References - Cardiovascular Signs and Symptoms

Jenna Greenberg; Anna Laurie; Joshua Greenberg

Svavarsdóttir AE, Jónasson MR, Gudmundsson GH, et al. Chest pain in family practice. Diagnosis and long-term outcome in a community setting. Can Fam Physician. 1996;42:1122-1128.

Gulati M, Levy PD, Mukherjee D, et al.; Writing Committee Members. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the evaluation and diagnosis of chest pain: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2021;78(22):e187-e285.

McConaghy JR, Oza RS. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013;87(3):177-182.

Hoorweg BBN, Willemsen RTA, Cleef LE, et al. Frequency of chest pain in primary care, diagnostic tests performed and final diagnoses. Heart. 2017;103(21):1727-1732.

McConaghy JR, Sharma M, Patel H. Acute chest pain in adults: outpatient evaluation. Am Fam Physician. 2020;102(12):721-727.

Centers for Disease Control and Prevention, National Center for Health Statistics. Health, United States. Heart disease prevalence. Last reviewed August 5, 2024. Accessed September 5, 2025. https://www.cdc.gov/nchs/hus/topics/heart-disease-prevalence.htm

Fanaroff AC, Rymer JA, Goldstein SA, et al. Does this patient with chest pain have acute coronary syndrome?: The rational clinical examination systematic review. JAMA. 2015;314(18):1955-1965.

Klompas M. Does this patient have an acute thoracic aortic dissection? JAMA. 2002;287(17):2262-2272.

Aerts M, Minalu G, Bösner S, et al.; International Working Group on Chest Pain in Primary Care (INTERCHEST). Pooled individual patient data from five countries were used to derive a clinical prediction rule for coronary artery disease in primary care. J Clin Epidemiol. 2017;81:120-128.

Winther S, Murphy T, Schmidt SE, et al. Performance of the American Heart Association/American College of Cardiology guideline-recommended pretest probability model for the diagnosis of obstructive coronary artery disease. J Am Heart Assoc. 2022;11(24):e027260.

Harskamp RE, Laeven SC, Himmelreich JC, et al. Chest pain in general practice: a systematic review of prediction rules. BMJ Open. 2019;9(2):e027081.

Bösner S, Becker A, Hani MA, et al. Chest wall syndrome in primary care patients with chest pain: presentation, associated features and diagnosis. Fam Pract. 2010;27(4):363-369.

Mousavi S, Tosi J, Eskandarian R, et al. Role of clinical presentation in diagnosing reflux-related non-cardiac chest pain. J Gastroenterol Hepatol. 2007;22(2):218-221.

Huffman JC, Pollack MH, Stern TA. Panic disorder and chest pain: mechanisms, morbidity, and management. Prim Care Companion J Clin Psychiatry. 2002;4(2):54-62.

Isselbacher EM, Preventza O, Hamilton Black J, et al.; Writing Committee Members. Peer Review Committee Members; AHA/ACC Joint Committee Members. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Thorac Cardiovasc Surg. 2023;166(5):e182-e331.

Kahn SR, de Wit K. Pulmonary embolism. N Engl J Med. 2022;387(1):45-57.

Acar L, Peters F, Marschall U, et al. Increased pulmonary embolism incidence and mortality in patients subsequently diagnosed with COVID-19: an analysis of health insurance claims data. Eur J Vasc Endovasc Surg. 2022;63(1):159-160.

Zethelius B, Attelind S, Westman G, et al. Pulmonary embolism after SARS-CoV-2 vaccination. Vaccine X. 2024;21:100571.

Snavely AC, Mahler SA, Hendley NW, et al. Prehospital translation of chest pain tools (RESCUE study): completion rate and inter-rater reliability. West J Emerg Med. 2022;23(2):222-228.

Lim W, Le Gal G, Bates SM, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism. Blood Adv. 2018;2(22):3226-3256.

Fesmire FM, Brown MD, Espinosa JA, et al.; American College of Emergency Physicians. Critical issues in the evaluation and management of adult patients presenting to the emergency department with suspected pulmonary embolism. Ann Emerg Med. 2011;57(6):628-652.e75.

