IHE Cardiology Technical Framework Supplement Cardiac Imaging ...

IHE Cardiology Technical Framework Supplement – Cardiac Imaging Report Content (CIRC)______________________________________________________________________________aortic or other major vascular surgery,peripheral vascular surgery, anticipatedprolonged surgical procedure associatedwith large fluid shifts and/or blood loss)● N/ANoncardiac surgery—patient activeconditions(Recommended if preoperative)Noncardiac surgery—patient risk factors(Recommended if preoperative)Medication ID—medications(Recommended)(Optional—TEE, TTE)For a patient scheduled to undergononcardiac surgery, does the patienthave any active cardiac conditions;defined as any of the following:● Unstable coronary syndrome● Decompensated heart failure (NYHAfunctional class IV, worsening or newheart failure)● Significant arrhythmias (e.g., highgradeAV block, ventricular arrhythmias,symptomatic bradycardia,supraventricular arrhythmias with anuncontrolled rate)● Severe valvular heart diseaseChoose 1 of the following:● Yes● NoFor a patient scheduled to undergononcardiac surgery, how many of thefollowing clinical risk factors are present:● Ischemic heart disease● Compensated or prior heart failure● Diabetes mellitus● Renal insufficiency● Cerebrovascular diseaseChoose 1 of the following:● 3 or more● 1 to 2● NoneIndicate which of the followingcategories of medications are routinelytaken by the patient. Choose allapplicable of the following:● ACE inhibitor/angiotensin receptorblocker● Aspirin, other antiplatelet agents● Calcium channel blockersMedications Section1.3.6.1.4.1.19376.1.5.3.1.3.19Parent Template CCD 3.9(2.16.840.1.113883.10.20.1.8)__________________________________________________________________________16Rev. 1.0 – 2011-04-22Copyright © 2011: IHE International, Inc.