205394 Other,C0458083 Hormonal,C1457887 Symptoms,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C1457887 "Symptoms"
32578 Long-term use of infused positive inotropic drugs is potentially harmful for patients with Heart FailurerEF, except as palliation for patients with end-stage disease who cannot be stabilized with standard medical treatment (see recommendations for stage D starting on page 34). C0012634 Disease,C0030705 Patients,C0034866 Recommendation,C0205088 End-stage,C0205166 Long,C0205476 Medical,C0444930 End,C0746919 NO TREATMENT,C0849833 Fear of medical treatment,C1306673 Stage,C1446409 Positive,C1947903 See,C0012634 "Disease",C0013227 "Pharmaceutical Preparations",C0354668 "Positive inotropic drug"
32579 Calcium channel–blocking drugs are NOT recommended as routine treatment for patients with Heart FailurerEF. C0006675 Calcium,C0030705 Patients,C0205547 Routine,C0332206 Blocking,C0439799 Channel,C0746919 NO TREATMENT,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0006675 "Calcium",C0013227 "Pharmaceutical Preparations"
32580 Systolic and diastolic blood pressure should be controlled in patients with Heart FailurepEF in accordance with published clinical practice guidelines to prevent morbidity. C0001876 Air Pressure,C0005767 Blood,C0005823 Blood Pressure,C0009488 Comorbidity,C0030705 Patients,C0162791 Guidelines,C0205210 Clinical,C0205318 Uncontrolled,C0332298 Controlled by,C0428883 Diastolic blood pressure,C0442709 end diastolic,C0445199 Pressure controlled method,C0489485 end systolic,C0564627 Pressure controlled SIMV,C1882095 No Pressure,C0005767 "Blood",C0460139 "Pressure (finding)",C1272641 "Systemic arterial pressure"
32581 Diuretics should be used for relief of symptoms due to volume overload in patients with Heart FailurepEF. C0012798 Diuretics,C0030705 Patients,C0449468 Volume,C1457887 Symptoms,C3146286 Due,C0012798 "Diuretics",C0564405 "Feeling relief",C1457887 "Symptoms"
32582 Coronary revascularization is reasonable in patient with CAD in whom symptoms (angina) or demonstrable myocardial ischemia is judged to be having an adverse effect on symptomatic Heart FailurepEF despite GDMT. C0022116 Ischemia,C0030705 Patients,C0151744 Myocardial Ischemia,C0231220 Symptomatic,C0332265 Demonstrable,C0472662 Limb revascularization,C0472666 Revascularization of hand,C0472667 Revascularization of thumb,C0472672 Revascularization of foot,C0581603 Revascularization - action,C1280500 Effect,C1457887 Symptoms,C1522318 Coronary,C1522564 Myocardial,C0002962 "Angina Pectoris",C0022116 "Ischemia",C0151744 "Myocardial Ischemia",C0581603 "Revascularization - action",C1457887 "Symptoms"
32584 The use of beta-blocking agents, ACE inhibitors, and ARBs in patients with hypertension is reasonable to control blood pressure in patients with Heart FailurepEF. C0001876 Air Pressure,C0005767 Blood,C0005823 Blood Pressure,C0030705 Patients,C0243077 inhibitors,C0332206 Blocking,C1882095 No Pressure,C1963138 Hypertension, CTCAE,C2748577 No hypertension,C0003015 "Angiotensin-Converting Enzyme Inhibitors",C0005767 "Blood",C0020538 "Hypertensive disease",C0450442 "Agent",C0460139 "Pressure (finding)",C1272641 "Systemic arterial pressure"
32585 In appropriately selected patients with Heart FailurepEF (with EF ?45%, elevated BNP levels or Heart Failure admission within 1 year, estimated glomerular filtration rate >30 mL/min, creatinine <2.5 mg/dL, potassium <5.0 mEq/L), aldosterone receptor antagonists might be considered to decrease hospitalizations. C0002006 Aldosterone,C0010294 Creatinine,C0016107 filtration,C0017654 Glomerular Filtration Rate,C0019993 Hospitalization,C0030705 Patients,C0032821 Potassium,C0232809 Glomerular filtration,C0243076 antagonists,C0332285 Within,C0439152 mEq,C0439234 year,C0439269 mg/dL,C0439445 mL/min,C0439526 /mL,C0457453 On admission,C0522271 Aldosterone receptor site,C0547047 Decrease,C0559269 Pre-admission,C0597357 receptor,C0750572 Estimated,C0750591 consider,C1521828 Rate,C3163633 Elevated,C3842588 30%,C4321396 MG,C4533677 at admission,C0002006 "Aldosterone",C0002007 "Aldosterone Antagonists",C0010294 "Creatinine",C0017654 "Glomerular Filtration Rate",C0032821 "Potassium",C0597357 "receptor",C2946261 "Level"
32587 Routine use of nitrates or phosphodiesterase-5 inhibitors to increase activity or QoL in patients with Heart FailurepEF is ineffective. C0028125 Nitrates,C0030705 Patients,C0045231 2'-phosphodiesterase,C0070828 Phosphodiesterase I,C0205547 Routine,C0243077 inhibitors,C0442805 Increase,C3242229 ineffective,C3845261 No activity,C0028125 "Nitrates"
32589 ICD therapy is recommended for primary prevention of sudden cardiac death (SCD) to reduce total mortality in selected patients with nonischemic DCM or ischemic heart disease ?40 days post-MI with LVEF of ?35% and NYHA class II or III symptoms on chronic GDMT, who have a reasonable expectation of meaningful survival for >1 year.a .a (I-A) C0012634 Disease,C0018787 Heart,C0018799 Heart Diseases,C0030705 Patients,C0033144 Primary Prevention,C0085298 Sudden Cardiac Death,C0150223 Fall prevention,C0205191 chronic,C0205225 Primary,C0439234 year,C0439509 /40,C0439810 Total,C0456387 Class,C0475224 Ischemic,C0475676 No FH: Ischemic heart disease,C0679138 Expectations,C0687676 Post,C0740220 Ischemic heart disease screen,C0848343 Subacute ischemic heart disease,C0946217 Meaningful life,C1457887 Symptoms,C1510446 Acute ischemic heart disease,C1820977 Recommended diet,C3494324 Meaningful Use,C3842587 40%,C3846195 Not Recommended,C3846199 Chem recommended,C4319605 35,C0011071 "Sudden death",C0012634 "Disease",C0018787 "Heart",C0018799 "Heart Diseases",C0033144 "Primary Prevention",C0085298 "Sudden Cardiac Death",C0087111 "Therapeutic procedure",C0151744 "Myocardial Ischemia",C0199176 "Prophylactic treatment",C0439631 "Primary operation",C1281570 "Entire heart",C1306577 "Death (finding)",C1457887 "Symptoms"
32590 Cardiac resynchronization therapy is indicated for patients who have LVEF of 35% or less, sinus rhythm, left bundle-branch block (LBBB) with a QRS duration of 150 ms or greater, and NYHA class II, III, or ambulatory class IV symptoms on GDMT. C0006384 Bundle-Branch Block,C0023211 Left Bundle-Branch Block,C0030705 Patients,C0085615 Right bundle branch block,C0205091 Left,C0225917 Entire left bundle branch,C0232201 Sinus rhythm,C0456387 Class,C0871269 Rhythm,C1253959 Branch of,C1444656 Indicated,C1457887 Symptoms,C1704243 Greater,C2926735 Duration,C4319605 35,C0006384 "Bundle-Branch Block",C0016169 "pathologic fistula",C0023211 "Left Bundle-Branch Block",C0028778 "Obstruction",C0087111 "Therapeutic procedure",C0225917 "Entire left bundle branch",C0232201 "Sinus rhythm",C0423772 "Cutaneous Fistula",C1457887 "Symptoms",C2926735 "Duration"
32591 ICD therapy is recommended for primary prevention of SCD to reduce total mortality in selected patients at least 40 days post-MI with LVEF of 30% or less and NYHA class I symptoms while receiving GDMT, who have a reasonable expectation of meaningful survival for more than 1 year. C0030705 Patients,C0033144 Primary Prevention,C0150223 Fall prevention,C0205172 More,C0205225 Primary,C0439234 year,C0439509 /40,C0439810 Total,C0456387 Class,C0679138 Expectations,C0687676 Post,C0750519 while,C0946217 Meaningful life,C1457887 Symptoms,C1820977 Recommended diet,C3494324 Meaningful Use,C3842587 40%,C3842588 30%,C3846195 Not Recommended,C3846199 Chem recommended,C0033144 "Primary Prevention",C0087111 "Therapeutic procedure",C0199176 "Prophylactic treatment",C0439631 "Primary operation",C1457887 "Symptoms"
32592 CRT can be useful for patients who have LVEF of ?35% , sinus rhythm, a non-LBBB pattern with a QRS duration of ?150 ms, and NYHA class III/ambulatory class IV symptoms on GDMT. C0030705 Patients,C0232201 Sinus rhythm,C0449774 Patterns,C0456387 Class,C0871269 Rhythm,C1457887 Symptoms,C2926735 Duration,C3827682 Useful,C4319605 35,C0016169 "pathologic fistula",C0232201 "Sinus rhythm",C0423772 "Cutaneous Fistula",C1457887 "Symptoms",C2926735 "Duration"
32593 CRT can be useful for patients who have LVEF of ?35%, sinus rhythm, LBBB with a QRS duration of 120–149 ms, and NYHA class II, III, or ambulatory class IV symptoms on GDMT. C0030705 Patients,C0232201 Sinus rhythm,C0456387 Class,C0871269 Rhythm,C1457887 Symptoms,C2926735 Duration,C3827682 Useful,C4319550 120,C4319605 35,C0016169 "pathologic fistula",C0232201 "Sinus rhythm",C0423772 "Cutaneous Fistula",C1457887 "Symptoms",C2926735 "Duration"
32594 CRT can be useful in patients with AF and LVEF of ?35% on GDMT if a) the patient requires ventricular pacing or otherwise meets CRT criteria and b) atrioventricular nodal ablation or pharmacological rate control will allow near 100% ventricular pacing with CRT. C0004245 Atrioventricular Block,C0030705 Patients,C0205464 pharmacological,C0225924 Atrioventricular valve,C0243161 criteria,C0428912 Atrioventricular nodal function,C0429115 Ventricular pacing pattern,C0547070 Ablation,C1521828 Rate,C1522565 Ventricular,C1706276 Near,C3272404 No Pacing,C3817553 100%,C3827682 Useful,C4319605 35,C0308718 "CONTROL veterinary product",C0547070 "Ablation"
32595 CRT can be useful for patients on GDMT who have LVEF of ?35% and are undergoing placement of a new or replacement device with anticipated requirement for significant (>40%) ventricular pacing. C0030705 Patients,C0205314 New,C0429115 Ventricular pacing pattern,C0439509 /40,C0559956 Replacement,C0699733 Devices,C0750502 Significant,C1446530 Replacement of device,C1514873 Requirement,C1522565 Ventricular,C1524072 Placement,C3272404 No Pacing,C3827682 Useful,C3840775 Anticipated,C3842587 40%,C4319605 35,C0021107 "Implantation procedure",C0035139 "Surgical Replantation",C0441587 "Clinical act of insertion",C1533810 "Placement action"
32596 The usefulness of implantation of an ICD is of uncertain benefit to prolong meaningful survival in patients with a high risk of nonsudden death as predicted by frequent hospitalizations, advanced frailty, or comorbidities such as systemic malignancy or severe renal dysfunction. C0005698 Blade Implantation,C0009488 Comorbidity,C0019993 Hospitalization,C0030705 Patients,C0035647 Risk,C0087130 Uncertainty,C0205250 High,C0205373 Systemic,C0332167 High risk of,C0332183 Frequently,C0424594 Frailty,C0426068 Uncertain lie,C0456040 Newborn renal dysfunction,C0814225 Benefit,C0946217 Meaningful life,C3494324 Meaningful Use,C3842363 No malignancy,C3887504 Dysfunction,C4319571 High risk,C0021107 "Implantation procedure",C0424594 "Frailty",C1306459 "Primary malignant neoplasm",C1306577 "Death (finding)"
32597 CRT may be considered for patients who have LVEF of ?35%, sinus rhythm, a non-LBBB pattern with a QRS duration of 120–149 ms, and NYHA class III/ambulatory class IV on GDMT. C0030705 Patients,C0232201 Sinus rhythm,C0449774 Patterns,C0456387 Class,C0750591 consider,C0871269 Rhythm,C2926735 Duration,C4319550 120,C4319605 35,C0016169 "pathologic fistula",C0232201 "Sinus rhythm",C0423772 "Cutaneous Fistula",C2926735 "Duration"
32598 CRT may be considered for patients who have LVEF of ?35%, sinus rhythm, a non-LBBB pattern with a QRS duration of ?150 ms, and NYHA class II symptoms on GDMT. C0030705 Patients,C0232201 Sinus rhythm,C0449774 Patterns,C0456387 Class,C0750591 consider,C0871269 Rhythm,C1457887 Symptoms,C2926735 Duration,C4319605 35,C0016169 "pathologic fistula",C0232201 "Sinus rhythm",C0423772 "Cutaneous Fistula",C1457887 "Symptoms",C2926735 "Duration"
32599 CRT may be considered for patients who have LVEF of ?30%, ischemic etiology of Heart Failure, sinus rhythm, LBBB with a QRS duration of ?150 ms, and NYHA class I symptoms on GDMT. C0030705 Patients,C0232201 Sinus rhythm,C0456387 Class,C0475224 Ischemic,C0750591 consider,C0871269 Rhythm,C1314792 Etiology,C1457887 Symptoms,C2926735 Duration,C3842588 30%,C0016169 "pathologic fistula",C0232201 "Sinus rhythm",C0423772 "Cutaneous Fistula",C1457887 "Symptoms",C2926735 "Duration"
32600 CRT is NOT recommended for patients with NYHA class I or II symptoms and non-LBBB pattern with a QRS duration of <150 ms. C0030705 Patients,C0449774 Patterns,C0456387 Class,C1457887 Symptoms,C1820977 Recommended diet,C2926735 Duration,C3846195 Not Recommended,C3846199 Chem recommended,C1457887 "Symptoms",C2926735 "Duration"
32601 CRT is NOT indicated for patients whose comorbidities and/or frailty limit survival with good functional capacity to <1 year. C0009488 Comorbidity,C0030705 Patients,C0205170 Good,C0205245 Functional,C0424594 Frailty,C0439234 year,C1444655 Not indicated,C1444656 Indicated,C1516240 Capacity,C1998319 Functional capacity,C0424594 "Frailty",C1998319 "Functional capacity"
32602 Fluid restriction (1.5–2 L/d) is reasonable in stage D, especially in patients with hyponatremia, to reduce congestive symptoms. C0020625 Hyponatremia,C0030705 Patients,C0150136 Area restriction,C0204700 Fluid restriction,C0742742 Congestive,C1306673 Stage,C1457887 Symptoms,C0020625 "Hyponatremia",C0204700 "Fluid restriction",C1457887 "Symptoms"
32603 Until definitive therapy (eg, coronary revascularization, MCS, heart transplantation) or resolution of the acute precipitating problem, patients with cardiogenic shock should receive temporary intravenous inotropic support to maintain systemic perfusion and preserve endorgan performance. C0018787 Heart,C0018823 Heart Transplantation,C0030705 Patients,C0033213 Problem,C0036974 Shock,C0036980 Shock, Cardiogenic,C0040732 Transplantation,C0205178 acute,C0205373 Systemic,C0348016 Intravenous,C0443196 Definitive,C0472662 Limb revascularization,C0472666 Revascularization of hand,C0472667 Revascularization of thumb,C0472672 Revascularization of foot,C0581603 Revascularization - action,C0597198 Performance,C1514756 Receive,C1522318 Coronary,C1720302 Until,C2699488 Resolution,C4242108 Cardiogenic area,C0018787 "Heart",C0018823 "Heart Transplantation",C0031001 "Perfusion (procedure)",C0033213 "Problem",C0036974 "Shock",C0036980 "Shock, Cardiogenic",C0040732 "Transplantation",C0087111 "Therapeutic procedure",C0183683 "Support, device",C0344211 "Supportive care",C0581603 "Revascularization - action",C1281570 "Entire heart"
32604 Continuous intravenous inotropic support is reasonable as “bridge therapy” in patients with stage D Heart Failure refractory to GDMT and device therapy who are eligible for and awaiting MCS or cardiac transplantation. C0030705 Patients,C0040732 Transplantation,C0348016 Intravenous,C0549178 Continuous,C0699733 Devices,C1306673 Stage,C1548635 Eligible,C0040732 "Transplantation",C0087111 "Therapeutic procedure",C0183683 "Support, device",C0344211 "Supportive care",C0456378 "Type of bridge device"
32605 Short-term, continuous intravenous inotropic support may be reasonable in those hospitalized patients presenting with documented severe systolic dysfunction who present with low blood pressure and significantly depressed cardiac output to maintain systemic perfusion and preserve end-organ performance. C0001876 Air Pressure,C0005767 Blood,C0005823 Blood Pressure,C0007165 Cardiac Output,C0008098 Child, Hospitalized,C0030705 Patients,C0150312 Present,C0178784 Organ,C0205251 low,C0205373 Systemic,C0348016 Intravenous,C0436599 O/E - depressed,C0444930 End,C0476454 Low blood pressure reading,C0489485 end systolic,C0549178 Continuous,C0597198 Performance,C0749225 Systolic dysfunction,C1301725 Documented,C1806781 Short,C1882095 No Pressure,C3887504 Dysfunction,C4055637 Significantly high,C4055638 Significantly low,C0005767 "Blood",C0020649 "Hypotension",C0031001 "Perfusion (procedure)",C0183683 "Support, device",C0344211 "Supportive care",C0344315 "Depressed mood",C0460139 "Pressure (finding)",C0749225 "Systolic dysfunction",C1272641 "Systemic arterial pressure"
32606 Long-term, continuous intravenous inotropic support may be considered as palliative therapy for symptom control in select patients with stage D Heart Failure despite optimal GDMT and device therapy who are not eligible for either MCS or cardiac transplantation. C0030705 Patients,C0040732 Transplantation,C0205166 Long,C0348016 Intravenous,C0549178 Continuous,C0699733 Devices,C0750591 consider,C1274136 Symptom control (regime/therapy),C1285530 Palliative,C1306673 Stage,C1457887 Symptoms,C1548635 Eligible,C1651012 Select-OB,C3844638 Either,C0040732 "Transplantation",C0087111 "Therapeutic procedure",C0183683 "Support, device",C0308718 "CONTROL veterinary product",C0344211 "Supportive care",C1274136 "Symptom control (regime/therapy)",C1457887 "Symptoms"
32607 Long-term use of either continuous or intermittent, intravenous parenteral positive inotropic agents, in the absence of specific indications or for reasons other than palliative care, is potentially harmful in the patient with Heart Failure. C0030231 Palliative Care,C0030705 Patients,C0205166 Long,C0205267 Intermittent,C0205394 Other,C0348016 Intravenous,C0549178 Continuous,C1285530 Palliative,C1446409 Positive,C2093656 PTCA indications:,C3844638 Either,C0030231 "Palliative Care",C0304509 "Inotropic agent",C0450442 "Agent",C1689985 "Absence (morphologic abnormality)"