Ortel TL, Neumann I, Ageno W, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020;4(19):4693-4738.

Swap CJ, Nagurney JT. Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes. JAMA. 2005;294(20):2623-2629.

Diercks DB, Boghos E, Guzman H, et al. Changes in the numeric descriptive scale for pain after sublingual nitroglycerin do not predict cardiac etiology of chest pain. Ann Emerg Med. 2005;45(6):581-585.

Hsia RY, Hale Z, Tabas JA. A national study of the prevalence of life-threatening diagnoses in patients with chest pain. JAMA Intern Med. 2016;176(7):1029-1032.

van Oosterhout REM, de Boer AR, Maas AHEM, et al. Sex differences in symptom presentation in acute coronary syndromes: a systematic review and meta-analysis. J Am Heart Assoc. 2020;9(9):e014733.

Grosmaitre P, Le Vavasseur O, Yachouh E, et al. Significance of atypical symptoms for the diagnosis and management of myocardial infarction in elderly patients admitted to emergency departments. Arch Cardiovasc Dis. 2013;106(11):586-592.

Thygesen K, Alpert JS, Jaffe AS, et al. Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018;72(18):2231-2264.

Rhinehardt J, Brady WJ, Perron AD, et al. Electrocardiographic manifestations of Wellens’ syndrome. Am J Emerg Med. 2002;20(7):638-643.

Winther S, Schmidt SE, Mayrhofer T, et al. Incorporating coronary calcification into pre-test assessment of the likelihood of coronary artery disease. J Am Coll Cardiol. 2020;76(21):2421-2432.

Shaw LJ, Mieres JH, Hendel RH, et al.; WOMEN Trial Investigators. Comparative effectiveness of exercise electrocardiography with or without myocardial perfusion single photon emission computed tomography in women with suspected coronary artery disease: results from the What Is the Optimal Method for Ischemia Evaluation in Women (WOMEN) trial. Circulation. 2011;124(11):1239-1249.

Bourque JM, Beller GA. Value of exercise ECG for risk stratification in suspected or known CAD in the era of advanced imaging technologies. JACC Cardiovasc Imaging. 2015;8(11):1309-1321.

Fihn SD, Gardin JM, Abrams J, et al.; American College of Cardiology Foundation/American Heart Association Task Force. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012;126(25):e354-e471.

Trankle CR, Canada JM, Jordan JH, et al. Exercise cardiovascular magnetic resonance: a review. J Magn Reson Imaging. 2022;55(3):720-754.

Cayley WE. Noninvasive cardiac testing. Am Fam Physician. 2024;110(6):577-584.

Meijboom WB, Meijs MFL, Schuijf JD, et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography: a prospective, multicenter, multivendor study. J Am Coll Cardiol. 2008;52(25):2135-2144.

Mirvis DM. Palpitations. In: Walker HK, Hall WD, Hurst JW, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Butterworths; 1990. Accessed June 30, 2025. https://www.ncbi.nlm.nih.gov/books/NBK202/

Lenderink T, Balkestein EJM. First time referral reasons, diagnoses and 10-year follow-up of patients seen at a Dutch fast lane outpatient cardiology clinic. Neth Heart J. 2019;27(7-8):354-361.

Raviele A, Giada F, Bergfeldt L, et al. Management of patients with palpitations: a position paper from the European Heart Rhythm Association. Europace. 2011;13(7):920-934.

Thavendiranathan P, Bagai A, Khoo C, et al. Does this patient with palpitations have a cardiac arrhythmia? JAMA. 2009;302(19):2135-2143.

Weber BE, Kapoor WN. Evaluation and outcomes of patients with palpitations. Am J Med. 1996;100(2):138-148.

Govender I, Nashed KK, Rangiah S, et al. Palpitations: evaluation and management by primary care practitioners. S Afr Fam Pract (2004). 2022;64(1):e1-e8.

