Clinical Cardiology Made Ridiculously Simple

ISBN-10: 0940780631

ISBN-13: 9780940780637

Edition: 1st 2003

List price: $34.95
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Book details

List price: $34.95
Edition: 1st
Copyright year: 2003
Publisher: MedMaster, Incorporated
Binding: Paperback
Pages: 368
Size: 8.50" wide x 10.75" long x 1.00" tall
Weight: 2.398
Language: English

Chief Medical Director, The Heart Center of Excellence, Fort Lauderdale Florida; Clinical Professor of Medicine, Univ of Miami School of Medicine and University of Florida College of Medicine.

Dedicationp. iii
About the authorp. iv
Forewordp. v
Prefacep. vii
Acknowledgmentsp. ix
The Five-Finger Approach to Cardiac Diagnosis
The Cardiac Historyp. 1
Chest Pain or Discomfortp. 1
Coronary Artery Disease (CAD)p. 1
Stable Angina Pectoris, Unstable Angina, and Acute Myocardial Infarctionp. 1
Pertinent Past Medical History and/or Risk Factors for CADp. 3
Chest Pain in Other Cardiovascular Conditionsp. 6
Pericarditisp. 7
Aortic Dissectionp. 7
Mitral Valve Prolapsep. 8
Left Ventricular Outflow Tract Obstruction (e.g., Valvular Aortic Stenosis, Hypertrophic Cardiomyopathy)p. 8
Pulmonary Hypertensionp. 8
Shortness of Breathp. 9
Fatigue and Weaknessp. 12
Cough and Hemoptysisp. 12
Palpitationsp. 13
Dizziness, Near-Syncope, and Syncopep. 15
Other Symptomsp. 18
Fever, Chills, and Sweatsp. 18
Gastrointestinal Symptomsp. 18
Embolic Symptomsp. 18
Intermittent Claudicationp. 18
Changes in Weightp. 18
The Cardiac Physical Examp. 20
Cardiac Anatomy and Physiologyp. 20
External Anatomy of the Heart and Great Vesselsp. 20
Cardiac Chambers and Blood Flow through the Heartp. 20
The Heart Valvesp. 22
Structure of the Heart Wallp. 22
Basic Cardiac Functionp. 23
Inspectionp. 23
General Appearancep. 23
Cutaneous Manifestations (Skin Color, Temperature, Texture)p. 27
Voicep. 29
Jugular Venous Pressure (JVP) and Pulsep. 29
Estimating JVPp. 29
Abdominojugular Testp. 31
Abnormalities of the Venous Wave Formp. 31
Palpationp. 33
Blood Pressure and Arterial Pulsep. 33
Abnormalities of Blood Pressurep. 33
Abnormalities of Arterial Pulsep. 36
Precordial Movements and Palpationp. 38
Auscultationp. 44
The Cardiac Cyclep. 44
Use of the Stethoscopep. 47
Dynamic Auscultationp. 52
Heart Sounds: Normal and Abnormalp. 57
First and Second heart sounds (S1 and S2)p. 57
Auscultation of S1 ("Lub")p. 57
Loud S1p. 57
Faint S1p. 58
Variable Intensity of S1p. 58
Auscultation of S2 ("Dub")p. 60
Intensity and Splitting of S2p. 60
Sounds in Systolep. 61
Ejection Sounds and Systolic Clicksp. 61
Sounds in Diastolep. 62
Third and Fourth Heart Sounds (S3 and S4)p. 62
Other Diastolic Soundsp. 64
Heart Murmurs: Systolic, Diastolic, and Continuousp. 65
Systolic Murmurs--Innocent vs Significant ("Guilty")p. 65
Early-mid Systolic (Ejection) Murmursp. 68
Innocent Murmursp. 68
Aortic Stenosisp. 68
Pulmonic Stenosisp. 68
Hypertrophic Obstructive Cardiomyopathyp. 70
Atrial Septal Defectp. 70
Holosystolic Murmursp. 71
Mitral Regurgitationp. 71
Tricuspid Regurgitationp. 72
Ventricular Septal Defectp. 72
Late Systolic Murmursp. 73
Mitral Valve Prolapsep. 73
Diastolic Murmursp. 73
Early Diastolic Murmursp. 73
Aortic Regurgitationp. 73
Pulmonic Regurgitationp. 75
Middiastolic and Presystolic Murmursp. 75
Mitral Stenosisp. 75
Tricuspid Stenosisp. 76
Continuous Murmursp. 76
Patent Ductus Arteriosusp. 77
Jugular Venous Hump. 76
Coronary Arteriovenous Fistulap. 76
Pulmonary Arteriovenous Fistulap. 76
Ruptured Sinus of Valsalva Aneurysmp. 77
Miscellaneousp. 78
Pericardial Friction Rubsp. 78
Electrocardiogramp. 79
Basic Electrocardiographyp. 79
Cardiac Electrical Activity and the Electrocardiogram (ECG)p. 79
Standard ECG Leadsp. 79
Approach to ECG Interpretationp. 80
Rate and Rhythmp. 84
The P Wavep. 86
The QRSp. 86
The T Wavep. 88
The U Wavep. 88
The PR Intervalp. 89
The ST Segmentp. 89
The QT Intervalp. 91
QRS Axisp. 91
Major ECG Abnormalities: Diagnostic Clues and Clinical Correlationsp. 92
