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Spacelabs Mcare 300 Patient Monitor Service Manual Full.17 ((BETTER))

Clinical diagnosis of DCM is made if the following three conditions are met: (a) cardiomegaly by an imaging study (b) ventricular systolic dysfunction by both standard echocardiography and RV pacing (c) >50% decrease in systolic function with normal or decreased LV wall thickness and without evidence of a primary valvular abnormality, pericardial effusion, LV aneurysm, or thrombus. S8.5.1.1-1 But whether there is only one or more of these conditions does not affect management of the individual patient.1-1 Thus, DCM is diagnosed in patients who display one or more of these conditions but is generally not diagnosed in patients who do not display any of these three conditions.1-1 Asymptomatic patients with DCM do not require formal follow-up with echocardiography unless there is a precipitating event or they deteriorate in clinical status or RV function.1-1 An echocardiogram should be obtained at the time of hospitalization, early in the course of the disease (during the sub-acute phase), and after any changes in clinical status or echocardiographic findings. If an ICD is implanted for primary prevention, it should be programmed to provide a margin of safety of 0.5 mV of T-wave and 10 mV of R-wave. Patients without the risk factors of LV hypertrophy or diabetes mellitus should be followed clinically on an annual basis to determine the need for monitoring or maintenance device programming. Patients with LV hypertrophy or diabetes should have an echocardiogram performed every 2 to 3 years.1-2, S8.1-3 But serial monitoring of LV systolic function and clinical status is not recommended if the patient has normal LV function. DCM patients with low LVEF may be monitored in the same way as patients with cardiomyopathy from other causes, such as coronary artery disease, valvular heart disease, or tachycardia. The clinical status should be monitored for development of arrhythmia or syncope.

spacelabs mcare 300 patient monitor service manual full.17

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