Steinberg JS, Varma N, Cygankiewicz I, et al. 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry. Heart Rhythm. 2017;14(7):e55-e96.

Jeong SY, Chen A, Wu YL, et al. Gender and age differences in the evaluation and clinical outcomes of patients with palpitations. J Gen Intern Med. 2024;39(15):3035-3041.

Probst MA, Mower WR, Kanzaria HK, et al. Analysis of emergency department visits for palpitations (from the National Hospital Ambulatory Medical Care Survey). Am J Cardiol. 2014;113(10):1685-1690.

Wexler RK, Pleister A, Raman SV. Palpitations: evaluation in the primary care setting. Am Fam Physician. 2017;96(12):784-789.

Barsky AJ. Palpitations, arrhythmias, and awareness of cardiac activity. Ann Intern Med. 2001;134(9 pt 2):832-837.

Kandiah JW, Blumberger DM, Rabkin SW. The fundamental basis of palpitations: a neurocardiology approach. Curr Cardiol Rev. 2022;18(3):e090921196306.

Marcus GM. Evaluation and management of premature ventricular complexes. Circulation. 2020;141(17):1404-1418.

Zimetbaum P, Josephson ME. Evaluation of patients with palpitations. N Engl J Med. 1998;338(19):1369-1373.

Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2018;72(14):e91-e220.

Gauer RL, Thomas MF, McNutt RA. Palpitations: evaluation, management, and wearable smart devices. Am Fam Physician. 2024;110(3):259-269.

Giles K, Green MS. Workup and management of patients with frequent premature ventricular contractions. Can J Cardiol. 2013;29(11):1512-1515.

Khalil AM, Al Badarin FA, Al Mahameed W, et al. Diagnostic yield of echocardiography in patients with palpitations: a retrospective analysis. Eur Heart J Cardiovasc Imaging. 2025;26(suppl 1):i4.

Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm. 2016;13(4):e136-e221.

Sheth S, Fares M, Kikano S, et al. Appropriate use of echocardiography for palpitations in paediatric cardiology clinics. Cardiol Young. 2021;31(1):60-62.

Doherty JU, Kort S, Mehran R, et al. ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2019 appropriate use criteria for multimodality imaging in the assessment of cardiac structure and function in nonvalvular heart disease: a report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and the Society of Thoracic Surgeons. J Am Coll Cardiol. 2019;73(4):488-516.

Kovell LC, Ali MT, Hays AG, et al. Defining the role of point-of-care ultrasound in cardiovascular disease. Am J Cardiol. 2018;122(8):1443-1450.

Spatz ES, Ginsburg GS, Rumsfeld JS, et al. Wearable digital health technologies for monitoring in cardiovascular medicine. N Engl J Med. 2024;390(4):346-356.

Romero I. Ambulatory electrocardiology. Cardiol Rev. 2013;21(5):239-248.

Quan KJ. Palpitation: extended electrocardiogram monitoring: which tests to use and when. Med Clin North Am. 2019;103(5):785-791.

Derkac WM, Finkelmeier JR, Horgan DJ, et al. Diagnostic yield of asymptomatic arrhythmias detected by mobile cardiac outpatient telemetry and autotrigger looping event cardiac monitors. J Cardiovasc Electrophysiol. 2017;28(12):1475-1478.

Rothman SA, Laughlin JC, Seltzer J, et al. The diagnosis of cardiac arrhythmias: a prospective multi-center randomized study comparing mobile cardiac outpatient telemetry versus standard loop event monitoring. J Cardiovasc Electrophysiol. 2007;18(3):241-247.

Brignole M, Vardas P, Hoffman E, et al.; Task Force members; EHRA Scientific Documents Committee; Document Reviewers; EHRA Scientific Documents Committee. Indications for the use of diagnostic implantable and external ECG loop recorders. Europace. 2009;11(5):671-687.

Bisignani A, De Bonis S, Mancuso L, et al. Implantable loop recorder in clinical practice. J Arrhythm. 2018;35(1):25-32.