32608 Use of parenteral inotropic agents in hospitalized patients without documented severe systolic dysfunction, low blood pressure, or impaired perfusion, and evidence of significantly depressed cardiac output, with or without congestion, is potentially harmful. C0001876 Air Pressure,C0005767 Blood,C0005823 Blood Pressure,C0007165 Cardiac Output,C0008098 Child, Hospitalized,C0030705 Patients,C0205251 low,C0221099 Impaired,C0332288 Without,C0436599 O/E - depressed,C0476454 Low blood pressure reading,C0489485 end systolic,C0700148 Congestion,C0749225 Systolic dysfunction,C1301725 Documented,C1882095 No Pressure,C3887504 Dysfunction,C3887511 Evidence,C4055637 Significantly high,C4055638 Significantly low,C0005767 "Blood",C0020649 "Hypotension",C0031001 "Perfusion (procedure)",C0304509 "Inotropic agent",C0344315 "Depressed mood",C0450442 "Agent",C0460139 "Pressure (finding)",C0700148 "Congestion",C0749225 "Systolic dysfunction",C1272641 "Systemic arterial pressure"
32609 MCS is beneficial in carefully selected patients with stage D Heart FailurerEF in whom definitive management (eg, cardiac transplantation) or cardiac recovery is anticipated or planned. C0002766 Pain management,C0030705 Patients,C0040732 Transplantation,C0443196 Definitive,C1301732 Planned,C1306673 Stage,C3840775 Anticipated,C0040732 "Transplantation"
32610 Nondurable MCS, including the use of percutaneous and extracorporeal ventricular assist devices, is reasonable as a “bridge to recovery” or a “bridge to decision” for carefully selecteda Heart FailurerEF a H patients with acute, profound hemodynamic compromise. C0019010 Hemodynamics,C0030705 Patients,C0205178 acute,C0439808 Profound,C0442087 Extracorporeal,C0522523 Percutaneous,C0679006 Decision,C0699733 Devices,C0919772 Hemodynamic test,C1522565 Ventricular,C2945640 compromise,C0456378 "Type of bridge device"
32612 Evaluation for cardiac transplantation is indicated for carefully selected patients with stage D Heart Failure despite GDMT, device, and surgical management. C0002766 Pain management,C0030705 Patients,C0040732 Transplantation,C0220825 Evaluation,C0699733 Devices,C1306673 Stage,C1444656 Indicated,C0040732 "Transplantation",C0543467 "Operative Surgical Procedures",C1261322 "Evaluation procedure"
32613 ACS precipitating acute Heart Failure decompensation should be promptly identified by ECG and serum biomarkers, including cardiac troponin testing, and treated optimally as appropriate to the overall condition and prognosis of the patient. C0030705 Patients,C0039593 Testing,C0041199 Troponin,C0205178 acute,C0205396 Identified,C0229671 Serum,C0231187 Decompensation,C0278252 Prognosis bad,C0348080 Condition,C1305957 Cardiac troponin I,C1548787 Appropriate,C1561607 Overall,C0033325 "Forecast of outcome",C0041199 "Troponin",C0229671 "Serum",C0231187 "Decompensation",C1623258 "Electrocardiography"
32614 Common precipitating factors for acute Heart Failure should be considered during initial evaluation, as recognition of these conditions is critical to guide appropriate therapy. C0205178 acute,C0205265 Initially,C0220825 Evaluation,C0347984 During,C0678836 cell recognition,C0750591 consider,C1511545 Critical,C1548787 Appropriate,C0087111 "Therapeutic procedure",C1261322 "Evaluation procedure"
32615 In patients with Heart FailurerEF experiencing a symptomatic exacerbation of Heart Failure requiring hospitalization during chronic maintenance treatment with GDMT, it is recommended that GDMT be continued in the absence of hemodynamic instability or contraindications. C0019010 Hemodynamics,C0019993 Hospitalization,C0024501 Maintenance,C0030705 Patients,C0079164 contraindications aspect,C0205191 chronic,C0231220 Symptomatic,C0347984 During,C0746919 NO TREATMENT,C0852649 Contraindications, Surgery,C0919772 Hemodynamic test,C0948268 Hemodynamic instability,C1317264 Contraindications section,C1444783 Instability,C1820977 Recommended diet,C3173979 Contraindications for test,C3846195 Not Recommended,C3846199 Chem recommended,C4086268 Exacerbation,C4505286 Contraindications, Drug,C0948268 "Hemodynamic instability",C1444783 "Instability"
32616 Initiation of beta-blocker therapy is recommended after optimization of volume status and successful discontinuation of intravenous diuretics, vasodilators, and inotropic agents. Beta-blocker therapy should be initiated at a low dose and only in stable patients. C0012798 Diuretics,C0030705 Patients,C0205251 low,C0348016 Intravenous,C0445550 Low dose,C0449438 Status,C0449468 Volume,C1272703 Successful,C1278478 Beta blocker therapy refused,C1704686 Initiation,C1820977 Recommended diet,C2698650 Optimization,C3846195 Not Recommended,C3846199 Chem recommended,C0012798 "Diuretics",C0028778 "Obstruction",C0042402 "Vasodilator Agents",C0087111 "Therapeutic procedure",C0304509 "Inotropic agent",C0450442 "Agent",C0457454 "Discontinuation (procedure)"
32618 Patients with Heart Failure admitted with evidence of significant fluid overload should be promptly treated with intravenous loop diuretics to reduce morbidity. C0009488 Comorbidity,C0012798 Diuretics,C0030705 Patients,C0348016 Intravenous,C0445022 Loop,C0546817 Fluid overload,C0750502 Significant,C3887511 Evidence,C4482331 Admitted to,C0012798 "Diuretics",C0354100 "Loop Diuretics",C0546817 "Fluid overload"
32619 If patients are already receiving loop diuretic therapy, the initial intravenous dose should equal or exceed their chronic oral daily dose C0012798 Diuretics,C0030705 Patients,C0205163 Equal,C0205191 chronic,C0205265 Initially,C0332173 Daily,C0348016 Intravenous,C0354100 Loop Diuretics,C0442027 Oral,C0445022 Loop,C0948575 Diuretic therapy,C0012798 "Diuretics",C0087111 "Therapeutic procedure",C0354100 "Loop Diuretics"
32620 The effect of Heart Failure treatment should be monitored with careful measurement of fluid intake and output, vital signs, body weight that is determined at the same time each day, and clinical signs and symptoms of systemic perfusion and congestion. Daily serum electrolytes, urea nitrogen, and creatinine concentrations should be measured during the use of intravenous diuretics or active titration of Heart Failure medications. C0005910 Body Weight,C0010294 Creatinine,C0012798 Diuretics,C0013832 Electrolytes,C0028158 Nitrogen,C0040223 Time,C0041942 Urea,C0043100 Weight,C0205177 Active,C0205210 Clinical,C0205373 Systemic,C0229671 Serum,C0242485 Measurement,C0332173 Daily,C0347984 During,C0348016 Intravenous,C0429791 Fluid intake,C0439228 day,C0444706 Measured,C0445247 Same,C0521095 Determined by,C0600137 Blood Urea Nitrogen,C0678756 drug concentration,C0700148 Congestion,C0746919 NO TREATMENT,C1280500 Effect,C1457887 Symptoms,C1512806 Intake,C3251814 Fluid Intake Measurement,C4284232 Medications,C0010294 "Creatinine",C0012798 "Diuretics",C0013227 "Pharmaceutical Preparations",C0013832 "Electrolytes",C0028158 "Nitrogen",C0031001 "Perfusion (procedure)",C0041942 "Urea",C0229671 "Serum",C0311392 "Physical findings",C0587355 "Electrolytes measurement, serum",C0700148 "Congestion",C1291218 "Carbonyldiamide",C1457887 "Symptoms"
32621 When diuresis is inadequate to relieve symptoms, it is reasonable to intensify the diuretic regimen using either: a. Higher doses of intravenous loop diuretics (IIa-B), or b. Addition of a second (eg, thiazide) diuretic (IIa-B). C0012797 Diuresis,C0012798 Diuretics,C0012802 Thiazide Diuretics,C0348016 Intravenous,C0445022 Loop,C0457385 seconds,C0541746 Thiazides,C1457887 Symptoms,C1879523 AT Regimen,C3844638 Either,C0012798 "Diuretics",C0354100 "Loop Diuretics",C1457887 "Symptoms"
32622 Low-dose dopamine infusion may be considered in addition to loop diuretic therapy to improve diuresis and better preserve renal functio and renal blood flow. C0005767 Blood,C0012797 Diuresis,C0012798 Diuretics,C0013030 Dopamine,C0184511 Improved,C0205251 low,C0232338 Blood flow,C0332272 Better,C0354100 Loop Diuretics,C0430118 Dopamine infusion test,C0445022 Loop,C0445550 Low dose,C0750591 consider,C0806140 Flow,C0948575 Diuretic therapy,C1527409 Renal blood flow,C0005767 "Blood",C0012798 "Diuretics",C0013030 "Dopamine",C0087111 "Therapeutic procedure",C0354100 "Loop Diuretics",C0574032 "Infusion procedures"
32623 Ultrafiltration may be considered for patients with obvious volume overload to alleviate congestive symptoms and fluid weight. C0030705 Patients,C0043100 Weight,C0403573 Loss of ultrafiltration,C0449468 Volume,C0742742 Congestive,C0750591 consider,C1457887 Symptoms,C1963879 Lack of ultrafiltration,C0041612 "Ultrafiltration (procedure)",C1274136 "Symptom control (regime/therapy)",C1457887 "Symptoms"
32624 Ultrafiltration may be considered for patients with refractory congestion not responding to medical therapy. C0030705 Patients,C0205476 Medical,C0403573 Loss of ultrafiltration,C0418981 Medical therapy,C0700148 Congestion,C0750591 consider,C1963879 Lack of ultrafiltration,C0041612 "Ultrafiltration (procedure)",C0087111 "Therapeutic procedure",C0418981 "Medical therapy",C0700148 "Congestion"
32625 If symptomatic hypotension is absent, intravenous nitroglycerin, nitroprusside, or nesiritide may be considered as an adjuvant to diuretic therapy for relief of dyspnea in patients admitted with acute decompensated Heart Failure. C0012798 Diuretics,C0013404 Dyspnea,C0017887 Nitroglycerin,C0020649 Hypotension,C0028193 Nitroprusside,C0030705 Patients,C0054015 Nesiritide,C0205178 acute,C0205434 Decompensated,C0231220 Symptomatic,C0332197 Absent,C0348016 Intravenous,C0750591 consider,C0948575 Diuretic therapy,C1522673 Adjuvant,C4482331 Admitted to,C0001551 "Immunologic Adjuvants",C0012798 "Diuretics",C0013404 "Dyspnea",C0017887 "Nitroglycerin",C0020649 "Hypotension",C0028193 "Nitroprusside",C0054015 "Nesiritide",C0087111 "Therapeutic procedure",C0564405 "Feeling relief"
32626 A patient admitted to the hospital with decompensated Heart Failure should receive venous thromboembolism prophylaxis with an anticoagulant medication if the risk–benefit ratio is favorable. C0003280 Anticoagulants,C0019994 Hospitals,C0030705 Patients,C0035647 Risk,C0040038 Thromboembolism,C0182428 Prophylaxis Cups,C0199242 Anticoagulant prophylaxis,C0205434 Decompensated,C0348013 Venous,C0456603 Ratio,C0814225 Benefit,C1514756 Receive,C3536711 Anti-coagulant [EPC],C3640814 Favorable,C4035588 Hospital-OR,C4284232 Medications,C4482331 Admitted to,C0003280 "Anticoagulants",C0013227 "Pharmaceutical Preparations",C0040038 "Thromboembolism",C0199176 "Prophylactic treatment"
32627 In patients hospitalized with volume overload, including Heart Failure, who have persistent severe hyponatremia and are at risk for or having active cognitive symptoms despite water restriction and maximization of GDMT, vasopressin antagonists may be considered in the short term to improve serum sodium concentration in hypervolemic, hyponatremic states with either a V2 receptor–selective or a nonselective vasopressin antagonist. C0008098 Child, Hospitalized,C0009633 Concentration Camps,C0020625 Hyponatremia,C0030705 Patients,C0035647 Risk,C0037473 Sodium,C0042413 Vasopressins,C0043047 Water,C0150136 Area restriction,C0184511 Improved,C0205177 Active,C0205322 Persistent,C0229671 Serum,C0243076 antagonists,C0449468 Volume,C0597357 receptor,C0750591 consider,C0857122 Hyponatraemic,C1457887 Symptoms,C1516691 Cognitive,C1705480 Vasopressin (USP),C1806781 Short,C3537128 Vasopressin Antagonist,C3844638 Either,C0020625 "Hyponatremia",C0037473 "Sodium",C0043047 "Water",C0229671 "Serum",C0457423 "V2 stage",C0523891 "Serum sodium measurement",C0597357 "receptor",C1457887 "Symptoms",C1705480 "Vasopressin (USP)"
32629 Throughout the hospitalization as appropriate, before hospital discharge, at the first postdischarge visit, and in subsequent follow-up visits, the following should be addressed (I-B): a. Initiation of GDMT if not previously established and not contraindicated b. Precipitant causes of Heart Failure, barriers to optimal care transitions, and limitations in postdischarge support c. Assessment of volume status and supine/upright hypotension with adjustment of Heart Failure therapy, as appropriate d. Titration and optimization of chronic oral Heart Failure therapy e. Assessment of renal function and electrolytes, where appropriate f. Assessment and management of comorbid conditions g. Reinforcement of Heart Failure education, self-care, emergency plans, and need for adherence h. Consideration for palliative care or hospice care in selected patients C0002766 Pain management,C0013832 Electrolytes,C0019993 Hospitalization,C0019994 Hospitals,C0020649 Hypotension,C0027552 Needs,C0030231 Palliative Care,C0030705 Patients,C0036588 Self,C0085555 Hospice Care,C0205191 chronic,C0232804 Renal function,C0332152 Before,C0332282 Following,C0442027 Oral,C0443211 Established,C0445111 No reinforcement,C0449295 Limitation,C0449438 Status,C0449468 Volume,C0518609 Consideration,C0522015 Upright,C0545082 Visit,C0547043 Up,C0586003 Discharge from hospital,C1160864 Coping support assessment,C1161117 Oxygen therapy assessment,C1275743 Co-morbid conditions,C1285530 Palliative,C1443495 Renal care assessment,C1444302 Speech therapy assessment,C1444399 Social therapy assessment,C1444657 Contraindicated,C1527398 Emergency Care,C1548175 On discharge,C1548787 Appropriate,C1704686 Initiation,C2114533 previously well,C2698650 Optimization,C3871203 At discharge,C4035588 Hospital-OR,C4281991 Follow,C0012621 "Body Fluid Discharge",C0013658 "Educational Status",C0013832 "Electrolytes",C0020649 "Hypotension",C0030231 "Palliative Care",C0039401 "Educational process of instructing",C0085555 "Hospice Care",C0087111 "Therapeutic procedure",C0183683 "Support, device",C0344211 "Supportive care",C0424927 "Details of education",C0587355 "Electrolytes measurement, serum",C0589120 "Follow-up status",C0600083 "Discharge, Body Substance, Sample",C0678211 "Reinforcement surgical repair",C1261322 "Evaluation procedure",C1275743 "Co-morbid conditions"
32630 Multidisciplinary Heart Failure disease-management programs are recommended for patients at high risk for hospital readmission, to facilitate the implementation of GDMT, to address different barriers to behavioral change, and to reduce the risk of subsequent rehospitalization for Heart Failure. C0002766 Pain management,C0004927 Behavior,C0012634 Disease,C0019994 Hospitals,C0030705 Patients,C0035647 Risk,C0205250 High,C0332167 High risk of,C1442065 Address,C1705242 Different,C1708476 Implementation,C1820977 Recommended diet,C3484370 Programs,C3846195 Not Recommended,C3846199 Chem recommended,C3872828 Multidisciplinary review,C4035588 Hospital-OR,C4075496 HOSPITAL readmission risk score,C4319571 High risk,C4489276 Readmission,C0012634 "Disease",C1303150 "Disease management program (regime/therapy)",C2728259 "Program"
32631 Scheduling an early follow-up visit (within 7–14 days) and early telephone follow-up (within 3 days) of hospital discharge is reasonable. C0019994 Hospitals,C0039457 Telephone,C0178941 Telephone follow-up,C0332285 Within,C0545082 Visit,C0547043 Up,C0586003 Discharge from hospital,C0589121 Follow-up visit,C0678742 drug scheduling,C1279919 Early,C1548175 On discharge,C3871203 At discharge,C4035588 Hospital-OR,C4281991 Follow,C0012621 "Body Fluid Discharge",C0589120 "Follow-up status",C0600083 "Discharge, Body Substance, Sample"
32633 In patients with NYHA class II and III Heart Failure and iron deficiency (ferritin <100 ng/mL or 100–300 ng/mL if transferrin saturation is <20%), intravenous iron replacement might be reasonable to improve functional status and QoL. C0011155 Deficiency,C0015879 Ferritin,C0030705 Patients,C0040679 Transferrin,C0184511 Improved,C0205245 Functional,C0240066 Iron deficiency,C0302583 Iron,C0348016 Intravenous,C0439526 /mL,C0449438 Status,C0451175 Functional status index,C0456387 Class,C0559956 Replacement,C3817553 100%,C3842589 20%,C4319604 300,C0015879 "Ferritin",C0035139 "Surgical Replantation",C0040679 "Transferrin",C0162429 "Malnutrition",C0240066 "Iron deficiency",C0302583 "Iron",C0332155 "Did not receive therapy or drug for",C0392916 "Intracellular ferritin",C1277709 "Transferrin saturation measurement"
32634 In patients with Heart Failure and anemia, erythropoietin-stimulating agents should not be used to improve morbidity and mortality. C0002871 Anemia,C0009488 Comorbidity,C0014822 Erythropoietin,C0030705 Patients,C0184511 Improved,C0445107 Not used,C0002871 "Anemia",C0014822 "Erythropoietin",C0450442 "Agent"
32635 In patients at increased risk, stage A Heart Failure, the optimal blood pressure in those with hypertension should be <130/80 mm Hg. C0001876 Air Pressure,C0005767 Blood,C0005823 Blood Pressure,C0030705 Patients,C0035647 Risk,C0205217 Increased,C1306673 Stage,C1882095 No Pressure,C1963138 Hypertension, CTCAE,C2748577 No hypertension,C3842583 80%,C4319552 130,C0005767 "Blood",C0020538 "Hypertensive disease",C0460139 "Pressure (finding)",C1272641 "Systemic arterial pressure"
32636 Patients with Heart FailurerEF and hypertension should be prescribed GDMT titrated to attain systolic blood pressure <130 mm Hg. C0001876 Air Pressure,C0005767 Blood,C0005823 Blood Pressure,C0030705 Patients,C0278329 Prescribed,C0489485 end systolic,C1277632 Target systolic blood pressure,C1282149 Minimum systolic blood pressure,C1282150 Maximum systolic blood pressure,C1282151 Average systolic blood pressure,C1282174 24 hour systolic blood pressure,C1303018 Standing systolic blood pressure,C1319893 Sitting systolic blood pressure,C1319895 Lying systolic blood pressure,C1882095 No Pressure,C1963138 Hypertension, CTCAE,C2748577 No hypertension,C4274438 Baseline systolic blood pressure,C4319552 130,C0005767 "Blood",C0020538 "Hypertensive disease",C0460139 "Pressure (finding)",C1272641 "Systemic arterial pressure"
