Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- chest pain
- dyspnea on exertion
- hypotension
- rales
- S3 gallop
- hypertension
- nausea
- diaphoresis
- tachycardia
- indigestion
Otros factores de diagnóstico
- unilateral weakness, numbness, and/or tingling
- headache
- intermittent claudication
- bruits
- aphasia
- hemisensory loss
- cranial nerve palsies
- seizures
- vertigo
- limb pain at rest
- diminished/absent lower extremity pulses
- ulcers or gangrene
- peripheral edema
- smooth shiny skin with hair loss
- pallor
Factores de riesgo
- cigarette smoking
- hypertension
- dyslipidemia
- poor glycemic control
- physical inactivity
- overweight and obesity
- albuminuria
- chronic kidney disease (CKD)
- elevated C-reactive protein
- family history of CVD
- female sex
- gestational diabetes
- mental illness
- metabolic dysfunction-associated steatotic liver disease (previously nonalcoholic fatty liver disease)
- atrial fibrillation
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- HbA1c
- lipid profile
Pruebas diagnósticas que deben considerarse
- B natriuretic peptide (BNP)/N-terminal prohormone B-natriuretic peptide (NT-proBNP)
- transthoracic doppler echocardiogram
- exercise ECG
- exercise (stress) imaging test
- pharmacologic (stress) imaging test
- cardiac MRI or stress cardiac MRI
- ankle-brachial index (ABI)
- CT coronary angiography
- CT coronary calcium scan
- invasive coronary angiography
- noncontrast head CT
- brain MRI
- duplex ultrasonography of carotid arteries
- C-reactive protein
- chest x-ray
Algoritmo de tratamiento
acute myocardial infarction or unstable angina
highly significant coronary artery disease: without acute myocardial infarction or unstable angina
diabetic cardiovascular disease: stable and/or after intervention
Colaboradores
Autores
Mohamed Al-Kazaz, MD
Assistant Professor of Medicine (Cardiology)
Section Chief, General Cardiology
Division of Cardiology, Department of Medicine
Northwestern University Feinberg School of Medicine
Bluhm Cardiovascular Institute
Northwestern Memorial Hospital
Chicago
IL
Divulgaciones
MA is a speaker for Kiniksa Pharmaceuticals in relation to pericarditis/rilonacept.
Agradecimientos
Dr Mohamed Al-Kazaz would like to gratefully acknowledge Dr Alexander Meyer, Dr Laura Davidson, Dr Charles Davidson, and Dr Leonard E. Egede, the previous contributors to this topic, and would like to gratefully acknowledge the review by Dr Shreenidhi Venuraju, MB BS, MRCP, Wellington Hospital South, UK.
Divulgaciones
AM, LD, CD, and LE declare that they have no competing interests. LEE is an author of a number of references cited in this topic. SV not disclosed.
Revisores por pares
Irfan Moinuddin, MD
Assistant Professor
Chicago Medical School
Rosalind Franklin University
Lombard
IL
Divulgaciones
IM declares that he has no competing interests.
David Leehey, MD
Medical Director
Hines VA Hospital
Hines
IL
Divulgaciones
DL declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
Marx N, Federici M, Schütt K, et al. 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023 Oct 14;44(39):4043-140.Texto completo Resumen
American Diabetes Association. Standards of care in diabetes - 2024. Diabetes Care 2024 Jan 1;47(suppl 1):S1-321.Texto completo
Joseph JJ, Deedwania P, Acharya T, et al. Comprehensive management of cardiovascular risk factors for adults with type 2 diabetes: a scientific statement from the American Heart Association. Circulation. 2022 Mar;145(9):e722-59.Texto completo Resumen
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018 May 15;71(19):e127-248.Texto completo Resumen
Writing Committee Members; Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. J Am Coll Cardiol. 2022 Jan 18;79(2):e21-129.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Unstable angina
- ST-elevation myocardial infarction (STEMI)
- Non-ST-elevation myocardial infarction (NSTEMI)
Más DiferencialesGuías de práctica clínica
- 2024 guideline for the primary prevention of stroke
- Newer pharmacological treatments in adults with type 2 diabetes
Más Guías de práctica clínicaFolletos para el paciente
Diabetes type 2: should I take insulin?
Diabetes type 2: what treatments work?
Más Folletos para el paciente
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明