Giada F, Gulizia M, Francese M, et al. Recurrent unexplained palpitations (RUP) study comparison of implantable loop recorder versus conventional diagnostic strategy. J Am Coll Cardiol. 2007;49(19):1951-1956.

Neiman ZM, Raitt MH, Rohrbach G, et al. Monitoring of remotely reprogrammable implantable loop recorders with algorithms to reduce false-positive alerts. J Am Heart Assoc. 2024;13(5):e032890.

Buda KG, Sengupta J. Smartwatches and atrial fibrillation: what works and what needs improvement? May 29, 2024. Accessed July 1, 2025. https://www.acc.org/latest-in-cardiology/articles/2024/05/29/16/56/smartwatches-and-atrial-fibrillation

Hughes A, Shandhi MMH, Master H, et al. Wearable devices in cardiovascular medicine. Circ Res. 2023;132(5):652-670.

Singh M, Rao R, Gupta S. KardiaMobile for ECG monitoring and arrhythmia diagnosis. Am Fam Physician. 2020;102(9):562-564.

Mohamoud A, Jensen J, Buda KG. Consumer-grade wearable cardiac monitors: What they do well, and what needs work. Cleve Clin J Med. 2024;91(1):23-29.

Baman JR, Mathew DT, Jiang M, et al. Mobile health for arrhythmia diagnosis and management. J Gen Intern Med. 2022;37(1):188-197.

Lubitz SA, Faranesh AZ, Selvaggi C, et al. Detection of atrial fibrillation in a large population using wearable devices: the fitbit heart study. Circulation. 2022;146(19):1415-1424.

Seshadri DR, Bittel B, Browsky D, et al. Accuracy of Apple watch for detection of atrial fibrillation. Circulation. 2020;141(8):702-703.

Prasitlumkum N, Cheungpasitporn W, Chokesuwattanaskul A, et al. Diagnostic accuracy of smart gadgets/wearable devices in detecting atrial fibrillation: a systematic review and meta-analysis. Arch Cardiovasc Dis. 2021;114(1):4-16.

Joglar JA, Chung MK, Armbruster AL, et al.; Peer Review Committee Members. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1):e1-e156.

Barat M, Barba DT, Ho G. Wolff-Parkinson-White syndrome: diagnostic and management strategies. Cleve Clin J Med. 2025;92(2):119-127.

Brugada J, Campuzano O, Arbelo E, et al. Present status of Brugada syndrome: JACC state-of-the-art review. J Am Coll Cardiol. 2018;72(9):1046-1059.

Sheldon RS, Grubb BP, Olshansky B, et al. 2015 Heart Rhythm Society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12(6):e41-e63.

Abbott AV. Diagnostic approach to palpitations. Am Fam Physician. 2005;71(4):743-750.

Wyse DG, Waldo AL, DiMarco JP, et al.; Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347(23):1825-1833.

Marrouche NF, Brachmann J, Andresen D, et al.; CASTLE-AF Investigators. Catheter ablation for atrial fibrillation with heart failure. N Engl J Med. 2018;378(5):417-427.

Kirchhof P, Camm AJ, Goette A, et al.; EAST-AFNET 4 Trial Investigators. Early rhythm-control therapy in patients with atrial fibrillation. N Engl J Med. 2020;383(14):1305-1316.

Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2019;140(8):e382-e482.

Shen WK, Sheldon RS, Benditt DG, et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017;136(5):e60-e122.

Brignole M, Moya A, de Lange FJ, et al.; ESC Scientific Document Group. 2018 ESC guidelines for the diagnosis and management of syncope. Eur Heart J. 2018;39(21):1883-1948.

Bayard M, Gerayli F, Holt J. Syncope: evaluation and differential diagnosis. Am Fam Physician. 2023;108(5):454-463.

Pecci R, Ceccofiglio A, Ungar A. Syncope-presyncope and dizziness, differential diagnosis. Minerva Med. 2022;113(2):273-280.

Muncie HL, Sirmans SM, James E. Dizziness: approach to evaluation and management. Am Fam Physician. 2017;95(3):154-162.

