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<title>Cardiac monitoring</title>

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<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Cardiac monitoring</span></span>

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</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Cardiac monitoring</th></tr><tr><td colspan="2" class="infobox-image"><div class="infobox-caption"><a href="Holter_monitor" title="Holter monitor">Holter monitor</a>.</div></td></tr></tbody></table>

<p><b>Cardiac monitoring</b> generally refers to continuous or intermittent <a href="Monitoring_(medicine)" title="Monitoring (medicine)">monitoring</a> of <a href="Heart" title="Heart">heart</a> activity to assess a patient's condition relative to their <a href="Cardiac_cycle" title="Cardiac cycle">cardiac rhythm</a>. Cardiac monitoring is usually carried out using <a href="Electrocardiography" title="Electrocardiography">electrocardiography</a>, which is a <a href="Non-invasive_procedure" title="Non-invasive procedure">noninvasive</a> process that records the <a href="Cardiac_conduction_system" title="Cardiac conduction system">heart's electrical</a> activity and displays it in an electrocardiogram.<sup id="cite_ref-Sattar-Chhabra_1-0" class="reference"><a href="#cite_note-Sattar-Chhabra-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> It is different from <a href="Hemodynamics" title="Hemodynamics">hemodynamic</a> monitoring, which monitors the <a href="Blood_pressure" title="Blood pressure">pressure</a> and <a href="Blood_flow" class="mw-redirect" title="Blood flow">flow</a> of blood within the <a href="Circulatory_system#Human_cardiovascular_system" title="Circulatory system">cardiovascular system</a>. The two may be performed simultaneously on <a href="Critical_care_medicine" class="mw-redirect" title="Critical care medicine">critical</a> heart patients. Cardiac monitoring for ambulatory patients (those well enough to walk around) is known as ambulatory electrocardiography and uses a small, wearable device, such as a <a href="Holter_monitor" title="Holter monitor">Holter monitor</a>, <a href="Wireless_ambulatory_ECG" title="Wireless ambulatory ECG">wireless ambulatory ECG</a>, or an <a href="Implantable_loop_recorder" title="Implantable loop recorder">implantable loop recorder</a>. Data from a cardiac monitor can be transmitted to a distant monitoring station in a process known as <a href="Telemetry" title="Telemetry">telemetry</a> or <a href="Biotelemetry" title="Biotelemetry">biotelemetry</a>.

</p><p>Cardiac monitoring in an <a href="Emergency_department" title="Emergency department">emergency department</a> setting focuses primarily on the monitoring of <a href="Arrhythmia" title="Arrhythmia">arrhythmia</a>, <a href="Myocardial_infarction" title="Myocardial infarction">myocardial infarction</a>, and <a href="QT_interval" title="QT interval">QT interval</a> monitoring.<sup id="cite_ref-Zegre-Hemsey-Garvey-Carey_2-0" class="reference"><a href="#cite_note-Zegre-Hemsey-Garvey-Carey-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> It is categorized into one of three classes using a rating system developed by the American College of Cardiology Emergency Cardiac Care Committee:

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<ul><li>Class I: Cardiac monitoring is indicated in all or most patients.</li>

<li>Class II: Cardiac monitoring may be beneficial, but it is not essential.</li>

<li>Class III: Cardiac monitoring is not indicated because the patient's serious event risk is low. Monitoring will not have therapeutic benefit.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup></li></ul>

<div class="mw-heading mw-heading2"><h2 id="Emergency_medical_services">Emergency medical services</h2></div>

<p>In the setting of out-of-hospital <a href="Acute_(medicine)" title="Acute (medicine)">acute medical care</a>, ambulance services and other <a href="Emergency_medical_services" title="Emergency medical services">emergency medical services</a> providers utilize heart monitors to assess the patient's cardiac rhythm. Providers licensed or certified at the <a href="Paramedic" title="Paramedic">Paramedic</a> level are qualified to interpret ECGs. Information obtained from ECGs can then be used to direct the patient's treatment at a care facility, particularly in catheterization labs.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading2"><h2 id="In_the_emergency_department">In the emergency department</h2></div>