Myocardial Ischemia and Infarctionp. 92
Cardiac Chamber Enlargement and Hypertrophyp. 100
Miscellaneous Patternsp. 104
Arrhythmias and Conduction Disturbancesp. 105
Chest X-Rayp. 120
The Cardiovascular Silhouette, Cardiac Chambers and the Aortap. 120
The Pulmonary Vasculaturep. 124
The Lung Fieldsp. 126
Thoracic Cage Abnormalitiesp. 126
Cardiac Diagnostic Laboratory Testsp. 128
Blood Testsp. 128
Routine Chemistriesp. 128
Cardiac Enzymesp. 130
Specialized Non-invasive Testsp. 131
Transthoracic M-Mode and Two Dimensional Color-Flow Doppler Echocardiograpyp. 131
Transesophageal Echocardiographyp. 134
Ambulatory Electrocardiography; Holter Monitoring and Transtelephonic ECG/Event Recordingp. 136
Signal Averaged Electrocardiographyp. 137
Tilt-Table Testingp. 138
Exercise and Pharmacologic Stress Testing, including Nuclear and Echocardiographic Imagingp. 139
Radionuclide Studiesp. 144
Electron Beam Computed Tomographyp. 145
Specialized Invasive Techniquesp. 146
Cardiac Catheterization: Coronary Angiography and Left Ventriculographyp. 146
Electrophysiologic Studies (EPS)p. 152
Summary: Non-invasive and Invasive Test Indications and Applicationsp. 153
Cardiovascular Therapy
General Considerations in Cardiovascular Therapyp. 157
Cardiac Drugsp. 161
Beta blockersp. 161
Calcium Channel Blockersp. 163
Nitratesp. 164
Angiotensin-Converting Enzyme (ACE) Inhibitorsp. 165
Angiotensin Receptor Blockers (ARBs)p. 167
Inotropic Agentsp. 167
Digitalis Glycosidesp. 167
Sympathomimetic Aminesp. 168
Phosphodiesterase Inhibitorsp. 168
Diureticsp. 169
Thiazidesp. 169
Loop Diureticsp. 169
Potassium Sparing Diureticsp. 169
Antiplatelet Agentsp. 170
Aspirinp. 170
Thienopyridinesp. 171
Glycoprotein II b/III a Receptor Inhibitorsp. 171
Thrombolytics and Anticoagulantsp. 172
Thrombolytic Agentsp. 172
Unfractionated and Low Molecular Weight Heparinp. 173
Warfarin (Coumadin)p. 174
Lipid Controlling Agentsp. 175
HMG CoA Reductase Inhibitors (Statins)p. 175
Nicotinic Acid (Niacin)p. 176
Bile Acid Sequestrants (Resins)p. 177
Fibric Acid Derivatives (Fibrates)p. 177
Other Agents (e.g., Ezetimibe)p. 177
Antiarrhythmic Agentsp. 177
Class I Agentsp. 179
Class II Agentsp. 181
Class III Agentsp. 181
Class IV Agentsp. 182
Other Agents (e.g., Digitalis, Adenosine)p. 182
Cardiac Nonpharmacologic and Interventional Techniquesp. 184
Percutaneous Coronary Intervention (PCI): Percutaneous Transluminal Coronary Angioplasty (PTCA) and Stentingp. 184
Transluminal Balloon Valvuloplastyp. 186
Radiofrequency Catheter Ablationp. 187
Electrical Cardioversion and Defibrillationp. 188
Cardiac Device Therapyp. 190
Cardiac Pacemakersp. 190
Implantable Cardioverter Defibrillatorp. 192
Cardiac Surgeryp. 195
Coronary Artery Bypass Graftingp. 195
Valvular Repair and/or Replacementp. 195
Cardiac Transplantationp. 197
Putting It All Together
Approach to the Patient with Coronary Artery Diseasep. 199
Angina Pectorisp. 202
Clinical Recognition of Stable Angina Pectorisp. 202
Clinical Recognition of Unstable Anginap. 205
Management of Stable Angina Pectorisp. 206
Management of Unstable Anginap. 207
Acute Myocardial Infarction (MI)p. 209
Clinical Recognition of Acute MIp. 210
Management of Acute MIp. 217
Complications of Acute MIp. 225
Electrical Complications of Acute MIp. 225
Ventricular Arrhythmiasp. 226
Supraventricular Arrhythmiasp. 226
Bradyarrhythmias and Conduction Disturbancesp. 226
Mechanical Complications of Acute MIp. 228
Left Ventricular (LV) Systolic Dysfunctionp. 228
Acute Ventricular Septal Defect and Papillary Muscle Rupturep. 229
Right Ventricular Infarctionp. 230
Left Ventricular Aneurysmp. 231
LV Free Wall Rupture and Pseudoaneurysmp. 232
Pericarditisp. 232
Secondary Prevention: Pharmacologic Therapy, Risk Factor Modification and Cardiac Rehabilitationp. 233
Approach to the Patient with Heart Failurep. 235
Etiology and Pathophysiologyp. 235
Left Ventricular Systolic Dysfunctionp. 235
Dilated Cardiomyopathyp. 239
Left Ventricular Diastolic Dysfunctionp. 243