Albassam OT, Redelmeier RJ, Shadowitz S, et al. Did this patient have cardiac syncope?: the rational clinical examination systematic review. JAMA. 2019;321(24):2448-2457.

da Silva RMFL. Syncope: epidemiology, etiology, and prognosis. Front Physiol. 2014;5:471.

Toarta C, Mukarram M, Arcot K, et al. Syncope prognosis based on emergency department diagnosis: a prospective cohort study. Acad Emerg Med. 2018;25(4):388-396.

Thiruganasambandamoorthy V, Sivilotti MLA, Le Sage N, et al. Multicenter emergency department validation of the Canadian syncope risk score. JAMA Intern Med. 2020;180(5):737-744.

Thiruganasambandamoorthy V, Stiell IG, Wells GA, et al. Outcomes in presyncope patients: a prospective cohort study. Ann Emerg Med. 2015;65(3):268-276.e6.

Juraschek SP, Daya N, Rawlings AM, et al. Association of history of dizziness and long-term adverse outcomes with early vs later orthostatic hypotension assessment times in middle-aged adults. JAMA Intern Med. 2017;177(9):1316-1323.

Saedon NIZ, Pin Tan M, Frith J. The prevalence of orthostatic hypotension: a systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci. 2020;75(1):117-122.

Saklani P, Krahn A, Klein G. Syncope. Circulation. 2013;127(12):1330-1339.

Costantino G, Perego F, Dipaola F, et al.; STePS Investigators. Short- and long-term prognosis of syncope, risk factors, and role of hospital admission: results from the STePS (Short-Term Prognosis of Syncope) study. J Am Coll Cardiol. 2008;51(3):276-283.

Wakai A, Sinert R, Zehtabchi S, et al. Risk-stratification tools for emergency department patients with syncope: a systematic review and meta-analysis of direct evidence for SAEM GRACE. Acad Emerg Med. 2025;32(1):72-86.

Sweanor RAL, Redelmeier RJ, Simel DL, et al. Multivariable risk scores for predicting short-term outcomes for emergency department patients with unexplained syncope: a systematic review. Acad Emerg Med. 2021;28(5):502-510.

Thiruganasambandamoorthy V, Yan JW, Rowe BH, et al. Personalised risk prediction following emergency department assessment for syncope. Emerg Med J. 2022;39(7):501-507.

Anderson TS, Thombley R, Dudley RA, et al. Trends in hospitalization, readmission, and diagnostic testing of patients presenting to the emergency department with syncope. Ann Emerg Med. 2018;72(5):523-532.

Sandhu RK, Raj SR, Thiruganasambandamoorthy V, et al. Canadian Cardiovascular Society clinical practice update on the assessment and management of syncope. Can J Cardiol. 2020;36(8):1167-1177.

Solbiati M, Casazza G, Dipaola F, et al. Syncope recurrence and mortality: a systematic review. Europace. 2015;17(2):300-308.

Behnoush AH, Yazdani K, Khalaji A, et al. Pharmacologic prevention of recurrent vasovagal syncope: a systematic review and network meta-analysis of randomized controlled trials. Heart Rhythm. 2023;20(3):448-460.

Martone AM, Parrini I, Ciciarello F, et al. Recent advances and future directions in syncope management: a comprehensive narrative review. J Clin Med. 2024;13(3):727.

Solbiati M, Costantino G, Casazza G, et al. Implantable loop recorder versus conventional diagnostic workup for unexplained recurrent syncope. Cochrane Database Syst Rev. 2016;4(4):CD011637.

Brignole M, Rivasi G, Fedorowski A. Mechanism-based therapy of non-cardiac syncope: a practical guide. Europace. 2024;26(4):euae073.

Kim JH, Baggish AL, Levine BD, et al.; American Heart Association Leadership Committee of the Council on Clinical Cardiology; Council on Basic Cardiovascular Sciences; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Surgery and Anesthesia; Council on Peripheral Vascular Disease; American College of Cardiology. Clinical considerations for competitive sports participation for athletes with cardiovascular abnormalities: a scientific statement from the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2025;85(10):1059-1108.