<p>In the <a href="Emergency_department" title="Emergency department">emergency department</a>, cardiac monitoring is a part of the monitoring of <a href="Vital_sign" class="mw-redirect" title="Vital sign">vital signs</a> in <a href="Emergency_medicine" title="Emergency medicine">emergency medicine</a>, and generally includes <a href="Electrocardiography" title="Electrocardiography">electrocardiography</a>.<sup id="cite_ref-Zegre-Hemsey-Garvey-Carey_2-1" class="reference"><a href="#cite_note-Zegre-Hemsey-Garvey-Carey-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading3"><h3 id="Monitor/defibrillators">Monitor/defibrillators</h3></div>

<p>Some digital patient monitors, especially those used by EMS services, often incorporate a defibrillator into the patient monitor itself. These monitor/defibrillators usually have the normal capabilities of an ICU monitor, but have manual (and usually semi-automatic AED) defibrillation capabilities. This is particularly good for EMS services, who need a compact, easy to use monitor and defibrillator, as well as for patient transport. Most monitor defibrillators also have transcutaneous pacing capability via large AED like adhesive pads (which often can be used for monitoring, defibrillation and pacing) that are applied to the patient in an anterior-posterior configuration. The monitor defibrillator units often have specialized monitoring parameters such as waveform capnography, invasive BP, and, in some monitors, Masimo Rainbow SET pulse oximetry, which can also monitor <a href="Carbon_monoxide" title="Carbon monoxide">carbon monoxide</a> and <a href="Methemoglobin" title="Methemoglobin">methemoglobin</a> levels. Most modern monitors also allow for transmission of an ECG sample to an emergency department for interpretation; this process may be used to speed up patient care in certain situations, such as bypassing the ED and proceeding to a <a href="Cath_lab" class="mw-redirect" title="Cath lab">cath lab</a>.

</p><p>Examples of monitor defibrillators are the <a href="Lifepak" title="Lifepak">Lifepak</a> 12, 15 and 20 made by <a href="Physio-Control" title="Physio-Control">Physio-Control</a>, the <a href="Philips" title="Philips">Philips</a> Heartstart MRx, and the E, R, and X Series by ZOLL Medical.

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<div class="mw-heading mw-heading2"><h2 id="Long-term_ambulatory_monitors">Long-term ambulatory monitors</h2></div>

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</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Holter_monitor" title="Holter monitor">Holter monitor</a></div>

<p>There are two broad classifications for cardiac event monitors: manual (or dumb) and automatic. Automatic ECG event monitors have the ability to monitor the patient's ECG and make recordings of abnormal events without requiring patient intervention. Manual ECG event recorders require the patient to be symptomatic and to activate the device to record an event; this makes these devices useless whilst, for example, the patient is sleeping. A third classification, the <a href="Implantable_loop_recorder" title="Implantable loop recorder">implantable loop recorder</a>, provides both automatic and manual abilities.

</p><p>An example of automatic monitoring is the transtelephonic cardiac event monitor. This monitor contacts ECG technicians, via telephone, on a regular basis, transmitting <a href="ECG" class="mw-redirect" title="ECG">ECG</a> rhythms for ongoing monitoring. The transtelephonic cardiac event monitor can normally store approximately five "cardiac events" usually lasting 30–60 seconds.

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<div class="gallerytext">Portable wireless ECG monitor</div>

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<div class="gallerytext">A close up of a person wearing the iRhythm ZIO XT patch, nine days after its placement</div>

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<div class="mw-heading mw-heading2"><h2 id="Heart_rate_monitoring">Heart rate monitoring</h2></div>

<div role="note" class="hatnote navigation-not-searchable">Further information: <a href="Heart_rate_monitor" title="Heart rate monitor">Heart rate monitor</a></div>

<p>Monitoring of the <a href="Heart_rate" title="Heart rate">heart rate</a> can be performed as part of <a href="Electrocardiography" title="Electrocardiography">electrocardiography</a>, but it can also be measured conveniently with specific <a href="Heart_rate_monitor" title="Heart rate monitor">heart rate monitors</a>. Such heart rate monitors are largely used by performers of various types of <a href="Physical_exercise" class="mw-redirect" title="Physical exercise">physical exercise</a>.