32637 Patients with Heart FailurepEF and persistent hypertension after management of volume overload should be prescribed GDMT titrated to attain systolic blood pressure <130 mm Hg C0001876 Air Pressure,C0002766 Pain management,C0005767 Blood,C0005823 Blood Pressure,C0030705 Patients,C0205322 Persistent,C0278329 Prescribed,C0449468 Volume,C0489485 end systolic,C1277632 Target systolic blood pressure,C1282149 Minimum systolic blood pressure,C1282150 Maximum systolic blood pressure,C1282151 Average systolic blood pressure,C1282174 24 hour systolic blood pressure,C1303018 Standing systolic blood pressure,C1319893 Sitting systolic blood pressure,C1319895 Lying systolic blood pressure,C1882095 No Pressure,C1963138 Hypertension, CTCAE,C2748577 No hypertension,C4274438 Baseline systolic blood pressure,C4319552 130,C0005767 "Blood",C0020538 "Hypertensive disease",C0460139 "Pressure (finding)",C1272641 "Systemic arterial pressure"
32638 In patients with NYHA class II–IV Heart Failure and suspicion of sleep disordered breathing or excessive daytime sleepiness, a formal sleep assessment is reasonable C0030705 Patients,C0037313 Sleep,C0242114 Suspicion,C0332169 Daytime,C0393766 Postviral excessive daytime sleepiness,C0442802 Excessive,C0456387 Class,C0522796 Sleep apnea assessment,C0013144 "Drowsiness",C0225386 "Breath",C0917799 "Hypersomnia",C1261322 "Evaluation procedure"
32639 In patients with cardiovascular disease and obstructive sleep apnea, CPAP may be reasonable to improve sleep quality and daytime sleepiness C0003578 Apnea,C0007222 Cardiovascular Diseases,C0007226 Cardiovascular system,C0012634 Disease,C0030705 Patients,C0037313 Sleep,C0184511 Improved,C0205304 Non-obstructive,C0264656 Cardiovascular renal disease,C0332169 Daytime,C0332306 Quality,C0424563 Quality of sleep,C0455346 No FH: Cardiovascular disease,C0455404 FH: Cardiovascular disease,C0455539 H/O: cardiovascular disease,C0520679 Sleep Apnea, Obstructive,C0849932 Fear of cardiovascular disease,C3472692 Obstructive sleep apnea of child,C3472696 Obstructive sleep apnea of adult,C3873659 Sleep apnea mask,C3887460 Cardiovascular,C0003578 "Apnea",C0007222 "Cardiovascular Diseases",C0012634 "Disease",C0013144 "Drowsiness",C0037315 "Sleep Apnea Syndromes",C0520679 "Sleep Apnea, Obstructive"
32640 In patients with NYHA class II–IV Heart FailurerEF and central sleep apnea, adaptive servo-ventilation causes harm C0003578 Apnea,C0030705 Patients,C0037313 Sleep,C0205099 Central,C0231193 adaptive,C0456387 Class,C0751762 Central Sleep Apnea, Primary,C3873659 Sleep apnea mask,C4050232 Servo,C0003578 "Apnea",C0037315 "Sleep Apnea Syndromes",C0520680 "Sleep Apnea, Central"
32641 Coronary artery revascularization via coronary artery bypass graft (CABG) or percutaneous intervention is indicated for patients (Heart FailurepEF and Heart FailurerEF) on GDMT with angina and suitable coronary anatomy, especially for a left main stenosis (>50%) or left main–equivalent disease. (I-C) C0010055 Coronary Artery Bypass Surgery,C0012634 Disease,C0030705 Patients,C0185098 Bypass graft,C0205042 Coronary artery,C0205091 Left,C0396756 Coronary artery bypass graft x 1,C0472662 Limb revascularization,C0472666 Revascularization of hand,C0472667 Revascularization of thumb,C0472672 Revascularization of foot,C0522523 Percutaneous,C0581603 Revascularization - action,C0741847 Bypass,C1261287 Stenosis,C1319321 Coronary artery bypass graft occlusion,C1320783 Iliac artery bypass,C1444656 Indicated,C1449706 Coronary Artery Bypass, Off-Pump,C1522318 Coronary,C1532338 Percutaneous Coronary Intervention,C1542147 Main,C1550513 via,C3842586 50%,C3843766 <50,C0002962 "Angina Pectoris",C0003842 "Arteries",C0009814 "Acquired stenosis",C0010055 "Coronary Artery Bypass Surgery",C0012634 "Disease",C0181074 "Graft material",C0185098 "Bypass graft",C0205042 "Coronary artery",C0332835 "Transplanted tissue",C0440761 "Coronary artery graft (morphologic abnormality)",C0581603 "Revascularization - action",C0741847 "Bypass",C1261287 "Stenosis",C1269008 "Entire coronary artery",C1273869 "Intervention regimes"
32642 Coronary artery revascularization via coronary artery bypass graft to improve survival is reasonable in patients with mild to moderate LV systolic dysfunction (EF 35%–50%) and significant (?70% diameter stenosis) multivessel CAD or proximal left anterior descending (LAD) coronary artery stenosis when viable myocardium is present in the region of intended revascularization. (IIa-B) C0010055 Coronary Artery Bypass Surgery,C0027061 Myocardium,C0030705 Patients,C0035067 Renal Artery Stenosis,C0150312 Present,C0184511 Improved,C0185098 Bypass graft,C0205042 Coronary artery,C0205091 Left,C0205094 Anterior,C0205107 Proximal,C0205147 regional,C0205386 Descending,C0242231 Coronary Stenosis,C0396756 Coronary artery bypass graft x 1,C0441998 Left anterior,C0443348 Viable,C0472662 Limb revascularization,C0472666 Revascularization of hand,C0472667 Revascularization of thumb,C0472672 Revascularization of foot,C0489485 end systolic,C0581603 Revascularization - action,C0729847 Iliac artery stenosis,C0741847 Bypass,C0749225 Systolic dysfunction,C0750502 Significant,C1261287 Stenosis,C1299392 Mild to moderate,C1319321 Coronary artery bypass graft occlusion,C1320783 Iliac artery bypass,C1449706 Coronary Artery Bypass, Off-Pump,C1522318 Coronary,C1550513 via,C3842584 70%,C3842586 50%,C3843766 <50,C3887504 Dysfunction,C4319605 35,C0003842 "Arteries",C0009814 "Acquired stenosis",C0010055 "Coronary Artery Bypass Surgery",C0027061 "Myocardium",C0181074 "Graft material",C0185098 "Bypass graft",C0205042 "Coronary artery",C0242231 "Coronary Stenosis",C0332835 "Transplanted tissue",C0440761 "Coronary artery graft (morphologic abnormality)",C0581603 "Revascularization - action",C0741847 "Bypass",C0749225 "Systolic dysfunction",C1261287 "Stenosis",C1269008 "Entire coronary artery"
32643 CABG or medical therapy is reasonable to improve morbidity and cardiovascular mortality for patients with severe LV dysfunction (EF <35%), Heart Failure, and significant CAD. C0007226 Cardiovascular system,C0009488 Comorbidity,C0030705 Patients,C0184511 Improved,C0205476 Medical,C0418981 Medical therapy,C0750502 Significant,C1301700 Cardiovascular morbidity,C3887460 Cardiovascular,C3887504 Dysfunction,C4319605 35,C0087111 "Therapeutic procedure",C0418981 "Medical therapy"
32644 Surgical aortic valve replacement is reasonable for patients with critical aortic stenosis and a predicted surgical mortality of <10%. (IIa-B) C0030705 Patients,C0190170 Double valve replacement,C0190174 Triple valve replacement,C0340373 Senile aortic stenosis,C0396978 Homograft aortic valve replacement,C0396979 Autograft aortic valve replacement,C0396980 Xenograft aortic valve replacement,C0396981 Porcine aortic valve replacement,C0396983 Ball valve aortic valve replacement,C0553904 Disc valve aortic valve replacement,C0553906 Bileaflet aortic valve replacement,C0559956 Replacement,C1261287 Stenosis,C1511545 Critical,C3266772 History of aortic valve replacement,C3842590 10%,C0003483 "Aorta",C0003501 "Aortic valve structure",C0003506 "Replacement of aortic valve (procedure)",C0003507 "Aortic Valve Stenosis",C0009814 "Acquired stenosis",C0035139 "Surgical Replantation",C0543467 "Operative Surgical Procedures",C1261287 "Stenosis",C1269005 "Entire aortic valve"
32645 Transcatheter aortic valve replacement after careful candidate consideration is reasonable for patients with critical aortic stenosis who are deemed inoperable. (IIa-B) C0030705 Patients,C0190170 Double valve replacement,C0190174 Triple valve replacement,C0205187 Inoperable,C0340373 Senile aortic stenosis,C0396978 Homograft aortic valve replacement,C0396979 Autograft aortic valve replacement,C0396980 Xenograft aortic valve replacement,C0396981 Porcine aortic valve replacement,C0396983 Ball valve aortic valve replacement,C0518609 Consideration,C0553904 Disc valve aortic valve replacement,C0553906 Bileaflet aortic valve replacement,C0559956 Replacement,C1261287 Stenosis,C1511545 Critical,C3266772 History of aortic valve replacement,C3509486 Transcatheter Aortic Valve Replacement,C4527371 Candidate,C0003483 "Aorta",C0003501 "Aortic valve structure",C0003506 "Replacement of aortic valve (procedure)",C0003507 "Aortic Valve Stenosis",C0009814 "Acquired stenosis",C0035139 "Surgical Replantation",C1261287 "Stenosis",C1269005 "Entire aortic valve"
32646 CABG may be considered with the intent of improving survival in patients with ischemic heart disease with severe LV systolic dysfunction (EF <35%) and operable coronary anatomy whether or not viable myocardium is present. (IIb-B) C0012634 Disease,C0018787 Heart,C0018799 Heart Diseases,C0027061 Myocardium,C0030705 Patients,C0150312 Present,C0205188 Operable,C0443348 Viable,C0475224 Ischemic,C0475676 No FH: Ischemic heart disease,C0489485 end systolic,C0740220 Ischemic heart disease screen,C0749225 Systolic dysfunction,C0750591 consider,C0848343 Subacute ischemic heart disease,C1283828 intent,C1510446 Acute ischemic heart disease,C1522318 Coronary,C3887504 Dysfunction,C4319605 35,C0012634 "Disease",C0018787 "Heart",C0018799 "Heart Diseases",C0027061 "Myocardium",C0151744 "Myocardial Ischemia",C0749225 "Systolic dysfunction",C1281570 "Entire heart"
32647 Transcatheter mitral valve repair or mitral valve surgery for functional mitral insufficiency is of uncertain benefit and should only be considered after careful candidate selection and with a background of GDMT. C0026264 Mitral Valve,C0026266 Mitral Valve Insufficiency,C0087130 Uncertainty,C0205245 Functional,C0231179 Insufficiency,C0426068 Uncertain lie,C0442969 Functional surgery,C0746591 mitral,C0750591 consider,C0814225 Benefit,C1706907 Background,C2921039 Transcatheter mitral valve repair,C4319951 Repair,C4527371 Candidate,C0026264 "Mitral Valve",C0026266 "Mitral Valve Insufficiency",C0374711 "Surgical repair",C0543467 "Operative Surgical Procedures",C1269004 "Entire mitral valve"
32648 Surgical reverse remodeling or LV aneurysmectomy may be considered in carefully selected patients with Heart FailurerEF for specific indications including intractable Heart Failure and ventricular arrhythmias. C0030200 Pain, Intractable,C0030705 Patients,C0085268 Bone remodeling,C0189598 Aneurysmectomy,C0750591 consider,C1522565 Ventricular,C1555029 Reverse,C2093656 PTCA indications:,C0003811 "Cardiac Arrhythmia",C0085612 "Ventricular arrhythmia",C0189598 "Aneurysmectomy",C0543467 "Operative Surgical Procedures"
32649 Effective systems of care coordination with special attention to care transitions should be deployed for every patient with chronic Heart Failure that facilitate and ensure effective care that is designed to achieve GDMT and prevent hospitalization. C0004268 Attention,C0019993 Hospitalization,C0030705 Patients,C0205191 chronic,C0205555 Special,C0237543 motor coordination,C0449913 System,C1704419 Effective,C0309872 "PREVENT (product)"
32650 Every patient with Heart Failure should have a clear, detailed, and evidencebased plan of care that ensures the achievement of GDMT goals, effective management of comorbid conditions, timely follow-up with the healthcare team, appropriate dietary and physical activities, and compliance with secondary prevention guidelines for cardiovascular disease. This plan of care should be updated regularly and made readily available to all members of each patient’s healthcare team. (I-C) C0001072 Achievement,C0002766 Pain management,C0007222 Cardiovascular Diseases,C0007226 Cardiovascular system,C0012634 Disease,C0030705 Patients,C0086388 Health Care,C0150223 Fall prevention,C0162791 Guidelines,C0175668 Secondary to,C0178916 Care plan,C0205485 Physical,C0264656 Cardiovascular renal disease,C0441655 Activities,C0444868 All,C0455346 No FH: Cardiovascular disease,C0455404 FH: Cardiovascular disease,C0455539 H/O: cardiovascular disease,C0547043 Up,C0557480 Carer readily available,C0679699 Secondary Prevention,C0680022 member,C0849932 Fear of cardiovascular disease,C0871489 Team,C1275743 Co-morbid conditions,C1519814 Update,C1548787 Appropriate,C1704419 Effective,C2963144 Clear,C3714738 Compliance,C3827828 Timely,C3887460 Cardiovascular,C4281991 Follow,C0007222 "Cardiovascular Diseases",C0012634 "Disease",C0199176 "Prophylactic treatment",C0277555 "Secondary disease, NOS",C0589120 "Follow-up status",C0679699 "Secondary Prevention",C1275743 "Co-morbid conditions"
32651 Palliative and supportive care is effective for patients with symptomatic advanced Heart Failure to improve quality of life. (I-B) C0030705 Patients,C0184511 Improved,C0231220 Symptomatic,C0332306 Quality,C0344211 Supportive care,C0376558 Life,C1285530 Palliative,C1704419 Effective,C0030231 "Palliative Care",C0344211 "Supportive care",C0518214 "Perceived quality of life"
32653 Participation in quality improvement programs and patient registries based on nationally endorsed, clinical practice guideline–based quality and performance measures can be beneficial in improving quality of Heart Failure care. C0030705 Patients,C0034975 Registries,C0079809 Measures,C0162791 Guidelines,C0205210 Clinical,C0332306 Quality,C0597198 Performance,C0679823 Participation,C2986411 Improvement,C3484370 Programs,C2728259 "Program"
32654 We suggest noninvasive sampling with semiquantitative cultures to diagnose VAP, rather than invasive sampling with quantitative cultures and rather than noninvasive sampling with quantitative cultures C0205281 Invasive,C0392762 Quantitative,C0870078 Sampling,C2986496 Noninvasive,C2986822 Semiquantitative Method,C0441621 "Sampling - Surgical action",C2242979 "Microbial culture (procedure)"
32655 Noninvasive sampling with semiquantitative cultures is the preferred methodology to diagnose VAP (see section I); however, the panel recognizes that invasive quantitative cultures will occasionally be performed by some clinicians. For patients with suspected VAP whose invasive quantitative culture results are below the diagnostic threshold for VAP, we suggest that antibiotics be withheld rather than continued C0003232 Antibiotics,C0030705 Patients,C0205281 Invasive,C0348026 Diagnostic,C0392762 Quantitative,C0449864 Threshold,C0558229 Recognizes self,C0870078 Sampling,C0871685 Clinician,C0884358 Performed,C1294291 Quantitative urine culture,C1947903 See,C1997218 NOT suspected,C2986496 Noninvasive,C2986822 Semiquantitative Method,C3266812 Methodology,C3845935 Occasionally moist,C3845943 Walks occasionally,C4075947 Occasionally tired,C4330848 Occasionally Agree,C0003232 "Antibiotics",C0441621 "Sampling - Surgical action",C2242979 "Microbial culture (procedure)"
32656 We suggest that patients with suspected HAP (non-VAP) be treated according to the results of microbiologic studies performed on respiratory samples obtained noninvasively, rather than being treated empirically C0030705 Patients,C0521346 respiratory,C0884358 Performed,C1301820 Obtain,C1882120 Not Obtained,C1997218 NOT suspected,C0444279 "Respiratory sample"
32657 For patients with suspected HAP/VAP, we recommend using clinical criteria alone, rather than using serum PCT plus clinical criteria, to decide whether or not to initiate antibiotic therapy C0003232 Antibiotics,C0030705 Patients,C0205210 Clinical,C0229671 Serum,C0243161 criteria,C0338237 Antibiotic therapy,C1997218 NOT suspected,C0003232 "Antibiotics",C0087111 "Therapeutic procedure",C0162566 "Porphyria Cutanea Tarda",C0229671 "Serum",C0338237 "Antibiotic therapy"
32658 For patients with suspected HAP/VAP, we recommend using clinical criteria alone, rather than using bronchoalveolar lavage fluid (BALF) sTREM-1 plus clinical criteria, to decide whether or not to initiate antibiotic therapy C0003232 Antibiotics,C0006279 Bronchoalveolar Lavage Fluid,C0030705 Patients,C0205210 Clinical,C0243161 criteria,C0338237 Antibiotic therapy,C1535502 Bronchoalveolar Lavage,C1997218 NOT suspected,C0003232 "Antibiotics",C0006279 "Bronchoalveolar Lavage Fluid",C0022100 "Irrigation",C0087111 "Therapeutic procedure",C0338237 "Antibiotic therapy",C1535502 "Bronchoalveolar Lavage"
32659 For patients with suspected HAP/VAP, we recommend using clinical criteria alone rather than using CRP plus clinical criteria, to decide whether or not to initiate antibiotic therapy C0003232 Antibiotics,C0030705 Patients,C0205210 Clinical,C0243161 criteria,C0338237 Antibiotic therapy,C1997218 NOT suspected,C0003232 "Antibiotics",C0006560 "C-reactive protein",C0087111 "Therapeutic procedure",C0338237 "Antibiotic therapy"
32660 For patients with suspected HAP/VAP, we suggest using clinical criteria alone, rather than using CPIS plus clinical criteria, to decide whether or not to initiate antibiotic therapy C0003232 Antibiotics,C0030705 Patients,C0205210 Clinical,C0243161 criteria,C0338237 Antibiotic therapy,C1997218 NOT suspected,C0003232 "Antibiotics",C0087111 "Therapeutic procedure",C0338237 "Antibiotic therapy"
32661 In patients with VAT, we suggest not providing antibiotic therapy C0003232 Antibiotics,C0030705 Patients,C0338237 Antibiotic therapy,C0003232 "Antibiotics",C0087111 "Therapeutic procedure",C0338237 "Antibiotic therapy"
32662 In patients with suspected VAP, we recommend including coverage for S. aureus, Pseudomonas aeruginosa, and other gram-negative bacilli in all empiric regimens C0030705 Patients,C0033808 Pseudomonas,C0033809 Pseudomonas aeruginosa,C0205160 Negative,C0205394 Other,C0308738 COVERAGE 256,C0439208 gram,C0444868 All,C1880496 Empiric,C1997218 NOT suspected,C3266626 Gram Negative Broth,C0449210 "OTH tumor staging notation"