Vernino S, Bourne KM, Stiles LE, et al. Postural orthostatic tachycardia syndrome (POTS): state of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1. Auton Neurosci. 2021;235:102828.

Ojha A, McNeeley K, Heller E, et al. Orthostatic syndromes differ in syncope frequency. Am J Med. 2010;123(3):245-249.

Fedorowski A. Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management. J Intern Med. 2019;285(4):352-366.

Sebastian SA, Co EL, Panthangi V, et al. Postural orthostatic tachycardia syndrome (POTS): an update for clinical practice. Curr Probl Cardiol. 2022;47(12):101384.

Sheldon RS, Grubb BP, Olshansky B, et al. 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12(6):e41-e63.

Pierson BC, Apilado K, Franzos MA, et al. Oral medications for the treatment of postural orthostatic tachycardia syndrome; a systematic review of studies before and during the COVID-19 pandemic. Front Neurol. 2025;15:1515486.

Besharat S, Grol-Prokopczyk H, Gao S, et al. Peripheral edema: a common and persistent health problem for older Americans. PLoS One. 2021;16(12):e0260742.

Largeau B, Cracowski JL, Lengellé C, et al. Drug-induced peripheral edema: an etiology-based review. Br J Clin Pharmacol. 2021;87(8):3043-3055.

Givertz MM, Mehra MR. Heart failure: pathophysiology and diagnosis. In: Longo DL, Fauci AS, Kasper DL, et al, eds. Harrison’s Principles of Internal Medicine. 22nd ed. McGraw-Hill Education; 2025.

Braunwald E, Loscalzo J. Edema. In: Longo DL, FauciAS, KasperDL, et al, eds. Harrison’s Principles of Internal Medicine. 19th ed. McGraw-Hill Education; 2015:250-253.

Creager M, Loscalzo J. Chronic venous disease and lymphedema. In: Longo DL, Fauci AS, Kasper DL, et al, eds. Harrison’s Principles of Internal Medicine. 19th ed. McGraw-Hill Education; 2015:1650-1655.

Patel H, Skok C, DeMarco A. Peripheral edema: evaluation and management in primary care. Am Fam Physician. 2022;106(5):557-564.

Suehiro K, Morikage N, Harada T, et al. Application of the l-dex score for the assessment of bilateral leg edema. Lymphat Res Biol. 2018;16(1):65-68.

Centers for Disease Control and Prevention. Cancer survivors: lymphedema. August 26, 2024. Accessed October 21, 2025. https://www.cdc.gov/cancer-survivors/patients/lymphedema.html

Trayes KP, Studdiford JS, Pickle S, et al. Edema: diagnosis and management. Am Fam Physician. 2013;88(2):102-110.

Markarian B, Toro C, Moreira K, et al. Assessment modalities for lower extremity edema, lymphedema, and lipedema: a scoping review. Cureus. 2024;16(3):e55906.

Smith A, Baumgartner K, Bositis C. Cirrhosis: diagnosis and management. Am Fam Physician. 2019;100(12):759-770.

Lee JH, Lee SH, Yun SJ. Comparison of 2-point and 3-point point-of-care ultrasound techniques for deep vein thrombosis at the emergency department: a meta-analysis. Medicine (Baltimore). 2019;98(22):e15791.

American College of Surgeons. ACS TQIP best practices in the management of orthopaedic trauma. November 2015. Accessed September 5, 2025. https://www.facs.org/media/mkbnhqtw/ortho_guidelines.pdf

Needleman L, Cronan JJ, Lilly MP, et al. Ultrasound for lower extremity deep venous thrombosis: multidisciplinary recommendations from the society of radiologists in ultrasound consensus conference. Circulation. 2018;137(14):1505-1515.

Ely JW, Osheroff JA, Chambliss ML, et al. Approach to leg edema of unclear etiology. J Am Board Fam Med. 2006;19(2):148-160.

