Society guidelines for cardiovascular conditions.

15 topics · 17 versions · 5 high-yield

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Acute coronary syndrome (STEMI + NSTE-ACS) ⭐

acs · society: ACC/AHA/ACEP/NAEMSP/SCAI · high-yield

Comprehensive 2025 multisociety guideline for management of acute coronary syndromes (STEMI, NSTEMI, unstable angina), replacing the 2013 STEMI, 2014 NSTE-ACS, 2015 PPCI focused update, and 2016 DAPT duration focused update guidelines. Major updates include preference for ticagrelor/prasugrel over clopidogrel, ticagrelor monotherapy after 1 month of DAPT in select patients, more aggressive LDL-C targets (<70 mg/dL, intensify if 55–<70), complete revascularization (preferably single-setting) in STEMI, routine radial access, intracoronary imaging for complex PCI, microaxial flow pump for selected AMI cardiogenic shock, and a more liberal transfusion threshold (Hb ~10 g/dL) in ACS with anemia.

Atrial fibrillation ⭐

atrial-fibrillation · society: ACC/AHA/ACCP/HRS · high-yield

Comprehensive update to the 2014 guideline and 2019 focused update for diagnosis and management of atrial fibrillation, introducing a new stage-based AF classification (Stages 1–4) emphasizing AF as a disease continuum. Major changes include upgrading catheter ablation to Class 1 first-line therapy in selected patients (including HFrEF), upgrading LAA occlusion to Class 2a for long-term anticoagulation contraindications, emphasizing early rhythm control, prescriptive lifestyle/risk factor modification, and refined recommendations for device-detected AF based on episode duration and CHA2DS2-VASc score.

Bradycardia / conduction delay

bradycardia · society: ACC/AHA/HRS

Comprehensive guideline on evaluation and management of adult patients (>18 years) with bradycardia and cardiac conduction delay, including sinus node dysfunction (SND), atrioventricular (AV) block, and intraventricular conduction disorders. Supersedes the 2008 device-based therapy guidelines and 2012 focused update. Emphasizes symptom-rhythm correlation for pacing decisions in SND, mandatory pacing for acquired Mobitz II/high-grade/third-degree AV block regardless of symptoms, screening for sleep apnea when nocturnal bradycardia is found, and use of more physiologic pacing (CRT, His bundle) when significant ventricular pacing is anticipated with LVEF 36-50%.

Chest pain evaluation

chest-pain · society: AHA/ACC

Multisociety guideline on evaluation and diagnosis of acute and stable chest pain in adults, emphasizing structured risk stratification, high-sensitivity cardiac troponin (hs-cTn), clinical decision pathways, and selective use of anatomic (CCTA) versus functional (stress) testing. Key shifts include preferring hs-cTn over conventional troponin/CK-MB, abandoning the term “atypical” chest pain in favor of “cardiac/possible cardiac/noncardiac,” routine use of CDPs in the ED, deferring testing in low-risk patients, and incorporating shared decision-making and cost-value considerations.

Chronic coronary disease (stable IHD)

chronic-coronary-disease · society: AHA/ACC

Comprehensive update consolidating evidence since the 2012/2014 stable ischemic heart disease guidelines for outpatient management of chronic coronary disease (CCD). Emphasizes team-based, patient-centered care with shared decision-making, social determinants of health, and cost/value considerations. Key new directions: limited role for long-term beta blockers without MI/LVEF≤50%, expanded use of SGLT2 inhibitors and GLP-1 RAs (including some without diabetes), shorter DAPT durations when bleeding risk is high, low-dose colchicine as adjunct, and recommendation against routine periodic ischemic/anatomic testing in stable asymptomatic patients.

Coronary revascularization

coronary-revascularization · society: ACC/AHA/SCAI

Consolidated update of prior PCI, CABG, STEMI, NSTE-ACS, and SIHD revascularization guidelines into a single patient-centric document. Emphasizes Heart Team decision-making, shared decision-making, equity of care, radial access, radial artery conduit over saphenous vein for second target, shorter DAPT durations with P2Y12 monotherapy transition, staged non-culprit PCI in STEMI, and CABG preference for diabetics with multivessel disease. Downgrades CABG from Class I to Class 2b for 3-vessel SIHD with preserved EF based on ISCHEMIA and contemporary trials.

Dyslipidemia / cholesterol ⭐

dyslipidemia · society: ACC/AHA · high-yield

The 2026 ACC/AHA multisociety guideline replaces the 2018 cholesterol guideline and broadens scope to dyslipidemias including LDL-C, triglycerides, and Lp(a). Major changes: adoption of PREVENT-ASCVD equations (replacing Pooled Cohort Equations) with new lower risk thresholds; reintroduction of explicit LDL-C and non-HDL-C treatment goals stratified by risk; universal one-time Lp(a) measurement; expanded role for apoB, CAC scoring (including incidental CAC on noncardiac CT), and combination nonstatin therapy (ezetimibe, PCSK9 mAb, bempedoic acid, inclisiran, olezarsen for FCS).