32663 We suggest including an agent active against MRSA for the empiric treatment of suspected VAP only in patients with any of the following: a risk factor for antimicrobial resistance (Table 2), patients being treated in units where >10%–20% of S. aureus isolates are methicillin resistant, and patients in units where the prevalence of MRSA is not known C0025643 Methicillin,C0030705 Patients,C0035647 Risk,C0035648 risk factors,C0205177 Active,C0205309 Known,C0332282 Following,C0439148 Unit,C0450442 Agent,C0521124 Against,C0746919 NO TREATMENT,C1512456 High Prevalence,C1518029 Low Prevalence,C1521761 Factor,C1550281 Mrsa:,C1552551 Any,C1880496 Empiric,C1997218 NOT suspected,C3842589 20%,C3842590 10%,C4281815 Resistance,C0450442 "Agent"
32664 We suggest including an agent active against methicillinsensitive S. aureus (MSSA) (and not MRSA) for the empiric treatment of suspected VAP in patients without risk factors for antimicrobial resistance, who are being treated in ICUs where <10%–20% of S. aureus isolates are methicillin resistant (weak recommendation, very low-quality evidence). C0025643 Methicillin,C0030705 Patients,C0034866 Recommendation,C0035647 Risk,C0205177 Active,C0205251 low,C0332288 Without,C0332306 Quality,C0442811 Very low,C0442824 Very,C0450442 Agent,C0455939 A/N risk factors,C0521124 Against,C0746919 NO TREATMENT,C1550281 Mrsa:,C1762617 Weak,C1880496 Empiric,C1997218 NOT suspected,C3842589 20%,C3842590 10%,C3887511 Evidence,C4281815 Resistance,C0442811 "Very low",C0450442 "Agent"
32666 When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem (weak recommendation, very low-quality evidence). Oxacillin, nafcillin, or cefazolin are preferred agents for treatment of proven MSSA, but are not necessary for the empiric treatment of VAP if one of the above agents is used. C0007546 Cefazolin,C0020933 Imipenem,C0027324 Nafcillin,C0029983 Oxacillin,C0031955 Piperacillin,C0034866 Recommendation,C0055003 cefepime,C0066005 meropenem,C0075870 tazobactam,C0205251 low,C0205447 One,C0282386 Levofloxacin,C0308738 COVERAGE 256,C0332306 Quality,C0442811 Very low,C0442824 Very,C0746919 NO TREATMENT,C1444656 Indicated,C1550281 Mrsa:,C1762617 Weak,C1879523 AT Regimen,C1880496 Empiric,C3887511 Evidence,C0007546 "Cefazolin",C0020933 "Imipenem",C0027324 "Nafcillin",C0029983 "Oxacillin",C0031955 "Piperacillin",C0055003 "cefepime",C0066005 "meropenem",C0075870 "tazobactam",C0282386 "Levofloxacin",C0450442 "Agent"
32667 Oxacillin, nafcillin, or cefazolin are preferred agents for treatment of proven MSSA, but are not necessary for the empiric treatment of VAP if one of the above agents is used C0007546 Cefazolin,C0027324 Nafcillin,C0029983 Oxacillin,C0205447 One,C0746919 NO TREATMENT,C1880496 Empiric,C0007546 "Cefazolin",C0027324 "Nafcillin",C0029983 "Oxacillin",C0450442 "Agent"
32668 We suggest prescribing 2 antipseudomonal antibiotics from different classes for the empiric treatment of suspected VAP only in patients with any of the following: a risk factor for antimicrobial resistance (Table 2), patients in units where >10% of gram-negative isolates are resistant to an agent being considered for monotherapy, and patients in an ICU where local antimicrobial susceptibility rates are not available C0003232 Antibiotics,C0030705 Patients,C0035647 Risk,C0035648 risk factors,C0183715 Susceptibility Panels,C0205160 Negative,C0205276 Local,C0332282 Following,C0427965 Antimicrobial susceptibility,C0439148 Unit,C0439208 gram,C0450442 Agent,C0746919 NO TREATMENT,C0750591 consider,C1521761 Factor,C1547045 *Susceptibility,C1552551 Any,C1705242 Different,C1880496 Empiric,C1997218 NOT suspected,C2936305 Over Prescribing,C3266626 Gram Negative Broth,C3842590 10%,C4281815 Resistance,C0003232 "Antibiotics",C0427965 "Antimicrobial susceptibility",C0450442 "Agent"
32669 We suggest prescribing one antibiotic active against P. aeruginosa for the empiric treatment of suspected VAP in patients without risk factors for antimicrobial resistance who are being treated in ICUs where ?10% of gram-negative isolates are resistant to the agent being considered for monotherapy C0003232 Antibiotics,C0030705 Patients,C0035647 Risk,C0205160 Negative,C0205177 Active,C0205447 One,C0332288 Without,C0439208 gram,C0450442 Agent,C0455939 A/N risk factors,C0521124 Against,C0746919 NO TREATMENT,C0750591 consider,C1880496 Empiric,C1997218 NOT suspected,C2936305 Over Prescribing,C3266626 Gram Negative Broth,C3842590 10%,C4281815 Resistance,C0003232 "Antibiotics",C0450442 "Agent"
32670 In patients with suspected VAP, we suggest avoiding aminoglycosides if alternative agents with adequate gram-negative activity are available C0002556 Aminoglycosides,C0030705 Patients,C0205160 Negative,C0205411 Adequate,C0439208 gram,C1523987 Alternative,C1997218 NOT suspected,C3266626 Gram Negative Broth,C3845261 No activity,C0002556 "Aminoglycosides",C0450442 "Agent"
32671 In patients with suspected VAP, we suggest avoiding colistin if alternative agents with adequate gram-negative activity are available C0009316 Colistin,C0030705 Patients,C0205160 Negative,C0205411 Adequate,C0439208 gram,C1523987 Alternative,C1997218 NOT suspected,C3266626 Gram Negative Broth,C3845261 No activity,C0009316 "Colistin",C0450442 "Agent"
32672 For patients being treated empirically for HAP, we recommend prescribing an antibiotic with activity against S. aureus C0003232 Antibiotics,C0030705 Patients,C0521124 Against,C2936305 Over Prescribing,C3845261 No activity,C0003232 "Antibiotics"
32673 For patients with HAP who are being treated empirically and have either a risk factor for MRSA infection (ie, prior intravenous antibiotic use within 90 days, hospitalization in a unit where >20% of S. aureus isolates are methicillin resistant, or the prevalence of MRSA is not known, or who are at high risk for mortality, we suggest prescribing an antibiotic with activity against MRSA C0003232 Antibiotics,C0019993 Hospitalization,C0025643 Methicillin,C0030705 Patients,C0035647 Risk,C0035648 risk factors,C0205250 High,C0205309 Known,C0332167 High risk of,C0332285 Within,C0348016 Intravenous,C0439083 >90,C0439087 <90,C0439148 Unit,C0521124 Against,C0559680 Intravenous antibiotic therapy,C1512456 High Prevalence,C1518029 Low Prevalence,C1521761 Factor,C1550281 Mrsa:,C2936305 Over Prescribing,C3714514 Infection,C3842582 90%,C3842589 20%,C3844638 Either,C3845261 No activity,C4319571 High risk,C0003232 "Antibiotics",C0343401 "MRSA - Methicillin resistant Staphylococcus aureus infection"
32674 For patients with HAP who require empiric coverage for MRSA, we recommend vancomycin or linezolid rather than an alternative antibiotic C0003232 Antibiotics,C0030705 Patients,C0042313 Vancomycin,C0308738 COVERAGE 256,C0663241 linezolid,C1523987 Alternative,C1550281 Mrsa:,C1880496 Empiric,C0003232 "Antibiotics",C0042313 "Vancomycin",C0663241 "linezolid"
32675 For patients with HAP who are being treated empirically and have no risk factors for MRSA infection and are not at high risk of mortality, we suggest prescribing an antibiotic with activity against MSSA. When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem. Oxacillin, nafcillin, or cefazolin are preferred for the treatment of proven MSSA, but are not necessary for empiric coverage of HAP if one of the above agents is used C0003232 Antibiotics,C0007546 Cefazolin,C0020933 Imipenem,C0027324 Nafcillin,C0029983 Oxacillin,C0030705 Patients,C0031955 Piperacillin,C0035647 Risk,C0055003 cefepime,C0066005 meropenem,C0075870 tazobactam,C0205250 High,C0205447 One,C0282386 Levofloxacin,C0308738 COVERAGE 256,C0332167 High risk of,C0455939 A/N risk factors,C0521124 Against,C0746919 NO TREATMENT,C1444656 Indicated,C1550281 Mrsa:,C1879523 AT Regimen,C1880496 Empiric,C2936305 Over Prescribing,C3714514 Infection,C3845261 No activity,C4319571 High risk,C0003232 "Antibiotics",C0007546 "Cefazolin",C0020933 "Imipenem",C0027324 "Nafcillin",C0029983 "Oxacillin",C0031955 "Piperacillin",C0055003 "cefepime",C0066005 "meropenem",C0075870 "tazobactam",C0282386 "Levofloxacin",C0343401 "MRSA - Methicillin resistant Staphylococcus aureus infection",C0450442 "Agent"
32676 When empiric treatment that includes coverage for MSSA (and not MRSA) is indicated, we suggest a regimen including piperacillin-tazobactam, cefepime, levofloxacin, imipenem, or meropenem. Oxacillin, nafcillin, or cefazolin are preferred for the treatment of proven MSSA, but are not necessary for empiric coverage of HAP if one of the above agents is used C0007546 Cefazolin,C0020933 Imipenem,C0027324 Nafcillin,C0029983 Oxacillin,C0031955 Piperacillin,C0055003 cefepime,C0066005 meropenem,C0075870 tazobactam,C0205447 One,C0282386 Levofloxacin,C0308738 COVERAGE 256,C0746919 NO TREATMENT,C1444656 Indicated,C1550281 Mrsa:,C1879523 AT Regimen,C1880496 Empiric,C0007546 "Cefazolin",C0020933 "Imipenem",C0027324 "Nafcillin",C0029983 "Oxacillin",C0031955 "Piperacillin",C0055003 "cefepime",C0066005 "meropenem",C0075870 "tazobactam",C0282386 "Levofloxacin",C0450442 "Agent"
32677 For patients with HAP who are being treated empirically, we recommend prescribing antibiotics with activity against P. aeruginosa and other gram-negative bacilli C0003232 Antibiotics,C0030705 Patients,C0205160 Negative,C0205394 Other,C0439208 gram,C0521124 Against,C2936305 Over Prescribing,C3266626 Gram Negative Broth,C3845261 No activity,C0003232 "Antibiotics",C0449210 "OTH tumor staging notation"
32678 For patients with HAP who are being treated empirically and have factors increasing the likelihood for Pseudomonas or other gram-negative infection (ie, prior intravenous antibiotic use within 90 days; also see Remarks) or a high risk for mortality, we suggest prescribing antibiotics from 2 different classes with activity against P. aeruginosa C0003232 Antibiotics,C0030705 Patients,C0033808 Pseudomonas,C0035647 Risk,C0205160 Negative,C0205250 High,C0205394 Other,C0332167 High risk of,C0332285 Within,C0348016 Intravenous,C0439083 >90,C0439087 <90,C0439208 gram,C0442808 Increasing,C0521124 Against,C0559680 Intravenous antibiotic therapy,C1274351 Gram-negative infection of toe web,C1705242 Different,C1947903 See,C2936305 Over Prescribing,C3266626 Gram Negative Broth,C3714514 Infection,C3842582 90%,C3845261 No activity,C4319571 High risk,C0003232 "Antibiotics",C0449210 "OTH tumor staging notation"
32679 For patients with HAP who are being treated empirically, we recommend not using an aminoglycoside as the sole antipseudomonal agent C0002556 Aminoglycosides,C0030705 Patients,C0450442 Agent,C3536835 Aminoglycoside [EPC],C0450442 "Agent"
32680 For patients with HAP/VAP, we suggest that antibiotic dosing be determined using PK/PD data, rather than the manufacturer’s prescribing information C0003232 Antibiotics,C0030705 Patients,C0521095 Determined by,C0946213 Manufacturer code,C0947322 Manufacturer Name,C1511726 Data,C1533716 Information,C1546888 Other manufacturer,C2936305 Over Prescribing,C0003232 "Antibiotics"
32681 For patients with VAP due to gram-negative bacilli that are susceptible to only aminoglycosides or polymyxins (colistin or polymyxin B), we suggest both inhaled and systemic antibiotics, rather than systemic antibiotics alone C0002556 Aminoglycosides,C0003232 Antibiotics,C0009316 Colistin,C0030705 Patients,C0032535 Polymyxin B,C0032538 Polymyxin M,C0032539 Polymyxins,C0205160 Negative,C0205373 Systemic,C0231204 Susceptible,C0439208 gram,C0606677 polymyxin S(1),C1706086 Both,C3146286 Due,C3266626 Gram Negative Broth,C0002556 "Aminoglycosides",C0003232 "Antibiotics",C0009316 "Colistin",C0032535 "Polymyxin B",C0032539 "Polymyxins"
32682 We recommend that MRSA HAP/VAP be treated with either vancomycin or linezolid rather than other antibiotics or antibiotic combinations C0003232 Antibiotics,C0042313 Vancomycin,C0205394 Other,C0663241 linezolid,C1550281 Mrsa:,C3844638 Either,C0003232 "Antibiotics",C0042313 "Vancomycin",C0356164 "Other antibiotics",C0449210 "OTH tumor staging notation",C0663241 "linezolid"
32683 For patients with HAP/VAP due to P. aeruginosa, we recommend that the choice of an antibiotic for definitive (not empiric) therapy be based upon the results of antimicrobial susceptibility testing C0003232 Antibiotics,C0030705 Patients,C0039593 Testing,C0183715 Susceptibility Panels,C0427965 Antimicrobial susceptibility,C0443196 Definitive,C0725610 CHOICE DM,C1547045 *Susceptibility,C1880496 Empiric,C3146286 Due,C0003232 "Antibiotics",C0087111 "Therapeutic procedure",C0201179 "Antimicrobial susceptibility test (procedure)",C0427965 "Antimicrobial susceptibility"
32684 For patients with HAP/VAP due to P. aeruginosa, we recommend against aminoglycoside monotherapy (strong recommendation, very low-quality evidence). C0002556 Aminoglycosides,C0030705 Patients,C0034866 Recommendation,C0205251 low,C0332306 Quality,C0442811 Very low,C0442821 Strong,C0442824 Very,C0521124 Against,C3146286 Due,C3536835 Aminoglycoside [EPC],C3887511 Evidence,C0442811 "Very low"
32685 For patients with HAP/VAP due to P. aeruginosa who are not in septic shock or at a high risk for death, and for whom the results of antibiotic susceptibility testing are known, we recommend monotherapy using an antibiotic to which the isolate is susceptible rather than combination therapy C0003232 Antibiotics,C0030705 Patients,C0035647 Risk,C0036974 Shock,C0036983 Septic Shock,C0039593 Testing,C0052142 AP combination,C0054603 CAP combination,C0183715 Susceptibility Panels,C0205250 High,C0205309 Known,C0231204 Susceptible,C0332167 High risk of,C0333534 septic,C0584697 Combination therapy to face,C0584698 Combination therapy to neck,C0584699 Combination therapy to trunk,C0584702 Combination therapy to elbow,C0584703 Combination therapy to wrist,C0584704 Combination therapy to hand,C0584705 Combination therapy to back,C0584706 Combination therapy to pelvis,C0584708 Combination therapy to hip,C0584709 Combination therapy to knee,C0584710 Combination therapy to ankle,C0584711 Combination therapy to foot,C1547045 *Susceptibility,C3146286 Due,C4319571 High risk,C0003232 "Antibiotics",C0036974 "Shock",C0036983 "Septic Shock",C0087111 "Therapeutic procedure",C0427965 "Antimicrobial susceptibility",C0556895 "Combination electrotherapy",C1306577 "Death (finding)"
32686 For patients with HAP/VAP due to P. aeruginosa who remain in septic shock or at a high risk for death when the results of antibiotic susceptibility testing are known, we suggest combination therapy using 2 antibiotics to which the isolate is susceptible rather than monotherapy C0003232 Antibiotics,C0030705 Patients,C0035647 Risk,C0036974 Shock,C0036983 Septic Shock,C0039593 Testing,C0052142 AP combination,C0054603 CAP combination,C0183715 Susceptibility Panels,C0205250 High,C0205309 Known,C0231204 Susceptible,C0332167 High risk of,C0333534 septic,C0584697 Combination therapy to face,C0584698 Combination therapy to neck,C0584699 Combination therapy to trunk,C0584702 Combination therapy to elbow,C0584703 Combination therapy to wrist,C0584704 Combination therapy to hand,C0584705 Combination therapy to back,C0584706 Combination therapy to pelvis,C0584708 Combination therapy to hip,C0584709 Combination therapy to knee,C0584710 Combination therapy to ankle,C0584711 Combination therapy to foot,C1547045 *Susceptibility,C3146286 Due,C4319571 High risk,C0003232 "Antibiotics",C0036974 "Shock",C0036983 "Septic Shock",C0087111 "Therapeutic procedure",C0427965 "Antimicrobial susceptibility",C0556895 "Combination electrotherapy",C1306577 "Death (finding)"
32688 For patients with HAP/VAP due to ESBL-producing gramnegative bacilli, we recommend that the choice of an antibiotic for definitive (not empiric) therapy be based upon the results of antimicrobial susceptibility testing and patient-specific factors C0003232 Antibiotics,C0030705 Patients,C0039593 Testing,C0183715 Susceptibility Panels,C0427965 Antimicrobial susceptibility,C0443196 Definitive,C0725610 CHOICE DM,C1444096 ESBL,C1547045 *Susceptibility,C1880496 Empiric,C3146286 Due,C0003232 "Antibiotics",C0087111 "Therapeutic procedure",C0427965 "Antimicrobial susceptibility"
32689 In patients with HAP/VAP caused by Acinetobacter species, we suggest treatment with either a carbapenem or ampicillin/sulbactam if the isolate is susceptible to these agents C0001138 Acinetobacter,C0002680 Ampicillin,C0006968 Carbapenems,C0030705 Patients,C0038665 Sulbactam,C0231204 Susceptible,C0746919 NO TREATMENT,C1264774 Acinetobacter species,C1705920 Species,C2930041 Ampicillin / Sulbactam,C3844638 Either,C0002680 "Ampicillin",C0006968 "Carbapenems",C0038665 "Sulbactam",C0450442 "Agent"
32690 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to polymyxins, we recommend intravenous polymyxin (colistin or polymyxin B) C0001138 Acinetobacter,C0009316 Colistin,C0030705 Patients,C0032535 Polymyxin B,C0032538 Polymyxin M,C0032539 Polymyxins,C0332324 Sensitive,C0348016 Intravenous,C0606677 polymyxin S(1),C1264774 Acinetobacter species,C1705920 Species,C0009316 "Colistin",C0032539 "Polymyxins"
32691 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to polymyxins, we suggest adjunctive inhaled colistin C0001138 Acinetobacter,C0009316 Colistin,C0030705 Patients,C0032539 Polymyxins,C0332324 Sensitive,C1264774 Acinetobacter species,C1292783 Adjunctive care,C1705920 Species,C0009316 "Colistin",C0032539 "Polymyxins"
32692 In patients with HAP/VAP caused by Acinetobacter species that is sensitive only to colistin, we suggest not using adjunctive rifampicin C0001138 Acinetobacter,C0009316 Colistin,C0030705 Patients,C0035608 Rifampin,C0058534 DMB-rifampicin,C0332324 Sensitive,C1264774 Acinetobacter species,C1292783 Adjunctive care,C1705920 Species,C0009316 "Colistin",C0035608 "Rifampin"