Lim W, Le Gal G, Bates SM, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism. Blood Adv. 2018;2(22):3226-3256.

Executive Committee of the International Society of Lymphology. The diagnosis and treatment of peripheral lymphedema: 2020 consensus document of the International Society of Lymphology. Lymphology. 2020;53(1):3-19.

Gloviczki P, Lawrence PF, Wasan SM, et al. The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II: endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine. J Vasc Surg Venous Lymphat Disord. 2024;12(1):101670.

Kearney D, Reisinger N, Lohani S. Integrative volume status assessment. POCUS J. 2022;7(Kidney):65-77.

Finkelstein ER, Crist TE, Shao T, et al. The utility of computed tomography venography in the routine evaluation of patients who present to a lymphedema center with lower extremity edema. J Vasc Surg Venous Lymphat Disord. 2023;11(5):1055-1062.

Ortel TL, Neumann I, Ageno W, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020;4(19):4693-4738.

Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022;79(17):e263-e421.

Hollenberg SM, Stevenson LW, Ahmad T, et al.; Writing Committee. 2024 ACC expert consensus decision pathway on clinical assessment, management, and trajectory of patients hospitalized with heart failure focused update: a report of the American College of Cardiology solution set oversight committee. J Am Coll Cardiol. 2024;84(13):1241-1267.

Biggins SW, Angeli P, Garcia-Tsao G, et al. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021;74(2):1014-1048.

Singal AK, Wong RJ, Dasarathy S, et al. ACG clinical guideline: malnutrition and nutritional recommendations in liver disease. Am J Gastroenterol. 2025;120(5):950-972.

Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int. 2021;100(4S):S1-S276.

Alavi A, Sibbald RG, Phillips TJ, et al. What’s new: management of venous leg ulcers: treating venous leg ulcers. J Am Acad Dermatol. 2016;74(4):643-664.

Araujo DN, Ribeiro CTD, Maciel ACC, et al. Physical exercise for the treatment of non-ulcerated chronic venous insufficiency. Cochrane Database Syst Rev. 2023(6):CD010637.

Fukaya E, Kolluri R. Nonsurgical management of chronic venous insufficiency. N Engl J Med. 2024;391(24):2350-2359.

O’Donnell TF, Passman MA. Clinical practice guidelines of the Society for Vascular Surgery (SVS) and the American Venous Forum (AVF)—Management of venous leg ulcers. Introduction. J Vasc Surg. 2014;60(2 suppl):1S-2S.

Lurie F, Passman M, Meisner M, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord. 2020;8(3):342-352.

De Maeseneer MG, Kakkos SK, Aherne T, et al. Editor’s Choice – European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. Eur J Vasc Endovasc Surg. 2022;63(2):184-267.

Greene AK. Epidemiology and morbidity of lymphedema. In: Greene AK, Slavin SA, Brorson H, eds. Lymphedema: Presentation, Diagnosis, and Treatment. Springer International Publishing; 2015:33-44.

Schaverien MV, Moeller JA, Cleveland SD. Nonoperative treatment of lymphedema. Semin Plast Surg. 2018;32(1):17-21.

Kligman L, Wong RKS, Johnston M, et al. The treatment of lymphedema related to breast cancer: a systematic review and evidence summary. Support Care Cancer. 2004;12(6):421-431.

Lurie F, Malgor RD, Carman T, et al. The American Venous Forum, American Vein and Lymphatic Society and the Society for Vascular Medicine expert opinion consensus on lymphedema diagnosis and treatment. Phlebology. 2022;37(4):252-266.

Thompson B, Gaitatzis K, Janse de Jonge X, et al. Manual lymphatic drainage treatment for lymphedema: a systematic review of the literature. J Cancer Surviv. 2021;15(2):244-258.

Bertsch T, Erbacher G, Elwell R. Lipoedema: a paradigm shift and consensus. J Wound Care. 2020;29(sup11b):1-51.

Cifarelli V. Lipedema: progress, challenges, and the road ahead. Obes Rev. 2025;26(10):e13953.

Continue Reading