</p><p>A generic cardiac monitor has the following functions:

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<ul><li>A display of heart rate and heart rhythm</li>

<li>Sound alarms above and below a pre-set limit</li>

<li>Ability to determine the presence of arrhythmia</li></ul>

<p>There are many different types of cardiac monitors. In personal use, the <a href="Holter_monitor" title="Holter monitor">Holter monitor</a> is an external monitor which uses wires with patches that attach to the skin to continuously measure and record heart activity for 1–2 days.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> An Event Recorder can be worn on the body for up to 30 days.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> A Mobile Cardiac Telemetry unit is a wearable monitor that detects, records, and transmits heart rhythms for up to 30 days. For long term use, an <a href="Insertable_cardiac_monitor" class="mw-redirect" title="Insertable cardiac monitor">Insertable Cardiac Monitor</a> is placed under the skin and automatically detects and records abnormal heart rhythms for up to 5 years.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading3"><h3 id="Fetal_heart_rate_monitoring">Fetal heart rate monitoring</h3></div>

<p>Monitoring the fetal heart rate is becoming increasingly prevalent in the standard care of antepartum pregnant patients.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> As of 2002, 85% of pregnancies in the United States were monitored using electronic fetal monitoring. Electronic fetal monitoring generally uses Doppler ultrasound technology to provide real-time feedback on the fetus's cardiac activity during both gestation and labor,<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> however other technologies such as analyzing the voltage generated by the contracting uterine muscle measured at the skin surface or recording both the fetal ECG and mother's ECG and filtering out the mother's ECG are emerging.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading3"><h3 id="Wearable_heart_rate_monitors_for_exercise">Wearable heart rate monitors for exercise</h3></div>

<p>The new wearable heart rate monitors indirectly measure the heart rate with reflectance photoplethysmography. The monitor illuminates the skin tissue with light emitting diode (LED) and detects the intensity of light reflected with the photodetector.<sup id="cite_ref-:0_11-0" class="reference"><a href="#cite_note-:0-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Wearable optical heart rate monitors are less reliable than electrode-based heart rate monitors. The accuracy of the wearable optical heart rate monitors varies with the type of exercise. Skin tone and motion artifacts contributes to this error.<sup id="cite_ref-:0_11-1" class="reference"><a href="#cite_note-:0-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup>

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<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

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<li id="cite_note-10"><span class="mw-cite-backlink"><b><a href="#cite_ref-10">^</a></b></span> <span class="reference-text"><cite id="CITEREFAdam2012" class="citation journal cs1">Adam, J (2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3594859">"The Future of Fetal Monitoring"</a>. <i>Obstetrics & Gynaecology</i>. <b>5</b> (<span class="nowrap">3–</span>4): e132-6. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3594859">3594859</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23483429">23483429</a>.</cite></span>

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<li id="cite_note-:0-11"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_11-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_11-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFPreejithAlexJosephSivaprakasam2016" class="citation book cs1">Preejith, S P; Alex, Annamol; Joseph, Jayaraj; Sivaprakasam, Mohanasankar (May 2016). "Design, development and clinical validation of a wrist-based optical heart rate monitor". <i>2016 IEEE International Symposium on Medical Measurements and Applications (MeMeA)</i>. Benevento, Italy: IEEE. pp. <span class="nowrap">1–</span>6. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1109%2FMeMeA.2016.7533786">10.1109/MeMeA.2016.7533786</a>. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>9781467391726</bdi>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:2344766">2344766</a>.</cite></span>

</li>

<li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><cite id="CITEREFGillinovEtiwyWangBlackburn2017" class="citation journal cs1">Gillinov, Stephen; Etiwy, Muhammad; Wang, Robert; Blackburn, Gordon; Phelan, Dermot; Gillinov, A. Marc; Houghtaling, Penny; Javadikasgari, Hoda; Desai, Milind Y. (August 2017). "Variable Accuracy of Wearable Heart Rate Monitors during Aerobic Exercise". <i>Medicine & Science in Sports & Exercise</i>. <b>49</b> (8): <span class="nowrap">1697–</span>1703. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1249%2FMSS.0000000000001284">10.1249/MSS.0000000000001284</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0195-9131">0195-9131</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28709155">28709155</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:46847998">46847998</a>.</cite></span>