Heart failure ⭐

heart-failure · society: AHA/ACC/HFSA · high-yield

Comprehensive update replacing the 2013 and 2017 ACCF/AHA HF guidelines, covering prevention, diagnosis, staging, and management across the full spectrum of heart failure. Key changes include four-pillar GDMT for HFrEF with addition of SGLT2 inhibitors, new recommendations for HFpEF (SGLT2i Class 2a; MRA and ARNi Class 2b), revised stage terminology (“at-risk” stage A, “pre-HF” stage B), introduction of HFimpEF category, expanded cardiac amyloidosis diagnostic/treatment recommendations, and cost-value statements for selected therapies.

Hypertension ⭐

hypertension · society: AHA/ACC · high-yield

Multisociety update replacing the 2017 hypertension guideline, redefining BP categories, treatment thresholds, and goals using the PREVENT 10-year CVD risk equation rather than pooled cohort equations. Universal BP target is <130/80 mm Hg, with risk-based initiation of pharmacotherapy at ≥130/80 mm Hg for high-risk patients and ≥140/90 mm Hg for all others. New recommendations address primary aldosteronism screening in resistant hypertension, potassium-based salt substitutes, pregnancy management (including aspirin prophylaxis), renal denervation, and management of acute ICH and stroke.

Peripheral artery disease

peripheral-artery-disease · society: ACC/AHA

Comprehensive update to the 2016 AHA/ACC PAD guideline covering diagnosis and management of lower extremity peripheral artery disease across four clinical subsets: asymptomatic PAD, chronic symptomatic PAD (claudication), chronic limb-threatening ischemia (CLTI), and acute limb ischemia (ALI). New emphasis on PAD-related risk amplifiers, health disparities, multispecialty team-based care for CLTI, structured exercise (including community/home-based), and incorporation of low-dose rivaroxaban plus aspirin for prevention of MACE/MALE. Reflects evidence from BEST-CLI, BASIL-2, VOYAGER PAD, and COMPASS trials.

Primary prevention of CVD

primary-prevention-cvd · society: ACC/AHA

Comprehensive ACC/AHA guideline consolidating primary prevention of ASCVD, heart failure, and atrial fibrillation in adults. Emphasizes healthy lifestyle as foundation, 10-year ASCVD risk estimation via Pooled Cohort Equations to guide pharmacotherapy decisions, and shared decision-making augmented by risk-enhancing factors and coronary artery calcium scoring. New recommendations downgrade routine aspirin for primary prevention, endorse SGLT-2 inhibitors/GLP-1 agonists for T2DM with high ASCVD risk, and address team-based care and social determinants of health.

Syncope

syncope · society: ACC/AHA/HRS

The 2017 ACC/AHA/HRS syncope guideline provides comprehensive recommendations for the evaluation and management of adult and pediatric patients with syncope, defined as abrupt transient loss of consciousness from cerebral hypoperfusion with rapid spontaneous recovery. Initial evaluation centers on detailed history, physical exam, and 12-lead ECG, with risk stratification directing disposition. The guideline addresses cardiac (arrhythmic, structural, inheritable channelopathies), reflex (vasovagal, carotid sinus, situational), and orthostatic causes, and gives population-specific guidance for pediatric, geriatric, athletic, ACHD patients, and drivers.

Thoracic aortic disease

thoracic-aortic-disease · society: ACC/AHA

Comprehensive update to ACC/AHA aortic disease guidance covering diagnosis, genetic evaluation, medical therapy, endovascular/surgical management, and surveillance of thoracic and abdominal aortic disease across asymptomatic, stable symptomatic, and acute presentations. Key changes include lowering the surgical threshold for sporadic root/ascending aneurysms from 5.5 cm to 5.0 cm at experienced Multidisciplinary Aortic Team centers, emphasis on indexed aortic measurements for small/large patients, expanded role of TEVAR in uncomplicated type B dissection, and routine first-degree relative screening for TAA/dissection.

Valvular heart disease

valvular-heart-disease · society: ACC/AHA

Comprehensive update replacing the 2014 VHD guideline and 2017 focused update, covering diagnosis, staging (A–D), and management of native and prosthetic valve disease in adults. Key changes include expanded TAVI indications across all surgical risk strata, lower thresholds for intervention in regurgitant lesions, formalized Heart Valve Team/Comprehensive Valve Center referral, updated antithrombotic regimens (NOACs permitted in most VHD with AF except rheumatic MS and mechanical valves), and new recommendations for TEER in primary and selected secondary MR.

Ventricular arrhythmias / SCD

ventricular-arrhythmias · society: AHA/ACC/HRS

Comprehensive guideline for managing ventricular arrhythmias (VA) and preventing sudden cardiac death (SCD), superseding the 2006 ACC/AHA/ESC document and the ICD sections of the 2008 device guideline. Covers acute VA management, ICD indications (primary and secondary prevention) across ischemic and nonischemic cardiomyopathy, channelopathies, HCM, ARVC, sarcoidosis, congenital heart disease, and special populations. Emphasizes shared decision-making, GDMT optimization before primary prevention ICD, and the role of catheter ablation for recurrent VT.

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