32693 In patients with HAP/VAP caused by Acinetobacter species, we recommend against the use of tigecycline C0001138 Acinetobacter,C0030705 Patients,C0521124 Against,C1260298 tigecycline,C1264774 Acinetobacter species,C1705920 Species,C1260298 "tigecycline"
32694 In patients with HAP/VAP caused by a carbapenem-resistant pathogen that is sensitive only to polymyxins, we recommend intravenous polymyxins (colistin or polymyxin B) C0006968 Carbapenems,C0009316 Colistin,C0030705 Patients,C0032535 Polymyxin B,C0032538 Polymyxin M,C0032539 Polymyxins,C0332324 Sensitive,C0348016 Intravenous,C0606677 polymyxin S(1),C3656682 Carbapenem resistant bacteria,C0006968 "Carbapenems",C0009316 "Colistin",C0032539 "Polymyxins"
32695 In patients with HAP/VAP caused by a carbapenem-resistant pathogen that is sensitive only to polymyxins, we suggest adjunctive inhaled colistin C0006968 Carbapenems,C0009316 Colistin,C0030705 Patients,C0032539 Polymyxins,C0332324 Sensitive,C1292783 Adjunctive care,C3656682 Carbapenem resistant bacteria,C0006968 "Carbapenems",C0009316 "Colistin",C0032539 "Polymyxins"
32696 For patients with VAP, we recommend a 7-day course of antimicrobial therapy rather than a longer duration C0030705 Patients,C0439228 day,C0750729 Course,C2926735 Duration,C0087111 "Therapeutic procedure",C2926735 "Duration"
32697 For patients with HAP, we recommend a 7-day course of antimicrobial therapy C0030705 Patients,C0439228 day,C0750729 Course,C0087111 "Therapeutic procedure"
32698 For patients with HAP/VAP, we suggest that antibiotic therapy be de-escalated rather than fixed C0003232 Antibiotics,C0030705 Patients,C0338237 Antibiotic therapy,C0003232 "Antibiotics",C0087111 "Therapeutic procedure",C0338237 "Antibiotic therapy"
32699 For patients with HAP/VAP, we suggest using PCT levels plus clinical criteria to guide the discontinuation of antibiotic therapy, rather than clinical criteria alone C0003232 Antibiotics,C0030705 Patients,C0205210 Clinical,C0243161 criteria,C0338237 Antibiotic therapy,C0003232 "Antibiotics",C0087111 "Therapeutic procedure",C0162566 "Porphyria Cutanea Tarda",C0338237 "Antibiotic therapy",C0457454 "Discontinuation (procedure)",C2946261 "Level"
32700 For patients with suspected HAP/VAP, we suggest not using the CPIS to guide the discontinuation of antibiotic therapy C0003232 Antibiotics,C0030705 Patients,C0338237 Antibiotic therapy,C1997218 NOT suspected,C0003232 "Antibiotics",C0087111 "Therapeutic procedure",C0338237 "Antibiotic therapy",C0457454 "Discontinuation (procedure)"
32701 Gram stain and culture of the pus or exudates from skin lesions of impetigo and ecthyma are recommended to help identify whether Staphylococcus aureus and/or a ?-hemolytic streptococcus is the cause C0013568 Ecthyma,C0015388 Exudate,C0021099 Impetigo,C0034161 Pus,C0038128 Stains,C0038170 Genus staphylococcus,C0038172 Staphylococcus aureus,C0038402 Streptococcus,C0061856 Gram's stain,C0221198 Lesion,C0318153 Alpha-hemolytic streptococcus,C0318154 Beta-hemolytic streptococcus,C0318155 Gamma-hemolytic streptococcus,C0439208 gram,C0579243 Alpha prime hemolytic streptococcus,C0579244 Alpha non-hemolytic streptococcus,C1123023 Skin,C1532385 Non-Beta-hemolytic Streptococcus,C1541907 Beta-hemolytic Streptococcus, group A,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0013568 "Ecthyma",C0015388 "Exudate",C0021099 "Impetigo",C0034161 "Pus",C0037284 "Skin lesion",C0038128 "Stains",C0061856 "Gram's stain",C0200966 "Bacterial stain, routine",C0221198 "Lesion",C1123023 "Skin",C1278993 "Entire skin",C2242979 "Microbial culture (procedure)"
32702 Treatment without gram stain and culture of the pus or exudates from skin lesions of impetigo and ecthyma is reasonable in typical cases C0013568 Ecthyma,C0015388 Exudate,C0021099 Impetigo,C0034161 Pus,C0038128 Stains,C0061856 Gram's stain,C0221198 Lesion,C0332288 Without,C0439208 gram,C0746919 NO TREATMENT,C1123023 Skin,C0013568 "Ecthyma",C0015388 "Exudate",C0021099 "Impetigo",C0034161 "Pus",C0037284 "Skin lesion",C0038128 "Stains",C0061856 "Gram's stain",C0200966 "Bacterial stain, routine",C0221198 "Lesion",C1123023 "Skin",C1278993 "Entire skin",C2242979 "Microbial culture (procedure)"
32703 Treatment of bullous and nonbullous impetigo should be with either mupirocin or retapamulin bid for 5 days C0021099 Impetigo,C0085259 Mupirocin,C0205405 Bullous,C0406096 Non-bullous impetigo,C0746919 NO TREATMENT,C1703334 retapamulin,C3844638 Either,C0021099 "Impetigo",C0021100 "Bullous impetigo",C0085259 "Mupirocin",C1703334 "retapamulin"
32704 Oral therapy for ecthyma or impetigo should be a 7-day regimen with an agent active against S. aureus unless cultures yield streptococci alone (when oral penicillin is the recommended agent) C0013568 Ecthyma,C0021099 Impetigo,C0030842 Penicillins,C0038402 Streptococcus,C0205177 Active,C0220892 Penicillin,C0439228 day,C0442027 Oral,C0450442 Agent,C0521124 Against,C1820977 Recommended diet,C1879523 AT Regimen,C3846195 Not Recommended,C3846199 Chem recommended,C0013568 "Ecthyma",C0021099 "Impetigo",C0030842 "Penicillins",C0087111 "Therapeutic procedure",C0220892 "Penicillin",C0450442 "Agent",C2242979 "Microbial culture (procedure)"
32705 Because Staphylococcus aureus isolates from impetigo and ecthyma are usually methicillin-susceptible, dicloxacillin or cephalexin is recommended. C0007716 Cephalexin,C0012093 Dicloxacillin,C0013568 Ecthyma,C0021099 Impetigo,C0025643 Methicillin,C0038170 Genus staphylococcus,C0038172 Staphylococcus aureus,C0231204 Susceptible,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C3888388 Usually,C0007716 "Cephalexin",C0012093 "Dicloxacillin",C0013568 "Ecthyma",C0021099 "Impetigo",C0025643 "Methicillin"
32706 When methicillin-resistant Staphylococcus aureus is suspected or confirmed, doxycycline, clindamycin, or sulfamethoxazole-trimethoprim is recommended C0008947 Clindamycin,C0013090 Doxycycline,C0025643 Methicillin,C0038170 Genus staphylococcus,C0038172 Staphylococcus aureus,C0038689 Sulfamethoxazole,C0041041 Trimethoprim,C0343401 MRSA - Methicillin resistant Staphylococcus aureus infection,C0521093 Confirmed by,C0729578 Methicillin resistant staphylococcus aureus positive,C1142536 Pneumonia due to methicillin resistant Staphylococcus aureus,C1265292 Methicillin-Resistant Staphylococcus aureus,C1294237 Methicillin resistant Staphylococcus aureus culture,C1303247 Methicillin resistant Staphylococcus aureus screening test,C1319191 Glycopeptide resistant Staphylococcus aureus,C1319192 Vancomycin resistant Staphylococcus aureus,C1507063 Methicillin resistant Staphylococcus aureus DNA,C1820977 Recommended diet,C1997218 NOT suspected,C2317549 Methicillin resistant staphylococcus aureus carrier (finding),C2586075 Culture positive for methicillin resistant Staphylococcus aureus,C2586183 Methicillin resistant Staphylococcus aureus screen negative,C2732959 Methicillin,C0008947 "Clindamycin",C0013090 "Doxycycline",C0025643 "Methicillin",C0038689 "Sulfamethoxazole",C0041041 "Trimethoprim",C0343401 "MRSA - Methicillin resistant Staphylococcus aureus infection"
32707 Systemic antimicrobials should be used for infections during outbreaks of post-streptococcal glomerulonephritis to help eliminate nephritogenic strains of Streptococcus pyogenes from the community C0009462 Community,C0017658 Glomerulonephritis,C0038402 Streptococcus,C0038411 Streptococcus pyogenes,C0205373 Systemic,C0347984 During,C0403414 Acute post-streptococcal glomerulonephritis,C0687676 Post,C3714514 Infection,C0017658 "Glomerulonephritis",C0080194 "Muscle strain",C0403414 "Acute post-streptococcal glomerulonephritis"
32708 Gram stain and culture of pus from carbuncles and abscesses are recommended, but treatment without these studies is reasonable in typical cases C0000833 Abscess,C0007078 carbuncle,C0034161 Pus,C0038128 Stains,C0061856 Gram's stain,C0332288 Without,C0439208 gram,C0746919 NO TREATMENT,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0000833 "Abscess",C0007078 "carbuncle",C0034161 "Pus",C0038128 "Stains",C0061856 "Gram's stain",C0200966 "Bacterial stain, routine",C2242979 "Microbial culture (procedure)"
32709 Gram stain and culture of pus from inflamed epidermoid cysts are NOT recommended C0010709 Cyst,C0034161 Pus,C0038128 Stains,C0061856 Gram's stain,C0439208 gram,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0010709 "Cyst",C0014511 "Epithelial cyst",C0034161 "Pus",C0038128 "Stains",C0061856 "Gram's stain",C0200966 "Bacterial stain, routine",C2242979 "Microbial culture (procedure)"
32710 Incision and drainage is the recommended treatment for inflamed epidermoid cysts, carbuncles, abscesses and large furuncles C0000833 Abscess,C0007078 carbuncle,C0010709 Cyst,C0152277 Incision and drainage,C0181296 Incision/drainage kit,C0242301 furuncle,C0549177 Large,C0746919 NO TREATMENT,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0000833 "Abscess",C0007078 "carbuncle",C0010709 "Cyst",C0012621 "Body Fluid Discharge",C0013103 "Drainage procedure",C0014511 "Epithelial cyst",C0152277 "Incision and drainage",C0184898 "Surgical incisions",C0242301 "furuncle"
32711 The decision to administer antibiotics directed against S. aureus as an adjunct to incision and drainage should be made based on the presence or absence of systemic inflammatory response syndrome (SIRS) such as temperature >38°C or <36°C, tachypnea >24 breaths/min, tachycardia >90 beats/min or white blood cell count (WBC) >12,000 or <4000 cells/mm3 C0003232 Antibiotics,C0005767 Blood,C0005771 Blood Cell Count,C0005773 Blood Cells,C0005903 Body Temperature,C0007584 Cell Count,C0007634 Cells,C0039082 Syndrome,C0039231 Tachycardia,C0039476 Temperature,C0152277 Incision and drainage,C0181296 Incision/drainage kit,C0205373 Systemic,C0225386 Breath,C0231835 Tachypnea,C0242966 Systemic Inflammatory Response Syndrome,C0333348 Inflammatory,C0438221 White blood cell count normal,C0439083 >90,C0439087 <90,C0521124 Against,C0580531 White blood cell count abnormal,C0679006 Decision,C0750480 Count,C1292504 White blood cell sample,C1300557 /mm3,C1879741 As Directed,C1960440 Systemic inflammatory response syndrome score,C3241939 White blood cell test,C3842327 4000,C3842582 90%,C4282382 No response,C4319606 36,C0003232 "Antibiotics",C0005767 "Blood",C0005771 "Blood Cell Count",C0005773 "Blood Cells",C0007584 "Cell Count",C0007634 "Cells",C0012621 "Body Fluid Discharge",C0013103 "Drainage procedure",C0023508 "White Blood Cell Count procedure",C0023516 "Leukocytes",C0039082 "Syndrome",C0039231 "Tachycardia",C0184898 "Surgical incisions",C0225386 "Breath",C0231835 "Tachypnea",C0242966 "Systemic Inflammatory Response Syndrome",C0392148 "Providing presence (regime/therapy)",C1269647 "Entire cell",C1689985 "Absence (morphologic abnormality)"
32712 An antibiotic active against MRSA is recommended for patients with carbuncles or abscesses who have failed initial antibiotic treatment, have markedly impaired host defenses, or in patients with SIRS and hypotension C0000833 Abscess,C0003232 Antibiotics,C0007078 carbuncle,C0020649 Hypotension,C0030705 Patients,C0205177 Active,C0205265 Initially,C0221099 Impaired,C0231175 Failed,C0521124 Against,C0746919 NO TREATMENT,C1550281 Mrsa:,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0000833 "Abscess",C0003232 "Antibiotics",C0007078 "carbuncle",C0020649 "Hypotension"
32713 A recurrent abscess at a site of previous infection should prompt a search for local causes such as a pilonidal cyst, hidradenitis suppurativa or foreign material C0000833 Abscess,C0010709 Cyst,C0031925 Pilonidal Cyst,C0085160 Hidradenitis,C0162836 Hidradenitis Suppurativa,C0205145 Site,C0205156 Previous,C0205276 Local,C0445615 Type of foreign material,C0449760 Foreign body material,C0520510 Materials,C1517294 foreign,C1550293 Pilonidal,C1602245 Prompt,C2945760 Recurrent,C3714514 Infection,C0000833 "Abscess",C0010709 "Cyst",C0016542 "Foreign Bodies",C0031925 "Pilonidal Cyst",C0085160 "Hidradenitis",C0162836 "Hidradenitis Suppurativa"
32714 Recurrent abscesses should be drained and cultured early in the course of infection C0000833 Abscess,C0750729 Course,C1279919 Early,C2945760 Recurrent,C3714514 Infection,C0000833 "Abscess"
32715 After obtaining cultures of recurrent abscess, treat with a 5- to 10-day course of an antibiotic active against the pathogen isolated C0000833 Abscess,C0003232 Antibiotics,C0205177 Active,C0205409 Isolated,C0439228 day,C0521124 Against,C0750729 Course,C2945760 Recurrent,C3842590 10%,C0000833 "Abscess",C0003232 "Antibiotics",C2242979 "Microbial culture (procedure)"
32716 Consider a 5-day decolonization regimen of intranasal mupirocin bid, daily chlorhexidine washes, and daily decontamination of personal items such as towels, sheets, and clothes for recurrent S. aureus infection ( C0008196 Chlorhexidine,C0011121 Decontamination,C0085259 Mupirocin,C0332173 Daily,C0336616 Towel,C0439228 day,C0750591 consider,C1879523 AT Regimen,C2718306 Clothed,C2945760 Recurrent,C3714514 Infection,C4520447 Decolonization,C0008196 "Chlorhexidine",C0011121 "Decontamination",C0085259 "Mupirocin"
32717 Adult patients should be evaluated for neutrophil disorders if recurrent abscesses began in early childhood C0000833 Abscess,C0001675 Adult,C0027950 neutrophil,C0030705 Patients,C0231335 Childhood,C0599196 Early childhood,C1279919 Early,C2945760 Recurrent,C0000833 "Abscess",C0012634 "Disease",C0027950 "neutrophil"
32718 Cultures of blood or cutaneous aspirates, biopsies, or swabs are NOT routinely recommended C0005767 Blood,C0221912 Cutaneous,C1261188 Swab,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0005767 "Blood",C0370199 "Aspirate substance",C1261188 "Swab",C2242979 "Microbial culture (procedure)"
32719 Cultures of blood are recommended in patients with malignancy on chemotherapy, neutropenia, severe cell-mediated immunodeficiency, immersion injuries, and animal bites C0003062 Animals,C0003794 Arm Injuries,C0005767 Blood,C0007634 Cells,C0015408 Eye Injuries,C0027947 Neutropenia,C0030705 Patients,C0086597 Mediate,C0392207 inborn immunodeficiency,C1820977 Recommended diet,C1855166 No immunodeficiency,C3665472 Chemotherapy,C3714592 Immersion,C3842363 No malignancy,C3846195 Not Recommended,C3846199 Chem recommended,C0003044 "Animal bite",C0005658 "bite injury",C0005767 "Blood",C0007634 "Cells",C0013216 "Pharmacotherapy",C0021051 "Immunologic Deficiency Syndromes",C0027947 "Neutropenia",C0038561 "Submersion",C0392920 "Chemotherapy Regimen",C1269647 "Entire cell",C1302713 "Injury caused by animal bite",C1306459 "Primary malignant neoplasm",C2242979 "Microbial culture (procedure)"
32720 cultures and microscopic examination of cutaneous aspirates, biopsies, or swabs should be considered in patients with malignancy on chemotherapy, neutropenia, severe cell-mediated immunodeficiency, immersion injuries, and animal bites ( C0003062 Animals,C0003794 Arm Injuries,C0007634 Cells,C0015408 Eye Injuries,C0027947 Neutropenia,C0030705 Patients,C0086597 Mediate,C0205288 Microscopic,C0221912 Cutaneous,C0392207 inborn immunodeficiency,C0750591 consider,C1261188 Swab,C1855166 No immunodeficiency,C3665472 Chemotherapy,C3714592 Immersion,C3842363 No malignancy,C4321457 Examination,C0003044 "Animal bite",C0005658 "bite injury",C0007634 "Cells",C0013216 "Pharmacotherapy",C0021051 "Immunologic Deficiency Syndromes",C0026018 "Microscopy",C0027947 "Neutropenia",C0031809 "Physical Examination",C0038561 "Submersion",C0370199 "Aspirate substance",C0392920 "Chemotherapy Regimen",C1261188 "Swab",C1269647 "Entire cell",C1302713 "Injury caused by animal bite",C1306459 "Primary malignant neoplasm",C2242979 "Microbial culture (procedure)"
32721 Typical cases of cellulitis without systemic signs of infection should receive an antimicrobial agent that is active against streptococci C0007642 Cellulitis,C0038402 Streptococcus,C0205177 Active,C0205373 Systemic,C0332288 Without,C0450442 Agent,C0521124 Against,C1514756 Receive,C3714514 Infection,C0007642 "Cellulitis",C0243026 "Sepsis",C0311392 "Physical findings",C0450442 "Agent"
32722 For cellulitis with systemic signs of infection (See Fig. 1/Nonpurulent/MODERATE) systemic antibiotics are indicated. Many clinicians could include coverage against methicillin-susceptible S. aureus (MSSA) ( C0003232 Antibiotics,C0007642 Cellulitis,C0025643 Methicillin,C0205373 Systemic,C0231204 Susceptible,C0308738 COVERAGE 256,C0521124 Against,C0871685 Clinician,C1444656 Indicated,C1947903 See,C3714514 Infection,C0003232 "Antibiotics",C0007642 "Cellulitis",C0025643 "Methicillin",C0243026 "Sepsis",C0311392 "Physical findings"
32723 For patients whose cellulitis is associated with penetrating trauma, evidence of MRSA infection elsewhere, nasal colonization with MRSA, injection drug use, or SIRS vancomycin or another antimicrobial effective against both MRSA and streptococci is recommended C0007642 Cellulitis,C0030705 Patients,C0038402 Streptococcus,C0042313 Vancomycin,C0332281 Associated with,C0521124 Against,C1272883 Injection,C1550281 Mrsa:,C1704419 Effective,C1706086 Both,C1820977 Recommended diet,C3639310 BPI - Penetrating,C3714514 Infection,C3714660 Trauma,C3846195 Not Recommended,C3846199 Chem recommended,C3887511 Evidence,C4289767 Colonization,C0007642 "Cellulitis",C0013227 "Pharmaceutical Preparations",C0028429 "Nose",C0042313 "Vancomycin",C0043251 "Wounds and Injuries",C0343401 "MRSA - Methicillin resistant Staphylococcus aureus infection",C1272883 "Injection",C1533685 "Injection procedure",C3263723 "Traumatic injury"