</li>

</ol></div></div>

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</style><div id="Medicine685" style="font-size:114%;margin:0 4em"><a href="Medicine" title="Medicine">Medicine</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Medical_specialty" title="Medical specialty">Specialties</a><br>and<br><a href="Subspecialty" title="Subspecialty">subspecialties</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Surgery" title="Surgery">Surgery</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Cardiac_surgery" title="Cardiac surgery">Cardiac surgery</a></li>

<li><a href="Cardiothoracic_surgery" title="Cardiothoracic surgery">Cardiothoracic surgery</a></li>

<li><a href="Endocrine_surgery" title="Endocrine surgery">Endocrine surgery</a></li>

<li><a href="Eye_surgery" title="Eye surgery">Eye surgery</a></li>

<li><a href="General_surgery" title="General surgery">General surgery</a>

<ul><li><a href="Colorectal_surgery" title="Colorectal surgery">Colorectal surgery</a></li>

<li><a href="Digestive_system_surgery" title="Digestive system surgery">Digestive system surgery</a></li></ul></li>

<li><a href="Neurosurgery" title="Neurosurgery">Neurosurgery</a></li>

<li><a href="Oral_and_maxillofacial_surgery" title="Oral and maxillofacial surgery">Oral and maxillofacial surgery</a></li>

<li><a href="Orthopedic_surgery" title="Orthopedic surgery">Orthopedic surgery</a></li>

<li><a href="Hand_surgery" title="Hand surgery">Hand surgery</a></li>

<li><a href="Otorhinolaryngology" title="Otorhinolaryngology">Otolaryngology</a>

<li><a href="Pediatric_surgery" title="Pediatric surgery">Pediatric surgery</a></li>

<li><a href="Plastic_surgery" title="Plastic surgery">Plastic surgery</a></li>

<li><a href="Reproductive_surgery" title="Reproductive surgery">Reproductive surgery</a></li>

<li><a href="Surgical_oncology" title="Surgical oncology">Surgical oncology</a></li>

<li><a href="Organ_transplantation" title="Organ transplantation">Transplant surgery</a></li>

<li><a href="Trauma_surgery" title="Trauma surgery">Trauma surgery</a></li>

<li><a href="Urology" title="Urology">Urology</a>

<ul><li><a href="Andrology" title="Andrology">Andrology</a></li></ul></li>

<li><a href="Vascular_surgery" title="Vascular surgery">Vascular surgery</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Internal_medicine" title="Internal medicine">Internal<br>medicine</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Allergy" title="Allergy">Allergy</a> / <a href="Immunology" title="Immunology">Immunology</a></li>

<li><a href="Angiology" title="Angiology">Angiology</a></li>

<li><a href="Cardiology" title="Cardiology">Cardiology</a>

<ul><li><a href="Interventional_cardiology" title="Interventional cardiology">Interventional</a></li></ul></li>

<li><a href="Endocrinology" title="Endocrinology">Endocrinology</a></li>

<li><a href="Gastroenterology" title="Gastroenterology">Gastroenterology</a>

<ul><li><a href="Hepatology" title="Hepatology">Hepatology</a></li></ul></li>

<li><a href="Geriatrics" title="Geriatrics">Geriatrics</a></li>

<li><a href="Hematology" title="Hematology">Hematology</a></li>

<li><a href="Hospital_medicine" title="Hospital medicine">Hospital medicine</a></li>

<li><a href="Infectious_diseases_(medical_specialty)" title="Infectious diseases (medical specialty)">Infectious diseases</a></li>

<li><a href="Nephrology" title="Nephrology">Nephrology</a></li>

<li><a href="Oncology" title="Oncology">Oncology</a></li>

<li><a href="Pulmonology" title="Pulmonology">Pulmonology</a></li>

<li><a href="Rheumatology" title="Rheumatology">Rheumatology</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Obstetrics_and_gynaecology" title="Obstetrics and gynaecology">Obstetrics and<br>gynaecology</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Gynaecology" title="Gynaecology">Gynaecology</a></li>

<li><a href="Gynecologic_oncology" title="Gynecologic oncology">Gynecologic oncology</a></li>

