190 Chapter 8 23. Cardiac arrhythmia Prerequisite: the complaints at ED presentation are due to this episode of cardiac arrhythmia and other causes have been excluded (i.e. acute coronary syndrome, pulmonary embolism, infection etc.). Cardiac arrhythmia may be indicated in the EHR as “atrial flutter”, “atrial fibrillation” or “AV-block”. Exception: • When the ED report or follow-up information states “sinus tachycardia”, please do not assign this diagnostic label. A sinus tachycardia could be due to an underlying cause such as infection. 24. Pulmonary embolism This label can be assigned in two situations: 1. CT-Angiography was positive for pulmonary embolism. 1. No CT-Angiography was performed, but the patient did have: a. Dyspnea AND b. Elevated D-dimer AND c. A first presentation of an echographically confirmed deep vein thrombosis AND e. No other abnormality was found on CR-thorax or ULD CT. NB: when in doubt, refer this case to the Adjudication Committee. NB: a deep vein thrombosis should not be given a diagnostic label in itself. References: [21, 22] 25. Lung cancer and pulmonary metastases This label can be assigned in two situations: 1. Pathology has confirmed lung cancer (lung cancer) 2. Growth of a pulmonary nodus or a new nodus when the patient has a known malignancy confirmed by pathology (pulmonary metastases) NB: if there is only a clinical suspicion of lung cancer or pulmonary metastases and/or a (PET-)CT or MRI shows signs of lung cancer or pulmonary metastases, please refer this case to the Adjudication Committee. References: [23] 26. Mediastinal tumor This label can be assigned in two situations: 1. The radiology report describes a mediastinal tumor (teratoma, thymoma, thyroid, lymphoma) AND pathology has confirmed a mediastinal tumor in one of the following categories: teratoma, thymoma, thyroid, lymphoma (mediastinal tumor). 2. The radiology report describes hilar glands AND this is the only manifestation of PA/ microbiologically proven sarcoidosis or tuberculosis (clarification: if there are other radiological findings consistent with sarcoidosis, label as “ILD”) NB: if there is only a clinical suspicion of mediastinal tumor/hilar glands and/or a (PET-) CT or MRI showed signs mediastinal tumor/hilar glands, please refer this case to the Adjudication Committee.
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