32724 In severely compromised patients (patients who have failed oral antibiotic treatment or those with systemic signs of infection (such as temperature >38°C, tachycardia (heart rate >90 beats per minute), tachypnea (respiratory rate >24 breaths per minute) or abnormal white blood cell count (<12 000 or <400 cells/?L), or those who are immunocompromised,or those with clinical signs of deeper infection such as bullae, skin sloughing, hypotension, or evidence of organ dysfunction) broad-spectrum antimicrobial coverage may be considered C0003232 Antibiotics,C0005758 Bulla,C0005767 Blood,C0005771 Blood Cell Count,C0005773 Blood Cells,C0005903 Body Temperature,C0007584 Cell Count,C0007634 Cells,C0018787 Heart,C0018810 heart rate,C0020649 Hypotension,C0030705 Patients,C0039231 Tachycardia,C0039476 Temperature,C0085393 Immunocompromised Host,C0152009 White blood cell abnormality,C0178784 Organ,C0205161 Abnormal,C0205210 Clinical,C0205373 Systemic,C0225386 Breath,C0231175 Failed,C0231832 Respiratory rate,C0231835 Tachypnea,C0308738 COVERAGE 256,C0349410 Single organ dysfunction,C0437769 O/E - skin bullae,C0438221 White blood cell count normal,C0439083 >90,C0439087 <90,C0439385 beats per minute,C0439386 breaths per minute,C0442027 Oral,C0521346 respiratory,C0580531 White blood cell count abnormal,C0587785 Immunocompromised diet,C0702093 Per Minute,C0746919 NO TREATMENT,C0750480 Count,C0750591 consider,C0877198 Lip sloughing,C1123023 Skin,C1292504 White blood cell sample,C1521828 Rate,C2827424 Spectrum,C3241939 White blood cell test,C3714514 Infect,C0003232 "Antibiotics",C0005758 "Bulla",C0005767 "Blood",C0005771 "Blood Cell Count",C0005773 "Blood Cells",C0007584 "Cell Count",C0007634 "Cells",C0018787 "Heart",C0020649 "Hypotension",C0023508 "White Blood Cell Count procedure",C0023516 "Leukocytes",C0027544 "Necrotic debris",C0039231 "Tachycardia",C0152009 "White blood cell abnormality",C0225386 "Breath",C0231835 "Tachypnea",C0243026 "Sepsis",C0275521 "Clinical infection",C0311392 "Physical findings",C0333717 "Abnormal cell",C0333794 "Abnormal cellular component of blood",C0449201 "PER tumor staging notation",C1123023 "Skin",C1269647 "Entire cell",C1278993 "Entire skin",C1281570 "Entire heart",C1294063 "Abnormal blood cell count (procedure)"
32725 Vancomycin plus either piperacillin-tazobactam or imipenem/meropenem is recommended as a reasonable empiric regimen for severe infections C0020933 Imipenem,C0031955 Piperacillin,C0042313 Vancomycin,C0066005 meropenem,C0075870 tazobactam,C1820977 Recommended diet,C1879523 AT Regimen,C1880496 Empiric,C3714514 Infection,C3844638 Either,C3846195 Not Recommended,C3846199 Chem recommended,C0020933 "Imipenem",C0031955 "Piperacillin",C0042313 "Vancomycin",C0066005 "meropenem",C0075870 "tazobactam"
32726 The recommended duration of antimicrobial therapy is 5 days, but treatment should be extended if the infection has not improved within this time period C0040223 Time,C0184511 Improved,C0231449 Extended,C0332285 Within,C0746919 NO TREATMENT,C1820977 Recommended diet,C2926735 Duration,C3714514 Infection,C3846195 Not Recommended,C3846199 Chem recommended,C0087111 "Therapeutic procedure",C2926735 "Duration"
32727 Elevation of the affected area and treatment of predisposing factors, such as edema or underlying cutaneous disorders, are recommended C0013604 Edema,C0205146 Area,C0221912 Cutaneous,C0349738 Cutaneous disorders of Yaws,C0702240 Elevation,C0746919 NO TREATMENT,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0012634 "Disease",C0013604 "Edema",C0439775 "Elevation procedure"
32728 In lower extremity cellulitis, clinicians should carefully examine the interdigital toe spaces because treating fissuring, scaling, or maceration may eradicate colonization with pathogens and reduce the incidence of recurrent infection C0007642 Cellulitis,C0021149 Incidence,C0023216 Lower Extremity,C0239998 Recurrent infections,C0333525 Maceration,C0442105 Interdigital,C0871685 Clinician,C1522326 Treating,C1837066 Recurrent viral infection,C1853193 Recurrent skin infections,C1947916 Scaling,C2945760 Recurrent,C3714514 Infection,C4289767 Colonization,C0007642 "Cellulitis",C0015385 "Limb structure",C0023216 "Lower Extremity",C0040357 "Toes",C0237849 "Peeling of skin",C0278456 "Structure of interdigital space",C0333525 "Maceration",C1281539 "Entire interdigital space",C1281589 "Entire toe"
32729 Outpatient therapy is recommended for patients who do not have SIRS, altered mental status, or hemodynamic instability C0019010 Hemodynamics,C0029921 Outpatients,C0030705 Patients,C0278060 Mental state,C0449438 Status,C0919772 Hemodynamic test,C0948268 Hemodynamic instability,C1444783 Instability,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0087111 "Therapeutic procedure",C0278060 "Mental state",C0948268 "Hemodynamic instability",C1444783 "Instability"
32730 Hospitalization is recommended if there is concern for a deeper or necrotizing infection, for patients with poor adherence to therapy, for infection in a severely immunocompromised patient or if outpatient treatment is failing C0019993 Hospitalization,C0029921 Outpatients,C0030705 Patients,C0085393 Immunocompromised Host,C0439664 Necrotizing,C0587785 Immunocompromised diet,C0746919 NO TREATMENT,C1820977 Recommended diet,C2699424 Concern,C3714514 Infection,C3846195 Not Recommended,C3846199 Chem recommended,C0087111 "Therapeutic procedure"
32731 Systemic corticosteroids (eg, prednisone 40 mg daily for 7 days) could be considered in nondiabetic adult patients with cellulitis C0001675 Adult,C0007642 Cellulitis,C0030705 Patients,C0032952 Prednisone,C0205373 Systemic,C0239126 corticosteroid use,C0332173 Daily,C0352680 corticosteroids cream,C0439509 /40,C0750591 consider,C3842587 40%,C4321396 MG,C0001617 "Adrenal Cortex Hormones",C0007642 "Cellulitis",C0032952 "Prednisone",C1382730 "Prednisone 40 MG"
32732 Identify and treat predisposing conditions such as edema, obesity, eczema, venous insufficiency, and toe web abnormalities. These practices should be performed as part of routine patient care and certainly during the acute stage of cellulitis. C0007642 Cellulitis,C0013595 Eczema,C0013604 Edema,C0015393 Eye Abnormalities,C0028754 Obesity,C0030705 Patients,C0042485 Venous Insufficiency,C0205178 acute,C0205547 Routine,C0231179 Insufficiency,C0347984 During,C0348013 Venous,C0449719 Part,C0884358 Performed,C1306673 Stage,C3809765 No abnormalities,C0007642 "Cellulitis",C0013595 "Eczema",C0013604 "Edema",C0028754 "Obesity",C0040357 "Toes",C0230506 "Interdigital space of foot",C0332875 "Congenital webbing",C1281589 "Entire toe"
32733 Administration of prophylactic antibiotics, such as oral penicillin or erythromycin bid for 4-52 weeks, or intramuscular benzathine penicillin every 2-4 weeks should be considered in patients who have 3-4 episodes of cellulitis per year despite attempts to treat or control predisposing factors C0001555 administration & dosage,C0001557 Administration, Buccal,C0003232 Antibiotics,C0007642 Cellulitis,C0014806 Erythromycin,C0030705 Patients,C0030829 penicillin G benzathine,C0030842 Penicillins,C0053153 benzathine,C0220892 Penicillin,C0404392 Prophylactic oxytocic administration,C0439230 week,C0439234 year,C0439508 per year,C0442027 Oral,C0442117 Intramuscular,C0442757 3/4,C0750591 consider,C1442457 2 Weeks,C1442462 3 Weeks,C1442465 4 Weeks,C2348003 Agent Administration,C3843352 No attempts,C0003232 "Antibiotics",C0007642 "Cellulitis",C0014806 "Erythromycin",C0030829 "penicillin G benzathine",C0030842 "Penicillins",C0199779 "Administration of antibiotic",C0220892 "Penicillin",C0308718 "CONTROL veterinary product",C0360341 "Erythromycin Oral Product",C1533734 "Administration procedure"
32734 This program should be continued so long as the predisposing factors persist C0205166 Long,C2728259 Program,C3499620 BD Persist,C2728259 "Program"
32735 Suture removal plus incision and drainage should be performed for surgical site infections C0152277 Incision and drainage,C0181296 Incision/drainage kit,C0183720 Suture removal kit,C0184936 Removal of sutures,C0205145 Site,C0884358 Performed,C3714514 Infection,C0012621 "Body Fluid Discharge",C0013103 "Drainage procedure",C0015252 "removal technique",C0038969 "Surgical sutures",C0184898 "Surgical incisions",C0543467 "Operative Surgical Procedures"
32736 Adjunctive systemic antimicrobial therapy is NOT routinely indicated but in conjunction with incision and drainage may be beneficial for surgical site infections associated with a significant systemic response such as erythema and induration extending >5 cm from the wound edge, temperature >38.5ºC, heart rate >110/min, or WBC count >12,000/mm3 C0005903 Body Temperature,C0018787 Heart,C0018810 heart rate,C0039476 Temperature,C0041834 Erythema,C0152277 Incision and drainage,C0181296 Incision/drainage kit,C0205145 Site,C0205373 Systemic,C0332281 Associated with,C0332534 Induration,C0750480 Count,C0750502 Significant,C1292783 Adjunctive care,C1300557 /mm3,C1444656 Indicated,C1521828 Rate,C1545981 Wound edge,C2699427 Conjunction,C3714514 Infection,C4282382 No response,C4517536 110,C0012621 "Body Fluid Discharge",C0013103 "Drainage procedure",C0018787 "Heart",C0023508 "White Blood Cell Count procedure",C0041834 "Erythema",C0043250 "Injury wounds",C0087111 "Therapeutic procedure",C0184898 "Surgical incisions",C0332534 "Induration",C0543467 "Operative Surgical Procedures",C1281570 "Entire heart"
32737 A brief course of systemic antimicrobial therapy is indicated in patients with surgical site infections after clean operations on the trunk, head and neck, or extremities that also have systemic signs of infection C0018670 Head,C0027530 Neck,C0030705 Patients,C0205145 Site,C0205373 Systemic,C0278454 All extremities,C0750729 Course,C1444656 Indicated,C1879313 Brief,C3714514 Infection,C0018670 "Head",C0027530 "Neck",C0087111 "Therapeutic procedure",C0185774 "Operation on trunk",C0243026 "Sepsis",C0311392 "Physical findings",C0460004 "Head and neck structure",C0460005 "Trunk structure",C0543467 "Operative Surgical Procedures",C1280632 "Entire trunk",C1281590 "Entire head",C1281592 "Entire neck",C1283900 "Entire head and neck"
32738 A first-generation cephalosporin or an anti-staphylococcal penicillin for MSSA or vancomycin, linezolid, daptomycin, telavancin or ceftaroline where risk factors for MRSA are high (nasal colonization, prior MRSA infection, recent hospitalization, recent antibiotics) is recommended C0003232 Antibiotics,C0019993 Hospitalization,C0030842 Penicillins,C0035647 Risk,C0038167 Staphylococcal Toxoid,C0042313 Vancomycin,C0055075 cephalosporin C,C0057144 Daptomycin,C0079411 Generations,C0205250 High,C0220892 Penicillin,C0304317 First generation cephalosporin,C0304319 Second generation cephalosporin,C0304320 Third generation cephalosporin,C0314650 F>1< generation,C0314651 F>2< generation,C0332185 Recent,C0361823 Fourth generation cephalosporin,C0392343 Generation Gap,C0455939 A/N risk factors,C0663241 linezolid,C1453642 telavancin,C1550281 Mrsa:,C1820977 Recommended diet,C2001521 ceftaroline,C3536856 Cephalosporins,C3714514 Infection,C3846195 Not Recommended,C3846199 Chem recommended,C4289767 Colonization,C0003232 "Antibiotics",C0028429 "Nose",C0030842 "Penicillins",C0042313 "Vancomycin",C0057144 "Daptomycin",C0220892 "Penicillin",C0304317 "First generation cephalosporin",C0343401 "MRSA - Methicillin resistant Staphylococcus aureus infection",C0663241 "linezolid",C1453642 "telavancin",C2001521 "ceftaroline",C2266959 "Cephalosporin Antibacterial [EPC]"
32739 Agents active against Gram-negative bacteria and anaerobes, such as a cephalosporin or fluoroquinolone in combination with metronidazole, are recommended for infections after operations on the axilla, gastrointestinal (GI) tract, perineum or female genital tract C0004454 Axilla,C0004611 Bacteria,C0017420 Genitalia,C0017421 Female genitalia,C0025872 Metronidazole,C0052142 AP combination,C0054603 CAP combination,C0055075 cephalosporin C,C0086287 Females,C0205160 Negative,C0205177 Active,C0227749 Female genital fluid,C0262498 Female genital tract problem,C0439208 gram,C0444206 Female genital swab,C0521124 Against,C0521362 gastrointestinal,C0567314 Female genital tract normal,C0762875 K-12, fluoroquinolone,C0949665 Fluoroquinolones,C1185740 Tract,C1443304 Entire female genital tract,C1636650 US scan of female genital tract,C1820977 Recommended diet,C3266626 Gram Negative Broth,C3536856 Cephalosporins,C3714514 Infection,C3846195 Not Recommended,C3846199 Chem recommended,C0004454 "Axilla",C0017421 "Female genitalia",C0025872 "Metronidazole",C0031066 "Anogenital region",C0450442 "Agent",C0543467 "Operative Surgical Procedures",C0559522 "Genital system",C0700038 "Female Reproductive System",C1279154 "Entire axilla",C1280088 "Entire perineum",C1283835 "Entire axillary fossa",C1284953 "Entire axillary region",C2266959 "Cephalosporin Antibacterial [EPC]"
32740 Prompt surgical consultation is recommended for patients with aggressive infections associated with signs of systemic toxicity or suspicion of necrotizing fasciitis or gas gangrene C0009818 Consultation,C0015645 Fasciitis,C0017086 Gangrene,C0017105 Gas Gangrene,C0030705 Patients,C0205373 Systemic,C0238124 Necrotizing fasciitis,C0242114 Suspicion,C0332281 Associated with,C0439664 Necrotizing,C1602245 Prompt,C1820977 Recommended diet,C3714514 Infection,C3846195 Not Recommended,C3846199 Chem recommended,C0009818 "Consultation",C0015645 "Fasciitis",C0017086 "Gangrene",C0017105 "Gas Gangrene",C0017110 "Gases",C0238124 "Necrotizing fasciitis",C0311392 "Physical findings",C0543467 "Operative Surgical Procedures",C0600688 "Toxic effect",C1602245 "Prompt",C1704673 "Gas Dosage Form"
32741 Empiric antibiotic treatment should be broad (eg, vancomycin or linezolid plus piperacillin-tazobactam or plus a carbapenem; or plus ceftriaxone and metronidazole), since the etiology can be polymicrobial (mixed aerobic-anaerobic microbes) or monomicrobial (Group A streptococcus, community-acquired MRSA) C0003232 Antibiotics,C0006968 Carbapenems,C0007561 Ceftriaxone,C0009462 Community,C0025872 Metronidazole,C0031955 Piperacillin,C0038402 Streptococcus,C0042313 Vancomycin,C0075870 tazobactam,C0318158 Group C streptococcus,C0318160 Streptococcus, group E,C0318161 Streptococcus, group F,C0318162 Streptococcus, group G,C0318163 Streptococcus, group H,C0318164 Streptococcus, group K,C0318165 Streptococcus, group L,C0318166 Streptococcus, group M,C0318167 Streptococcus, group N,C0318168 Streptococcus, group O,C0318169 Streptococcus, group P,C0318170 Streptococcus, group Q,C0318171 Streptococcus, group R,C0318172 Streptococcus, group S,C0318173 Streptococcus, group T,C0441833 Groups,C0456394 Community acquired,C0663241 linezolid,C0746919 NO TREATMENT,C1314792 Etiology,C1510824 Aerobic,C1550281 Mrsa:,C1711239 Since,C1880496 Empiric,C3641081 Anaerobic,C0003232 "Antibiotics",C0006968 "Carbapenems",C0007561 "Ceftriaxone",C0025872 "Metronidazole",C0031955 "Piperacillin",C0042313 "Vancomycin",C0075870 "tazobactam",C0663241 "linezolid"
32742 Penicillin plus clindamycin is recommended for treatment of documented Group A streptococcal necrotizing fasciitis C0008947 Clindamycin,C0015645 Fasciitis,C0030842 Penicillins,C0038402 Streptococcus,C0220892 Penicillin,C0238124 Necrotizing fasciitis,C0439664 Necrotizing,C0441833 Groups,C0746919 NO TREATMENT,C0854084 Streptococcal necrotizing fasciitis,C1301725 Documented,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0008947 "Clindamycin",C0015645 "Fasciitis",C0030842 "Penicillins",C0220892 "Penicillin",C0238124 "Necrotizing fasciitis",C0854084 "Streptococcal necrotizing fasciitis"
32743 Magnetic resonance imaging (MRI) is the recommended imaging modality for establishing the diagnosis of pyomyositis. Computed tomography (CT) scan and ultrasound studies are also useful. C0011900 Diagnosis,C0024485 Magnetic Resonance Imaging,C0040395 tomography,C0040405 X-Ray Computed Tomography,C0412588 Computed tomography of orbits,C0412604 Computed Tomography (CT) of Neck,C0695347 Modality,C1275506 Imaging modality,C1285464 Ultrasound studies by site,C1704275 Pyomyositis,C1820977 Recommended diet,C2364239 Establishing Trust,C3827682 Useful,C3846195 Not Recommended,C3846199 Chem recommended,C0011900 "Diagnosis",C0011923 "Diagnostic Imaging",C0024485 "Magnetic Resonance Imaging",C0040395 "tomography",C0040405 "X-Ray Computed Tomography",C0041618 "Ultrasonography",C0231881 "Pulmonary resonance",C1704275 "Pyomyositis"
32744 Cultures of blood and abscess material should be obtained C0000833 Abscess,C0005767 Blood,C0520510 Materials,C1301820 Obtain,C1882120 Not Obtained,C0000833 "Abscess",C0005767 "Blood",C2242979 "Microbial culture (procedure)"
32745 Vancomycin is recommended for initial empiric therapy. An agent active against enteric Gram-negative bacilli should be added for infection in immunocompromised patients or after open trauma to the muscles (SR-M). C0030705 Patients,C0042313 Vancomycin,C0085393 Immunocompromised Host,C0175566 Open,C0205160 Negative,C0205177 Active,C0205265 Initially,C0439208 gram,C0450442 Agent,C0521124 Against,C0587785 Immunocompromised diet,C1820977 Recommended diet,C1880496 Empiric,C3266626 Gram Negative Broth,C3714514 Infection,C3714660 Trauma,C3846195 Not Recommended,C3846199 Chem recommended,C0026845 "Muscle Tissue",C0042313 "Vancomycin",C0043251 "Wounds and Injuries",C0087111 "Therapeutic procedure",C0450442 "Agent",C3263723 "Traumatic injury"
32746 Cefazolin or antistaphylococcal penicillin (eg, nafcillin or oxacillin) is recommended for treatment of pyomyositis caused by MSSA (SR-M). C0007546 Cefazolin,C0027324 Nafcillin,C0029983 Oxacillin,C0030842 Penicillins,C0220892 Penicillin,C0746919 NO TREATMENT,C1704275 Pyomyositis,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0007546 "Cefazolin",C0027324 "Nafcillin",C0029983 "Oxacillin",C0030842 "Penicillins",C0220892 "Penicillin",C1704275 "Pyomyositis"