<li><a href="Maternal%E2%80%93fetal_medicine" title="Maternal–fetal medicine">Maternal–fetal medicine</a></li>

<li><a href="Obstetrics" title="Obstetrics">Obstetrics</a></li>

<li><a href="Reproductive_endocrinology_and_infertility" title="Reproductive endocrinology and infertility">Reproductive endocrinology and infertility</a></li>

<li><a href="Urogynecology" title="Urogynecology">Urogynecology</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Medical_diagnosis" title="Medical diagnosis">Diagnostic</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Radiology" title="Radiology">Radiology</a>

<ul><li><a href="Interventional_radiology" title="Interventional radiology">Interventional radiology</a></li>

<li><a href="Neuroradiology" title="Neuroradiology">Neuroradiology</a></li>

<li><a href="Nuclear_medicine" title="Nuclear medicine">Nuclear medicine</a></li></ul></li>

<li><a href="Pathology" title="Pathology">Pathology</a>

<ul><li><a href="Anatomical_pathology" title="Anatomical pathology">Anatomical</a></li>

<li><a href="Clinical_pathology" title="Clinical pathology">Clinical pathology</a></li>

<li><a href="Clinical_chemistry" title="Clinical chemistry">Clinical chemistry</a></li>

<li><a href="Cytopathology" title="Cytopathology">Cytopathology</a></li>

<li><a href="Medical_microbiology" title="Medical microbiology">Medical microbiology</a></li>

<li><a href="Transfusion_medicine" title="Transfusion medicine">Transfusion medicine</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Addiction_medicine" title="Addiction medicine">Addiction medicine</a></li>

<li><a href="Adolescent_medicine" title="Adolescent medicine">Adolescent medicine</a></li>

<li><a href="Anesthesiology" title="Anesthesiology">Anesthesiology</a>

<ul><li><a href="Obstetric_anesthesiology" title="Obstetric anesthesiology">Obstetric anesthesiology</a></li>

<li><a href="Neurosurgical_anesthesia" title="Neurosurgical anesthesia">Neurosurgical anesthesiology</a></li></ul></li>

<li><a href="Aviation_medicine" title="Aviation medicine">Aviation medicine</a></li>

<li><a href="Dermatology" title="Dermatology">Dermatology</a></li>

<li><a href="Disaster_medicine" title="Disaster medicine">Disaster medicine</a></li>

<li><a href="Diving_medicine" title="Diving medicine">Diving medicine</a></li>

<li><a href="Emergency_medicine" title="Emergency medicine">Emergency medicine</a>

<ul><li><a href="Mass_gathering_medicine" title="Mass gathering medicine">Mass gathering medicine</a></li></ul></li>

<li><a href="Evolutionary_medicine" title="Evolutionary medicine">Evolutionary medicine</a></li>

<li><a href="Family_medicine" title="Family medicine">Family medicine</a> / <a href="General_practice" title="General practice">General practice</a></li>

<li><a href="Hospital_medicine" title="Hospital medicine">Hospital medicine</a></li>

<li><a href="Intensive_care_medicine" title="Intensive care medicine">Intensive care medicine</a></li>

<li><a href="Medical_genetics" title="Medical genetics">Medical genetics</a></li>

<li><a href="Narcology" title="Narcology">Narcology</a></li>

<li><a href="Neurology" title="Neurology">Neurology</a>

<ul><li><a href="Clinical_neurophysiology" title="Clinical neurophysiology">Clinical neurophysiology</a></li></ul></li>

<li><a href="Occupational_medicine" title="Occupational medicine">Occupational medicine</a></li>

<li><a href="Ophthalmology" title="Ophthalmology">Ophthalmology</a></li>

<li><a href="Oral_medicine" title="Oral medicine">Oral medicine</a></li>

<li><a href="Pain_management" title="Pain management">Pain management</a></li>

<li><a href="Palliative_care" title="Palliative care">Palliative care</a></li>

<li><a href="Pediatrics" title="Pediatrics">Pediatrics</a>

<ul><li><a href="Neonatology" title="Neonatology">Neonatology</a></li></ul></li>

<li><a href="Phlebology" title="Phlebology">Phlebology</a></li>

<li><a href="Physical_medicine_and_rehabilitation" title="Physical medicine and rehabilitation">Physical medicine and rehabilitation</a> (PM&R)</li>

