VistA-WorldVistAEHR/r/AUTOMATED_MED_INFO_EXCHANGE.../DVBCWAM1.m

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DVBCWAM1 ;ALB/JFP ARRHYTHMIAS WKS TEXT - 1 ; 11 FEB 1997
;;2.7;AMIE;**16**;Apr 10, 1995
;
;
TXT ;
;;A. Review of Medical Records:
;;
;;B. Medical History (Subjective Complaints):
;;
;; 1. Type of arrhythmia, onset of disorder, frequency and
;; duration of attacks. Attacks confirmed by EKG or Holter
;; monitor?.
;; 2. Pacemaker present? If so, when was it inserted,
;; effectiveness, side effects?
;; 3. Other treatment? If so, type, effectiveness, side effects?
;; 4. For sustained ventricular arrhythmias, atrioventricular
;; block, and implantable cardiac pacemakers (if ventricular
;; arrhythmia or atrioventricular block was the reason for the
;; pacemaker), the examiner must provide the METs level,
;; determined by exercise testing, at which symptoms of dyspnea,
;; fatigue, angina, dizziness, or syncope result.
;; 5. Exercise testing is not required for the above listed
;; conditions in the following circumstances:
;; a. If exercise testing is medically contraindicated:
;; 1) In that case, provide the medical reason exercise
;; testing cannot be conducted, and
;; 2) Provide an estimate of the level of activity
;; (expressed in METs and supported by specific
;; examples, such as slow stair climbing, or
;; shoveling snow) that results in dyspnea, fatigue,
;; angina, dizziness, or syncope.
;; b. For sustained ventricular arrhythmia-from date of
;; hospital admission for initial evaluation and medical
;; therapy for a sustained ventricular arrhythmia or for
;; ventricular aneurysmectomy, and for six months
;; following discharge.
;; c. With an automatic implantable Cardioverter-Defibrillator
;; (AICD) in place.
;; d. For two months following hospital admission for
;; implantation or reimplantation of an implantable
;; cardiac pacemaker.
;; e. If an exercise test has been done within the past year,
;; the results are of record, and there is no indication
;; that there has been a change in the cardiac status of
;; the veteran since.
;; 6. For implantable cardiac pacemakers - if supraventricular
;; arrhythmia was the reason for the pacemaker - describe any
;; attacks of atrial fibrillation or other symptoms.
;; 7. Describe the effects of the condition on the veteran's
;; usual occupation and daily activities.
;;
;;C. Physical Examination (Objective Findings):
;;
;; Address each of the following and fully describe current findings:
;; 1. Heart size and method of determination, heart rate and
;; rhythm, blood pressure.
;; 2. Status of cardiac function - evidence of congestive heart
;; failure.
;; 3. Cardiac arrhythmia - type. Confirmed by EKG or Holter
;; monitor?
;;
;;D Diagnostic and Clinical Tests:
;;
;; 1. EKG.
;; 2. Holter monitor, other tests as indicated.
;; 3. Chest X-ray, exercise stress test, echocardiogram, Holter
;; monitor, thallium study, angiography, etc., as appropriate,
;; and as required or indicated.
;; 4. Include results of all diagnostic and clinical tests
;; conducted in the examination report, including status of
;; left ventricular function, if measured.
;;
;;E. Diagnosis:
;;
;;
;;
;;Signature: Date:
;;END