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Microsoft word - ctaformfin.doc
DOB (or place label here)_________________________
Acute Chest Pain Protocol
ED Physician Name:_______________________________________
ED MD Pager#____________________________________________
Referring/Follow-up Physician Name:_____________________________________________________________________________________
Coronary and Aortic CTA for ruling CAD and/or Aortic Dissection
(estimated radiation dose: less than 5 millisivert) Triple Rule out for ruling out CAD, acute PE, and Aortic Dissection
(estimated radiation dose: 10-13 millisivert)
Diagnosis/explanation for patient’s symptoms:
3. Acute Aortic Dissection (type A or B)
History of documented coronary artery disease,
Possible acute coronary syndrome with or without
e.g. previous MI, coronary stenting or coronary artery
on-going chest pain (must have no dynamic ST
bypass surgery, unless ordered in agreement with
segment deviation on initial ECG in the ED and
Heart rate remains greater than 70 bpm 1 hour
after oral administration of 100 mg metoprolol or IV
Test may be appropriate for patient with previous
calcium channel blocker for those who can not take
interpretable or equivocal stress test results
(exercise, perfusion, or stress echo) unless patient is
scheduled to have coronary angiography in the near future.
Inability to cooperate with scan acquisition and/or
Contraindication to nitroglycerin (use of Viagra,
Cialis, or Levitra within the last 24 (Viagra) – 48 (Cialis and Levitra) hr.
1. A 20 gauge angiograph and preferably on right antecubital vein. 2. Give 50 mg oral metoprolol if the heart rate is lower than 70 but greater than or equal to 50. No beta blocker if
3. Give 100 mg of oral metoprolol if the heart rate is greater than or equal to 70. 4. Use intravenous calcium channel blocker, e.g. cardizem or verapamil, if patient is a labile asthmatic.
Please complete the form below before ordering a cardiac CTA.
1. Family History of Coronary Artery Disease (MI age <55)
2. HTN (blood pressure > 140/90 or on BP Meds)
3. Dyslipidemia (LDL >100 mg/dL, HDL <40 mg/dL, or Triglyceride > 150 mg/dL)
if yes, HDL level _______ and total cholesterol level ________ and on meds
recent (quit >1 month but less than 1 year)
6. Known CAD (stenosis ≥ 50% or history of MI, Stent, or CABG)
8. Sedentary life style (sitting or remaining inactive most of the day and exercise less than 1.5 hours a week)
14. History of significant valve disease
18. Chronic kidney disease (Cr < 1.5 or eGFR >50)
19. Any diagnostic study with intravenous contrast (within 48 hours)?
DEPRESSÃO, O MAL DO SÉCULO: DE QUE SÉCULO? DEPRESSION, THE ILLNESS OF THE CENTURY: WHAT CENTURY? RESUMO: Conhecer a história da depressão nos leva a entender o ser humano como hoje o conhecemose incorporamos. Este artigo tem por objetivo resgatar a história da depressão no mundo ocidental. Nãose trata de reescrever a história, mas sim de realizar uma análise historico-social, revisita
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