<li><a href="Preventive_healthcare" title="Preventive healthcare">Preventive medicine</a></li>

<li><a href="Prison_healthcare" title="Prison healthcare">Prison healthcare</a></li>

<li><a href="Psychiatry" title="Psychiatry">Psychiatry</a>

<ul><li><a href="Addiction_psychiatry" title="Addiction psychiatry">Addiction psychiatry</a></li></ul></li>

<li><a href="Radiation_therapy" title="Radiation therapy">Radiation oncology</a></li>

<li><a href="Reproductive_medicine" title="Reproductive medicine">Reproductive medicine</a></li>

<li><a href="Sexual_medicine" title="Sexual medicine">Sexual medicine</a>

<ul><li><a href="Venereology" title="Venereology">Venereology</a></li></ul></li>

<li><a href="Sleep_medicine" title="Sleep medicine">Sleep medicine</a></li>

<li><a href="Sports_medicine" title="Sports medicine">Sports medicine</a></li>

<li><a href="Organ_transplantation" title="Organ transplantation">Transplantation medicine</a></li>

<li><a href="Tropical_medicine" title="Tropical medicine">Tropical medicine</a>

<ul><li><a href="Travel_medicine" title="Travel medicine">Travel medicine</a></li></ul></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Medical_education" title="Medical education">Medical<br>education</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Medical_school" title="Medical school">Medical school</a></li>

<li><a href="Bachelor_of_Medicine%2C_Bachelor_of_Surgery" title="Bachelor of Medicine, Bachelor of Surgery">Bachelor of Medicine, Bachelor of Surgery</a></li>

<li><a href="Bachelor_of_Medical_Sciences" title="Bachelor of Medical Sciences">Bachelor of Medical Sciences</a></li>

<li><a href="Master_of_Medicine" title="Master of Medicine">Master of Medicine</a></li>

<li><a href="Master_of_Surgery" title="Master of Surgery">Master of Surgery</a></li>

<li><a href="Doctor_of_Medicine" title="Doctor of Medicine">Doctor of Medicine</a></li>

<li><a href="Doctor_of_Osteopathic_Medicine" title="Doctor of Osteopathic Medicine">Doctor of Osteopathic Medicine</a></li>

<ul><li><a href="Medical_Scientist_Training_Program" title="Medical Scientist Training Program">Medical Scientist Training Program</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Allied_health_professions" title="Allied health professions">Allied health</a></li>

<li><a href="Molecular_oncology" title="Molecular oncology">Molecular oncology</a></li>

<li><a href="Nanomedicine" title="Nanomedicine">Nanomedicine</a></li>

<li><a href="Personalized_medicine" title="Personalized medicine">Personalized medicine</a></li>

<li><a href="Public_health" title="Public health">Public health</a></li>

<li><a href="Rural_health" title="Rural health">Rural health</a></li>

<li><a href="Therapy" title="Therapy">Therapy</a></li>

<li><a href="Veterinary_medicine" title="Veterinary medicine">Veterinary medicine</a></li>

<li><a href="Physician" title="Physician">Physician</a>

<ul><li><a href="Chief_physician" title="Chief physician">Chief physician</a></li></ul></li>

<li><a href="History_of_medicine" title="History of medicine">History of medicine</a></li></ul>

</div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div>

<ul><li><span class="noviewer" typeof="mw:File"><span title="Category"></span></span> Category</li>

<li><span class="noviewer" typeof="mw:File"><span title="Commons page"></span></span> <a href="https://commons.wikimedia.org/wiki/Medicine" class="extiw external" title="commons:Medicine">Commons</a></li>

<li><span class="noviewer" typeof="mw:File"><span title="WikiProject"></span></span> Wikiproject</li>

<li><span class="noviewer" typeof="mw:File"></span> <a href="Portal%3AMedicine" title="Portal:Medicine">Portal</a></li>

<li><span class="noviewer" typeof="mw:File"><span title="Outline"></span></span> <a href="Outline_of_medicine" title="Outline of medicine">Outline</a></li></ul>

</div></td></tr></tbody></table></div></div><div><div class="zim-footer">

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