32747 Early drainage of purulent material should be performed C0439665 Purulent,C0520510 Materials,C0884358 Performed,C1279919 Early,C0012621 "Body Fluid Discharge",C0013103 "Drainage procedure"
32748 Repeat imaging studies should be performed in patients with persistent bacteremia to identify undrained foci of infection C0004610 Bacteremia,C0030705 Patients,C0205322 Persistent,C0205341 Repeat,C0884358 Performed,C3714514 Infection,C4321394 Foci,C0004610 "Bacteremia",C0011923 "Diagnostic Imaging"
32749 Antibiotics should be administered intravenously initially, but once the patient is clinically improved oral antibiotics are appropriate for patients in whom bacteremia cleared promptly and there is no evidence of endocarditis or metastatic abscess. Two to three weeks of therapy is recommended. C0000833 Abscess,C0003232 Antibiotics,C0004610 Bacteremia,C0014118 Endocarditis,C0030705 Patients,C0036525 Metastatic to,C0184511 Improved,C0205265 Initially,C0205448 Two,C0205449 Three,C0332125 No evidence of,C0439230 week,C0442027 Oral,C0521097 Cleared by,C1442457 2 Weeks,C1442462 3 Weeks,C1442465 4 Weeks,C1548562 Not Administered,C1548787 Appropriate,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C3887511 Evidence,C4082109 Three weeks,C0000833 "Abscess",C0003232 "Antibiotics",C0004610 "Bacteremia",C0014118 "Endocarditis",C0087111 "Therapeutic procedure"
32750 Urgent surgical exploration of the suspected gas gangrene site and surgical debridement of involved tissue should be performed C0011079 Debridement,C0017086 Gangrene,C0017105 Gas Gangrene,C0205145 Site,C0439609 Urgent,C0455097 Surgical debridement of wound,C0884358 Performed,C1997218 NOT suspected,C4296884 Not involved,C0011079 "Debridement",C0017086 "Gangrene",C0017105 "Gas Gangrene",C0017110 "Gases",C0040300 "Body tissue",C0184899 "Exploratory incision",C0543467 "Operative Surgical Procedures",C1280903 "Exploration procedure",C1704673 "Gas Dosage Form"
32751 In the absence of a definitive etiologic diagnosis, broad-spectrum treatment with vancomycin plus either piperacillin/tazobactam, ampicillin/sulbactam or a carbapenem antimicrobial is recommended (SR-L). C0002680 Ampicillin,C0006968 Carbapenems,C0011900 Diagnosis,C0031955 Piperacillin,C0038665 Sulbactam,C0042313 Vancomycin,C0075870 tazobactam,C0443196 Definitive,C0746919 NO TREATMENT,C1820977 Recommended diet,C2827424 Spectrum,C2930041 Ampicillin / Sulbactam,C3844638 Either,C3846195 Not Recommended,C3846199 Chem recommended,C0002680 "Ampicillin",C0006968 "Carbapenems",C0011900 "Diagnosis",C0031955 "Piperacillin",C0038665 "Sulbactam",C0042313 "Vancomycin",C0075870 "tazobactam",C1689985 "Absence (morphologic abnormality)"
32752 Definitive antimicrobial therapy with penicillin and clindamycin is recommended for treatment of clostridial myonecrosis (SR-L). C0008947 Clindamycin,C0030842 Penicillins,C0220892 Penicillin,C0443196 Definitive,C0746919 NO TREATMENT,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0008947 "Clindamycin",C0017105 "Gas Gangrene",C0030842 "Penicillins",C0087111 "Therapeutic procedure",C0220892 "Penicillin"
32753 Hyperbaric oxygen therapy is NOT recommended because it has not been proven as a benefit to patients and may delay resuscitation and surgical debridement (SR-L). C0011079 Debridement,C0020431 Hyperbaric oxygenation therapy,C0030054 Oxygen,C0030705 Patients,C0150238 Fluid resuscitation,C0184633 Oxygen Therapy Care,C0455097 Surgical debridement of wound,C0814225 Benefit,C1293855 Whole body hyperbaric oxygen therapy,C1820977 Recommended diet,C1960973 Home oxygen therapy,C3846195 Not Recommended,C3846199 Chem recommended,C0011079 "Debridement",C0020431 "Hyperbaric oxygenation therapy",C0030054 "Oxygen",C0035273 "Resuscitation procedure",C0087111 "Therapeutic procedure",C0184633 "Oxygen Therapy Care",C0543467 "Operative Surgical Procedures"
32754 Preemptive early antimicrobial therapy for 3-5 days is recommended for patients who: a) are immunocompromised; b) are asplenic; c) have advanced liver disease; d) have preexisting or resultant edema of the affected area; e) have moderate to severe injuries, especially to the hand or face; or f) have injuries that may have penetrated the periosteum or joint capsule (SR-L). C0003794 Arm Injuries,C0012634 Disease,C0013604 Edema,C0015408 Eye Injuries,C0015450 Face,C0018563 Hand,C0022417 Joints,C0023884 Liver,C0023895 Liver diseases,C0030705 Patients,C0031110 Periosteum,C0085393 Immunocompromised Host,C0205146 Area,C0348754 Toxic liver disease,C0442758 3/5,C0455417 FH: Liver disease,C0455550 H/O: liver disease,C0587785 Immunocompromised diet,C1279919 Early,C1299393 Moderate to severe,C1820977 Recommended diet,C2347662 Pre-existing,C3846195 Not Recommended,C3846199 Chem recommended,C0006935 "capsule (pharmacologic)",C0012634 "Disease",C0013604 "Edema",C0015450 "Face",C0018563 "Hand",C0022417 "Joints",C0023884 "Liver",C0023895 "Liver diseases",C0031110 "Periosteum",C0087111 "Therapeutic procedure",C1269611 "Entire joint",C1278929 "Entire liver",C1281583 "Entire hand",C1281591 "Entire face"
32755 Postexposure prophylaxis for rabies may be indicated. Consultation with local health officials is recommended to determine if vaccination should be initiated (SR-L). C0009818 Consultation,C0018684 Health,C0042196 Vaccination,C0182428 Prophylaxis Cups,C0205276 Local,C0521095 Determined by,C1320204 Rabies prophylaxis,C1444656 Indicated,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C0009818 "Consultation",C0034494 "Rabies (disorder)",C0042196 "Vaccination",C0199176 "Prophylactic treatment"
32756 An antimicrobial agent or agents active against both aerobic and anaerobic bacteria such as amoxicillin-clavulanate should be used C0002645 Amoxicillin,C0004611 Bacteria,C0004613 Bacteria, Anaerobic,C0054066 Amoxicillin / Clavulanate,C0110038 Clavulanate,C0205177 Active,C0450442 Agent,C0521124 Against,C1510824 Aerobic,C1532934 Strict anaerobic bacteria,C1706086 Both,C3641081 Anaerobic,C0002645 "Amoxicillin",C0110038 "Clavulanate",C0450442 "Agent"
32757 Tetanus toxoid should be administered to patients without toxoid vaccination within 10 years. Tdap is preferred over Td if the former has not been previously given (SR-L). C0030705 Patients,C0039614 Tetanus,C0040555 Toxoids,C0042196 Vaccination,C0332285 Within,C0332288 Without,C0439234 year,C0750523 FORMER,C1270260 Tetanus toxoid RAST,C1442162 GIVEN,C1548562 Not Administered,C2114533 previously well,C3842590 10%,C3843647 > 2 years,C0039614 "Tetanus",C0039620 "Tetanus Vaccine",C0040555 "Toxoids",C0042196 "Vaccination",C0305060 "Tetanus and diphtheria toxoid adsorbed for adult use",C0305062 "tetanus toxoid vaccine, inactivated"
32758 Primary wound closure is NOT recommended for wounds, with the exception of those to the face, which should be managed with copious irrigation, cautious debridement and preemptive antibiotics. C0003232 Antibiotics,C0011079 Debridement,C0015450 Face,C0022100 Irrigation,C0205225 Primary,C1521802 Closure,C1547545 No Exception,C1820977 Recommended diet,C3845930 Copious,C3846195 Not Recommended,C3846199 Chem recommended,C0003232 "Antibiotics",C0011079 "Debridement",C0015450 "Face",C0022100 "Irrigation",C0043250 "Injury wounds",C0185003 "Reparative closure",C0439631 "Primary operation",C0441503 "primary closure",C1281591 "Entire face"
32759 Other wounds may be approximated (WR-L). C0205394 Other,C0332232 Approximate,C0043250 "Injury wounds",C0449210 "OTH tumor staging notation"
32760 Oral penicillin V 500 mg qid for 7-10 days is the recommended treatment for naturally acquired cutaneous anthrax (SR-H). C0003177 Cutaneous anthrax,C0030842 Penicillins,C0220892 Penicillin,C0221912 Cutaneous,C0442027 Oral,C0746919 NO TREATMENT,C1820977 Recommended diet,C3816747 500,C3842590 10%,C3846195 Not Recommended,C3846199 Chem recommended,C4321396 MG,C0003175 "Anthrax disease",C0003177 "Cutaneous anthrax",C0030840 "Penicillin V",C0030842 "Penicillins",C0220892 "Penicillin",C1125626 "Penicillin V 500 MG"
32761 Ciprofloxacin 500 mg PO bid or levofloxacin 500 mg IV/PO q24h for 60 days is recommended for bioterrorism cases because of presumed aerosol exposure. C0001712 Aerosols,C0008809 Ciprofloxacin,C0101745 Aerosol OT,C0282386 Levofloxacin,C0332157 Exposure to,C0872021 Bioterrorism,C1820977 Recommended diet,C3816747 500,C3842585 60%,C3846195 Not Recommended,C3846199 Chem recommended,C4321396 MG,C0008809 "Ciprofloxacin",C0150009 "At risk for activity intolerance",C0150032 "At risk for deficient fluid volume",C0150061 "At risk for poisoning injury",C0150082 "At risk for suffocation",C0231357 "At risk for impaired skin integrity",C0231359 "At risk for imbalanced body temperature",C0231379 "At risk for joint contractures",C0231393 "At risk for cognitive impairment",C0231416 "At risk for deficient parenting",C0231418 "At risk for violence",C0274281 "Injury due to exposure to external cause",C0282386 "Levofloxacin",C0582147 "At risk of infection",C0582456 "At risk of injury",C0992502 "Levofloxacin 500 MG",C1112870 "Aerosol Dose Form",C1123173 "Ciprofloxacin 500 MG"
32762 Azithromycin is recommended for cat scratch disease. Patients >45 kg, 500 mg on day 1 followed by 250 mg for 4 additional days. Patients <45 kg, 10 mg/kg on day 1 and 5 mg/kg for 4 more days C0007361 Cat-Scratch Disease,C0012634 Disease,C0030705 Patients,C0052796 Azithromycin,C0205172 More,C0238909 Cat scratch,C0301453 Cat scratch disease antigen,C0332283 Followed by,C0439228 day,C0439400 mg/day/kg,C0439418 kg/day,C1524062 Additional,C1532536 g/kg/day,C1820977 Recommended diet,C3665414 mg/kg/day,C3816747 500,C3842590 10%,C3846195 Not Recommended,C3846199 Chem recommended,C4321396 MG,C0007361 "Cat-Scratch Disease",C0012634 "Disease",C0052796 "Azithromycin",C0238909 "Cat scratch",C1384489 "Scratch marks"
32763 Erythromycin 500 mg qid or doxycycline 100 mg bid for 2 weeks to 2 months is recommended for treatment of bacillary angiomatosis (SR-M). C0002992 Angiomatosis,C0013090 Doxycycline,C0014806 Erythromycin,C0085434 Angiomatosis, Bacillary,C0439230 week,C0439231 month,C0746919 NO TREATMENT,C1442456 2 Months,C1442457 2 Weeks,C1442461 3 Months,C1442462 3 Weeks,C1442465 4 Weeks,C1820977 Recommended diet,C3816747 500,C3817553 100%,C3843385 36+ months,C3846195 Not Recommended,C3846199 Chem recommended,C4321396 MG,C0002992 "Angiomatosis",C0013090 "Doxycycline",C0014806 "Erythromycin",C0085434 "Angiomatosis, Bacillary",C1123142 "Doxycycline 100 MG",C1374596 "Erythromycin 500 MG"
32764 Penicillin 500 mg qid or amoxicillin 500 mg tid for 7-10 days is recommended for treatment of erysipeloid (SR-H). C0002645 Amoxicillin,C0030842 Penicillins,C0220892 Penicillin,C0746919 NO TREATMENT,C1820977 Recommended diet,C3816747 500,C3842590 10%,C3846195 Not Recommended,C3846199 Chem recommended,C4321396 MG,C0002645 "Amoxicillin",C0014736 "Erysipelothrix infection",C0030842 "Penicillins",C0220892 "Penicillin",C0993263 "Amoxicillin 500 MG",C1276801 "Infection due to Erysipelothrix rhusiopathiae (disorder)"
32765 Ceftazidime, gentamicin, imipenem, doxycycline or ciprofloxacin is recommended based on in vitro susceptibility (SR-L). C0007559 Ceftazidime,C0008809 Ciprofloxacin,C0013090 Doxycycline,C0020933 Imipenem,C0183715 Susceptibility Panels,C1547045 *Susceptibility,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C3854019 Gentamicin,C0007559 "Ceftazidime",C0008809 "Ciprofloxacin",C0013090 "Doxycycline",C0017436 "Gentamicins",C0020933 "Imipenem"
32766 Bubonic plague should be diagnosed by Gram stain and culture of aspirated material from a suppurative lymph node C0024202 Lymph,C0024204 lymph nodes,C0032064 Plague,C0038128 Stains,C0061856 Gram's stain,C0282312 Bubonic Plague,C0439208 gram,C0520510 Materials,C0024202 "Lymph",C0024204 "lymph nodes",C0032064 "Plague",C0038128 "Stains",C0061856 "Gram's stain",C0200966 "Bacterial stain, routine",C0282312 "Bubonic Plague",C1269047 "Entire lymph node",C2242979 "Microbial culture (procedure)",C3249881 "Infection - suppurative"
32767 Streptomycin 15 mg/kg IM q12h or doxycycline 100 mg bid PO is recommended for treatment of bubonic plague (SR-L). C0013090 Doxycycline,C0032064 Plague,C0038425 Streptomycin,C0282312 Bubonic Plague,C0746919 NO TREATMENT,C1820977 Recommended diet,C3817553 100%,C3846195 Not Recommended,C3846199 Chem recommended,C4321396 MG,C0013090 "Doxycycline",C0032064 "Plague",C0038425 "Streptomycin",C0150009 "At risk for activity intolerance",C0150032 "At risk for deficient fluid volume",C0150061 "At risk for poisoning injury",C0150082 "At risk for suffocation",C0231357 "At risk for impaired skin integrity",C0231359 "At risk for imbalanced body temperature",C0231377 "At risk for impaired home maintenance management",C0231379 "At risk for joint contractures",C0231393 "At risk for cognitive impairment",C0231416 "At risk for deficient parenting",C0231418 "At risk for violence",C0282312 "Bubonic Plague",C0582147 "At risk of infection",C0582456 "At risk of injury",C1123142 "Doxycycline 100 MG"
32769 Serologic tests are the preferred method of diagnosing tularemia (WR-L). C0011900 Diagnosis,C0025663 Methods,C0041351 Tularemia,C0205473 Serologic,C0036743 "Serologic tests",C0041351 "Tularemia"
32770 Streptomycin 15 mg/kg q12h IM or gentamicin 1.5 mg/kg q8h IV is recommended for treatment of severe cases of tularemia (SR-L). C0038425 Streptomycin,C0041351 Tularemia,C0746919 NO TREATMENT,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C3854019 Gentamicin,C4321396 MG,C0017436 "Gentamicins",C0038425 "Streptomycin",C0041351 "Tularemia",C0231377 "At risk for impaired home maintenance management"
32771 Tetracycline 500 mg qid or doxycycline 100 mg bid PO is recommended for treatment of mild cases of tularemia (SR-L). C0013090 Doxycycline,C0039644 Tetracycline,C0041351 Tularemia,C0746919 NO TREATMENT,C1820977 Recommended diet,C3816747 500,C3817553 100%,C3846195 Not Recommended,C3846199 Chem recommended,C4321396 MG,C0013090 "Doxycycline",C0039644 "Tetracycline",C0041351 "Tularemia",C0150009 "At risk for activity intolerance",C0150032 "At risk for deficient fluid volume",C0150061 "At risk for poisoning injury",C0150082 "At risk for suffocation",C0231357 "At risk for impaired skin integrity",C0231359 "At risk for imbalanced body temperature",C0231379 "At risk for joint contractures",C0231393 "At risk for cognitive impairment",C0231416 "At risk for deficient parenting",C0231418 "At risk for violence",C0582147 "At risk of infection",C0582456 "At risk of injury",C1123142 "Doxycycline 100 MG",C1123624 "Tetracycline 500 MG"
32772 Notify the microbiology laboratory if tularemia is suspected (SR-H). C0001867 Air Microbiology,C0016477 Food Microbiology,C0022877 Laboratory,C0037593 Soil Microbiology,C0041351 Tularemia,C1997218 NOT suspected,C0041351 "Tularemia",C0085672 "Microbiology procedure"
32773 In addition to infection, differential diagnosis of skin lesions should include drug eruption, cutaneous infiltration with the underlying malignancy, chemotherapy- or radiation-induced reactions, Sweet’s syndrome, erythema multiforme, leukocytoclastic vasculitis and graftversus-host disease among allogeneic transplant recipients (SR-H). C0011609 Drug Eruptions,C0011900 Diagnosis,C0011906 Differential Diagnosis,C0012634 Disease,C0014742 Erythema Multiforme,C0039082 Syndrome,C0041834 Erythema,C0042384 Vasculitis,C0085077 Sweet Syndrome,C0151436 Vasculitis, Leukocytoclastic, Cutaneous,C0221198 Lesion,C0221242 Fixed drug eruption,C0221912 Cutaneous,C0302295 Eruptions,C0332448 Infiltration,C0442740 No reaction,C0851346 Radiation,C1123023 Skin,C1515895 Allogeneic,C1705242 Different,C3665472 Chemotherapy,C3714514 Infection,C3841811 Transplant,C3842363 No malignancy,C0011609 "Drug Eruptions",C0011900 "Diagnosis",C0011906 "Differential Diagnosis",C0012634 "Disease",C0013216 "Pharmacotherapy",C0013227 "Pharmaceutical Preparations",C0014742 "Erythema Multiforme",C0015230 "Exanthema",C0037284 "Skin lesion",C0039082 "Syndrome",C0040732 "Transplantation",C0041834 "Erythema",C0042384 "Vasculitis",C0151436 "Vasculitis, Leukocytoclastic, Cutaneous",C0221198 "Lesion",C0302295 "Eruptions",C0332448 "Infiltration",C0332835 "Transplanted tissue",C0392920 "Chemotherapy Regimen",C0702249 "Infiltration (procedure)",C1123023 "Skin",C1278993 "Entire skin",C1306459 "Primary malignant neoplasm",C2973529 "Leukocytoclastic vasculitis"
32774 Differential diagnosis for infection of skin lesions should include bacterial, fungal, viral and parasitic agents (SR-H). C0011900 Diagnosis,C0011906 Differential Diagnosis,C0221198 Lesion,C0521009 Bacterial,C0521026 Viral,C0521033 Fungal,C0521066 parasitic,C1123023 Skin,C1705242 Different,C3714514 Infection,C0011900 "Diagnosis",C0011906 "Differential Diagnosis",C0037278 "Skin Diseases, Infectious",C0037284 "Skin lesion",C0221198 "Lesion",C0304207 "Bacterial product",C0450442 "Agent",C1123023 "Skin",C1268919 "Fungal product",C1278993 "Entire skin"
32775 Biopsy or aspiration of the lesion to obtain material for histologic and microbiologic evaluation should always be implemented as an early diagnostic step (SR-H). C0005558 Biopsy,C0205462 Histologic,C0220825 Evaluation,C0221198 Lesion,C0348026 Diagnostic,C0520510 Materials,C1279919 Early,C1301820 Obtain,C4520547 Implemented,C0005558 "Biopsy",C0220787 "Endotracheal aspiration",C0221198 "Lesion",C0349707 "Aspiration-action",C0700198 "Pulmonary aspiration",C1261322 "Evaluation procedure"