Treatment of Chronic Heart Failurep. 245
Treatment of Acute Pulmonary Edemap. 247
Approach to the Patient with Systemic Arterial Hyertensionp. 249
Primary and Secondary Forms of Hypertensionp. 249
Clinical Manifestations of Hypertensionp. 249
Therapy of Hypertensionp. 252
Approach to the Patient with Dyslipidemiap. 259
Pathogenesis of Atherosclerosisp. 259
Therapeutic Considerationsp. 259
Approach to the Patient with Valvular Heart Diseasep. 262
Aortic Stenosis (AS)p. 262
Clinical Recognition of ASp. 262
Management of ASp. 266
Aortic Regurgitation (AR)p. 268
Chronic ARp. 268
Clinical Recognition of Chronic ARp. 268
Acute ARp. 269
Clinical Recognition of Acute ARp. 269
Management of Chronic and Acute ARp. 269
Mitral Regurgitation (MR)p. 271
Chronic MRp. 271
Clinical Recognition of Chronic MRp. 271
Management of Chronic MRp. 272
Acute MRp. 274
Clinical Recognition and Management of Acute MRp. 274
Mitral Valve Prolapse (MVP)p. 274
Clinical Recognition of MVPp. 274
Management of MVPp. 275
Rheumatic Mitral Stenosis (MS)p. 275
Clinical Recognition of Rheumatic MSp. 275
Management of Rheumatic MSp. 279
Tricuspid Regurgitation (TR)p. 280
Clinical Recognition of TRp. 280
Management of TRp. 280
Approach to the Patient with Hypertrophic Cardiomyopathyp. 281
Clinical Recognition of Hypertrophic Obstructive Cardiomyopathy (HOCM)p. 281
Treatment Options for HOCMp. 283
Risk of Sudden Deathp. 284
Approach to the Patient with Infective Endocarditisp. 285
Etiology and Risk Factorsp. 285
Clinical Presentation of Infective Endocarditisp. 285
Therapy of Infective Endocarditisp. 287
Approach to the Patient with Aortic Dissectionp. 291
Classification and Pathogenesisp. 291
Clinical Manifestations of Aortic Dissectionp. 292
Medical and Surgical Considerations in Aortic Dissectionp. 293
Approach to the Patient with Pericardial Diseasep. 294
Acute Pericarditisp. 294
Cardiac Tamponadep. 295
Constrictive Pericarditisp. 297
Approach to the Patient with Pulmonary Hypertensionp. 300
Pathophysiologic Mechanismsp. 300
Clinical Recognition of Primary Pulmonary Hypertensionp. 300
Management of Primary Pulmonary Hypertensionp. 301
Approach to the Patient with a Heart Murmurp. 303
When to Order a Doppler-Echop. 303
Approach to the Patient with Cardiac Arrhythmias and Conduction Disturbancesp. 308
General Considerationsp. 308
Atrial Fibrillationp. 311
Supraventricular Tachycardiasp. 315
Ventricular Tachycardiap. 316
Bradyarrhythmias and Conduction Abnormalitiesp. 318
Approach to the Patient with Adult Congenital Heart Diseasep. 319
Bicuspid Aortic Valvep. 319
Pulmonic Valve Stenosisp. 319
Atrial Septal Defectp. 321
Ventricular Septal Defectp. 321
Coarctation of the Aortap. 322
Patent Ductus Arteriosusp. 324
Marfan's Syndromep. 324
Approach to the Patient with Heart Disease Undergoing Noncardiac Surgeryp. 325
Preoperative Assessment of Riskp. 325
Clinical Predictors of Riskp. 325
Surgery Specific Markers of Riskp. 326
Perioperative Evaluation and Managementp. 327
Approach to the Patient with Neoplastic Heart Diseasep. 328
Primary Tumors of the Heartp. 328
Atrial Myxomap. 328
Angiosarcomap. 329
Secondary Tumors of the Heart and the Effects of Treatmentp. 329
Carcinoid Syndromep. 329
Approach to the Patient with "False" Heart Diseasep. 331
Pitfalls in the Clinical Recognition and Management of Heart Diseasep. 331
Misleading Clues in the Clinical Cardiovascular Evaluationp. 331
Misinterpretation of Symptoms and Signsp. 331
Misinterpretation of ECG, CXR, and Diagnostic Laboratory Datap. 332
The Athlete's Heartp. 335
Iatrogenic Heart Diseasep. 337
Approach to the Patient with an Acute Cardiac Emergencyp. 338
General Considerationsp. 338
Universal Approach to Adult Emergency Cardiac Carep. 339
Ventricular Fibrillation/Pulseless Ventricular Tachycardiap. 340
Pulseless Electrical Activityp. 340
Asystolep. 341
Bradycardiap. 341
Tachycardiap. 342
Shockp. 343
Selected Readingp. 344
Indexp. 347
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