32776 Determine whether the current presentation of fever and neutropenia is the patient’s initial episode of fever and neutropenia or a persistent unexplained fever from their initial episode (after 4-7 days), or a subsequent episode of fever and neutropenia (recurrent) C0015967 Fever,C0027947 Neutropenia,C0030705 Patients,C0205265 Initially,C0205322 Persistent,C0332189 Episode of,C0449450 Presentation,C0521095 Determined by,C2945760 Recurrent,C3842885 No episode,C4288071 Unexplained,C0015967 "Fever",C0027947 "Neutropenia"
32777 Aggressively determine the etiology of the skin and soft tissue infection by aspiration and/or biopsy of skin and soft tissue lesions and submit these for thorough cytologic/histologic assessments, microbial staining and cultures C0005558 Biopsy,C0149778 Soft Tissue Infection,C0205358 Soft,C0205462 Histologic,C0205471 Cytologic,C0221198 Lesion,C0225317 soft tissue,C0263955 Thoroughpin,C0521095 Determined by,C1123023 Skin,C1314792 Etiology,C3714514 Infection,C0005558 "Biopsy",C0037278 "Skin Diseases, Infectious",C0038128 "Stains",C0040300 "Body tissue",C0149778 "Soft Tissue Infection",C0150866 "Biopsy of skin procedure",C0200965 "Microbial staining",C0220787 "Endotracheal aspiration",C0221198 "Lesion",C0225317 "soft tissue",C0349707 "Aspiration-action",C0410013 "Soft tissue lesion",C0684084 "Skin tissue",C0700198 "Pulmonary aspiration",C1123023 "Skin",C1261322 "Evaluation procedure",C1278993 "Entire skin",C1298701 "Microbial stain",C2242979 "Microbial culture (procedure)"
32778 Risk-stratify patients with fever and neutropenia according to susceptibility to infection: high-risk patients are those with anticipated prolonged (>7 days) and profound neutropenia (ANC <100 cells/?L) or with a Multinational Association for Supportive Care (MASCC) score of <21; low-risk patients are those with anticipated brief (<7 days) periods of neutropenia and few comorbidities or with a MASCC of ?21 C0007634 Cells,C0009488 Comorbidity,C0015967 Fever,C0027947 Neutropenia,C0030705 Patients,C0035647 Risk,C0183715 Susceptibility Panels,C0205250 High,C0205251 low,C0205388 Few,C0332167 High risk of,C0344211 Supportive care,C0439590 Prolonged,C0439808 Profound,C0449820 Score,C1547045 *Susceptibility,C1879313 Brief,C3538919 Low Risk,C3714514 Infection,C3817553 100%,C3840775 Anticipated,C3843331 No periods,C4319571 High risk,C0007634 "Cells",C0015967 "Fever",C0027947 "Neutropenia",C0344211 "Supportive care",C1269647 "Entire cell"
32779 Determine the extent of infection through a thorough physical examination, blood cultures, chest radiograph and additional imaging (including chest CT) C0005767 Blood,C0031809 Physical Examination,C0202823 Chest CT,C0205485 Physical,C0263955 Thoroughpin,C0332273 Through,C0439792 Extent,C0521095 Determined by,C0817096 Chest,C1524062 Additional,C3714514 Infection,C4321457 Examination,C0005767 "Blood",C0011923 "Diagnostic Imaging",C0031809 "Physical Examination",C0200949 "Blood culture",C0202823 "Chest CT",C0817096 "Chest",C1306645 "Plain x-ray",C2242979 "Microbial culture (procedure)"
32780 Hospitalization and empiric antibacterial therapy with vancomycin plus antipseudomonal antibiotics such as cefepime, a carbapenem (imipenem-cilastatin or meropenem or doripenem) or piperacillintazobactam are recommended C0003232 Antibiotics,C0006968 Carbapenems,C0008777 Cilastatin,C0019993 Hospitalization,C0020933 Imipenem,C0042313 Vancomycin,C0055003 cefepime,C0066005 meropenem,C0071972 Cilastatin / Imipenem,C0389169 doripenem,C1820977 Recommended diet,C1880496 Empiric,C3846195 Not Recommended,C3846199 Chem recommended,C0003232 "Antibiotics",C0006968 "Carbapenems",C0008777 "Cilastatin",C0020933 "Imipenem",C0042313 "Vancomycin",C0055003 "cefepime",C0066005 "meropenem",C0087111 "Therapeutic procedure",C0279516 "Anti-Bacterial Agents",C0389169 "doripenem"
32781 Documented clinical and microbiologic skin and soft tissue infections should be treated based on antimicrobial susceptibilities of isolated organisms C0029235 Organism,C0205210 Clinical,C0205358 Soft,C0205409 Isolated,C0225317 soft tissue,C1123023 Skin,C1301725 Documented,C3714514 Infection,C0037278 "Skin Diseases, Infectious",C0040300 "Body tissue",C0149778 "Soft Tissue Infection",C0225317 "soft tissue",C0684084 "Skin tissue",C1123023 "Skin",C1278993 "Entire skin"
32782 The treatment duration for most bacterial skin and soft tissue infections should be 7-14 days C0205358 Soft,C0205393 Most,C0225317 soft tissue,C0444921 Duration of treatment,C0521009 Bacterial,C0746919 NO TREATMENT,C1123023 Skin,C2926735 Duration,C3714514 Infection,C0004623 "Bacterial Infections",C0037278 "Skin Diseases, Infectious",C0040300 "Body tissue",C0149778 "Soft Tissue Infection",C0225317 "soft tissue",C0684084 "Skin tissue",C1123023 "Skin",C1278993 "Entire skin",C2926735 "Duration"
32783 Surgical intervention is recommended for drainage of soft-tissue abscess after marrow recovery or for a progressive polymicrobial necrotizing fasciitis or myonecrosis C0000833 Abscess,C0015645 Fasciitis,C0205329 Progressive,C0205358 Soft,C0225317 soft tissue,C0238124 Necrotizing fasciitis,C0376152 Marrow,C0439664 Necrotizing,C0444063 Abscess tissue,C1820977 Recommended diet,C3846195 Not Recommended,C3846199 Chem recommended,C4302231 Polymicrobial necrotizing fasciitis,C0000833 "Abscess",C0012621 "Body Fluid Discharge",C0013103 "Drainage procedure",C0015645 "Fasciitis",C0040300 "Body tissue",C0225317 "soft tissue",C0344096 "Drainage of abscess",C0543467 "Operative Surgical Procedures",C1273869 "Intervention regimes"
32784 Adjunct colony-stimulating factor therapy (G-CSF, GM-CSF) or granulocyte transfusions C0009392 Colony-Stimulating Factors,C0018183 granulocyte,C0079784 Macrophage Colony-Stimulating Factor,C0314599 Colony-stimulating factor, multiple,C1521761 Factor,C0018183 "granulocyte",C0087111 "Therapeutic procedure",C1879316 "Transfusion (procedure)"
32785 Acyclovir should be administered to patients suspected or confirmed to have cutaneous or disseminated herpes simplex (HSV) or varicella zoster virus (VZV) infection (SR-M). C0001367 Acyclovir,C0030705 Patients,C0042776 Virus,C0205221 Disseminated,C0221912 Cutaneous,C0276224 Disseminated herpes simplex,C0276248 Disseminated herpes zoster,C0370133 Varicella zoster virus IgM,C0443710 Varicella-zoster virus antibody,C0450101 Varicella-zoster virus antigen,C0521093 Confirmed by,C0586989 Varicella Zoster Virus Infection,C1304000 Disseminated cutaneous herpes simplex infection,C1304015 Disseminated cutaneous mycosis,C1548562 Not Administered,C1997218 NOT suspected,C3714514 Infection,C4511149 Varicella-zoster virus clade 1,C4511150 Varicella-zoster virus clade 2,C4511151 Varicella-zoster virus clade 3,C4511152 Varicella-zoster virus clade 4,C4511153 Varicella-zoster virus clade 5,C0001367 "Acyclovir",C0008049 "Chickenpox",C0019348 "Herpes Simplex Infections",C0019360 "Herpes zoster disease"
32786 Yeasts and molds remain the primary cause of infection-associated fever and neutropenia. Therefore, empiric antifungal therapy (Table 5) should be added to the antibacterial regimen (SR-H). C0015967 Fever,C0027947 Neutropenia,C0043393 Yeasts,C0205225 Primary,C0272313 Infection-associated purpura,C0332281 Associated with,C0678026 Antifungal therapy,C1879523 AT Regimen,C1880496 Empiric,C3714514 Infection,C0003308 "Antifungal Agents",C0015967 "Fever",C0027947 "Neutropenia",C0087111 "Therapeutic procedure",C0279516 "Anti-Bacterial Agents",C0439631 "Primary operation"
32787 Empiric administration of vancomycin or other agents with Gram-positive activity (linezolid, daptomycin or ceftaroline) should be added if not already being administered C0001555 administration & dosage,C0001557 Administration, Buccal,C0018155 Gram-Positive Cocci,C0042313 Vancomycin,C0057144 Daptomycin,C0205394 Other,C0439208 gram,C0663241 linezolid,C1446409 Positive,C1548562 Not Administered,C1880496 Empiric,C2001521 ceftaroline,C2348003 Agent Administration,C3845261 No activity,C0042313 "Vancomycin",C0057144 "Daptomycin",C0449210 "OTH tumor staging notation",C0450442 "Agent",C0663241 "linezolid",C1533734 "Administration procedure",C2001521 "ceftaroline"
32788 Candida species skin and soft tissue infections should be treated with an echinocandin or, if Candida parapsilosis has been isolated, lipid formulation amphotericin-B (SR-H) C0023767 Lipid A,C0023779 Lipids,C0058920 echinocandin B,C0085795 Amphotericin,C0205358 Soft,C0205409 Isolated,C0225317 soft tissue,C0319878 Candida parapsilosis,C0486500 Candida species DNA,C0720512 Formulation R,C0908707 AO-8 formulation,C1123023 Skin,C1268551 Echinocandins,C1705920 Species,C3482104 Candida parapsilosis DNA,C3712748 echinocandin C,C3714514 Infection,C3873288 Candida species IgA,C4508237 CD101 echinocandin,C0002679 "Amphotericin B",C0006840 "Candidiasis",C0023779 "Lipids",C0037278 "Skin Diseases, Infectious",C0040300 "Body tissue",C0085795 "Amphotericin",C0149778 "Soft Tissue Infection",C0225317 "soft tissue",C0684084 "Skin tissue",C1123023 "Skin",C1268551 "Echinocandins",C1278993 "Entire skin"
32789 if Candida parapsilosis has been isolated treat with fluconazole as an acceptable alternative to lipid formulation amphotericin-B C0016277 Fluconazole,C0023767 Lipid A,C0023779 Lipids,C0085795 Amphotericin,C0205409 Isolated,C0319878 Candida parapsilosis,C0720512 Formulation R,C0908707 AO-8 formulation,C1523987 Alternative,C1879533 Acceptable,C3482104 Candida parapsilosis DNA,C0002679 "Amphotericin B",C0016277 "Fluconazole",C0023779 "Lipids",C0085795 "Amphotericin"
32790 Treatment should be for 2 weeks after clearance of blood stream infection or resolution of skin lesions. C0005767 Blood,C0221198 Lesion,C0439230 week,C0442540 Streams,C0449297 Clearance,C0746919 NO TREATMENT,C1123023 Skin,C1442457 2 Weeks,C1442462 3 Weeks,C1442465 4 Weeks,C2699488 Resolution,C3714514 Infection,C0005767 "Blood",C0037284 "Skin lesion",C0221198 "Lesion",C1123023 "Skin",C1278993 "Entire skin"
32791 Aspergillus skin and soft tissue infections should be treated with voriconazole C0004034 Aspergillus,C0205358 Soft,C0225317 soft tissue,C0393080 voriconazole,C1123023 Skin,C3714514 Infection,C0037278 "Skin Diseases, Infectious",C0040300 "Body tissue",C0149778 "Soft Tissue Infection",C0225317 "soft tissue",C0393080 "voriconazole",C0684084 "Skin tissue",C1123023 "Skin",C1278993 "Entire skin"
32792 alternatively to voriconazole treat Aspergillus skin and soft tissue infections with lipid formulations of amphotericin B, posaconazole or echinocandin for 6-12 weeks C0004034 Aspergillus,C0023767 Lipid A,C0023779 Lipids,C0058920 echinocandin B,C0085795 Amphotericin,C0205358 Soft,C0225317 soft tissue,C0393080 voriconazole,C0439230 week,C0936148 posaconazole,C1123023 Skin,C1268551 Echinocandins,C1442457 2 Weeks,C1442462 3 Weeks,C1442465 4 Weeks,C3712748 echinocandin C,C3714514 Infection,C4508237 CD101 echinocandin,C0002679 "Amphotericin B",C0023779 "Lipids",C0037278 "Skin Diseases, Infectious",C0040300 "Body tissue",C0085795 "Amphotericin",C0149778 "Soft Tissue Infection",C0225317 "soft tissue",C0393080 "voriconazole",C0684084 "Skin tissue",C0936148 "posaconazole",C1123023 "Skin",C1268551 "Echinocandins",C1278993 "Entire skin"
32793 Mucor/Rhizopus infections should be treated with lipid formulation amphotericin B C0023767 Lipid A,C0023779 Lipids,C0026716 Mucor,C0035477 Rhizopus,C0085795 Amphotericin,C0720512 Formulation R,C0908707 AO-8 formulation,C3714514 Infection,C0002679 "Amphotericin B",C0023779 "Lipids",C0085795 "Amphotericin"
32794 Mucor/Rhizopus infections should be treated with posaconazole C0026716 Mucor,C0035477 Rhizopus,C0936148 posaconazole,C3714514 Infection,C0936148 "posaconazole"
32795 The addition of an echinocandin could be considered based on synergy in murine models of mucormycosis and observational clinical data (WR-L). C0026718 Mucormycosis,C0058920 echinocandin B,C0205210 Clinical,C0591833 Murine,C0750591 consider,C1268551 Echinocandins,C1511726 Data,C1518527 Observational Study,C3161035 Model,C3712748 echinocandin C,C4288563 Observational Model,C4508237 CD101 echinocandin,C0026718 "Mucormycosis",C1268551 "Echinocandins"
32796 Fusarium species infections should be treated with high-dose IV voriconazole or posaconazole C0016871 Fusarium,C0205250 High,C0393080 voriconazole,C0444956 High dose,C0936148 posaconazole,C1705920 Species,C3714514 Infection,C0276758 "Fusariosis",C0393080 "voriconazole",C0936148 "posaconazole"
32798 Intravenous acyclovir should be added to the patient’s antimicrobial regimen for suspected or confirmed cutaneous or disseminated HSV or VZV infections (SR-M). C0001367 Acyclovir,C0030705 Patients,C0205221 Disseminated,C0221912 Cutaneous,C0348016 Intravenous,C0521093 Confirmed by,C1304015 Disseminated cutaneous mycosis,C1879523 AT Regimen,C1997218 NOT suspected,C3714514 Infection,C0001367 "Acyclovir"
32799 Blood cultures should be obtained, and skin lesions in this population of patients should be aggressively evaluated by culture aspiration, biopsy or surgical excision since they may be caused by resistant microbes, yeast or molds C0005558 Biopsy,C0005767 Blood,C0030705 Patients,C0043393 Yeasts,C0221198 Lesion,C0565118 Surgical biopsy,C0728940 Excision,C1123023 Skin,C1298665 Surgical excision sample,C1301820 Obtain,C1711239 Since,C1882120 Not Obtained,C0005558 "Biopsy",C0005767 "Blood",C0037284 "Skin lesion",C0200949 "Blood culture",C0220787 "Endotracheal aspiration",C0221198 "Lesion",C0349707 "Aspiration-action",C0543467 "Operative Surgical Procedures",C0700198 "Pulmonary aspiration",C0728940 "Excision",C1123023 "Skin",C1278993 "Entire skin",C2242979 "Microbial culture (procedure)"
32800 Polymerase chain reaction (PCR) in peripheral blood for HSV and VZV might be helpful in establishing a diagnosis of disseminated infection in patients with unexplained skin lesions (WR-M). C0005767 Blood,C0011900 Diagnosis,C0030705 Patients,C0032520 Polymerase Chain Reaction,C0205100 Peripheral,C0205221 Disseminated,C0221198 Lesion,C0229664 peripheral blood,C0443286 Reaction,C1123023 Skin,C1335439 Polymerase,C2364239 Establishing Trust,C3714514 Infection,C3898897 Helpful,C4288071 Unexplained,C0005767 "Blood",C0011900 "Diagnosis",C0032520 "Polymerase Chain Reaction",C0037284 "Skin lesion",C0221198 "Lesion",C0229664 "peripheral blood",C1123023 "Skin",C1278993 "Entire skin"
32801 Consider immediate consultation with a dermatologist familiar with cutaneous manifestations of infection in patients with cellular immune defects (eg, those with lymphoma, lymphocytic leukemia, recipients of organ transplants, or those receiving immunosuppressive drugs such as anti-tumor necrosis factors or certain monoclonal antibodies) C0003241 Antibodies,C0009818 Consultation,C0015411 Eye Manifestations,C0021081 Immunosuppressive Agents,C0023418 leukemia,C0023434 Chronic Lymphocytic Leukemia,C0023449 Acute lymphocytic leukemia,C0024264 Lymphocyte,C0024299 Lymphoma,C0027540 Necrosis,C0029166 Oral Manifestations,C0030705 Patients,C0037285 Skin Manifestations,C0178539 Cellular,C0178784 Organ,C0205253 Immediate,C0221912 Cutaneous,C0241888 Familial,C0259831 Dermatologist,C0333516 Tumor necrosis,C0439662 Immune,C0746619 monoclonal,C0750591 consider,C0855095 Small Lymphocytic Lymphoma,C1280464 Manifestation of,C1334804 Motor Manifestations,C3696887 Sepsis with cutaneous manifestations,C3714514 Infection,C0009818 "Consultation",C0013227 "Pharmaceutical Preparations",C0023418 "leukemia",C0023448 "Lymphoid leukemia",C0024299 "Lymphoma",C0040732 "Transplantation",C0301889 "Immune defect",C0332835 "Transplanted tissue",C1533651 "Deficiency of cell-mediated immunity"
32802 Consider biopsy and surgical debridement early in the management of these patients C0002766 Pain management,C0005558 Biopsy,C0011079 Debridement,C0030705 Patients,C0455097 Surgical debridement of wound,C0565118 Surgical biopsy,C0750591 consider,C1279919 Early,C0005558 "Biopsy",C0011079 "Debridement",C0543467 "Operative Surgical Procedures"
32804 The use of specific agents should be decided with the input of the primary team, dermatology, infectious disease and other consulting teams C0012634 Disease,C0151317 Chronic infectious disease,C0205225 Primary,C0205394 Other,C0260050 Mole (Dermatology),C0275518 Acute infectious disease,C0871489 Team,C1708517 Input,C0009450 "Communicable Diseases",C0012634 "Disease",C0439631 "Primary operation",C0449210 "OTH tumor staging notation",C0450442 "Agent"
32805 In patients with a suspected or known abdominal aortic aneurysm (AAA), the SVS recommends performing physical examination that includes an assessment of femoral and popliteal arteries. C0002940 Aneurysm,C0003486 Aortic Aneurysm,C0003842 Arteries,C0030705 Patients,C0031809 Physical Examination,C0162871 Aortic Aneurysm, Abdominal,C0205309 Known,C0205485 Physical,C0229026 Abdominal aortic plexus,C0265012 Ruptured abdominal aortic aneurysm,C0340632 Leaking abdominal aortic aneurysm,C0425669 Abdominal aortic bruit,C0442037 Popliteal,C0553958 Y graft abdominal Aortic aneurysm,C0682001 Performing Arts,C1268311 Femoral and popliteal arteries, CS,C1282539 Recurrent abdominal aortic aneurysm,C1960866 Enlarging abdominal aortic aneurysm,C1997218 NOT suspected,C3698466 Abdominal aortic aneurysm screening,C4275172 Familial abdominal aortic aneurysm,C4321457 Examination,C0000726 "Abdomen",C0002940 "Aneurysm",C0003483 "Aorta",C0003486 "Aortic Aneurysm",C0015811 "Femur",C0031809 "Physical Examination",C0162871 "Aortic Aneurysm, Abdominal",C0442037 "Popliteal",C1261322 "Evaluation procedure"