Electric Review

Culture & Criticism From the Far Distant Realms

Cardiology

Snapshot On Medicine: Interviews With University of California San Francisco Cardiologists Kanu Chatterjee & Teresa De Marco

Remarks On Medicine: Salute To Doctor Kanu Chatterjee

New Releases from Elsevier

New Releases from McGraw-Hill

New Releases from Wiley

BRAUNWALD’S HEART DISEASE: A Textbook of Cardiovascular Medicine. 10th Edition. Two Volume Set. Douglas Mann. Douglas Zipes. Peter Libby. Robert Bonow. Saunders.

Braunwald's Heart Disease

Image courtesy of Elsevier.

Braunwald’s Heart Disease, now in its 10th Edition, presents as an indispensable reference housing the complete study of cardiology. The 10th edition is notable for a plethora of reasons, with in depth review of burgeoning areas of the discipline, including the principles of cardiovascular genetics and personalized medicine. This material is especially illuminating as it traces the myriad foundational changes taking place in cardiology, with the authors striving to help physicians keep pace with the evolution of the times. Additional topics of coverage include the global aspects of heart disease; evaluation of the patient; the role of the chest radiograph in cardiovascular disease; nuclear medicine; cardiac catheterization; and an incisive and layered discussion of management of the heart failure patient (to name select high points). Over 1,200 illustrations augment the text, fleshing out complex theories while promoting permanent retention. Obviously, Braunwald’s Heart Disease has been around through 10 revisions for a reason. And that reason is intertwined in the fact that the authors present a ‘one-stop’ reference encompassing the whole of the discipline, its ultimate mission to give specialists the most up-to-date cardiac information in a easy-to-navigate format.

Recommended reading with Braunwald’s Heart Disease

PRINCIPLES OF CARDIOVASCULAR IMAGING. Stuart J. Hutchison. Four Volume Set. Saunders.

Principles of Cardiovascular Imaging

Image courtesy of Elsevier.

Hutchison is a world-renown expert in the field, and this text provides the ultimate primer meant to teach radiologists how to proceed with cardiac imaging so that the best pictures can be obtained. Principles of Cardiovascular Imaging will immediately prove itself vital to the clinical setting: Readers who delve into these pages and master Hutchison’s techniques will achieve a higher level of patient care while simultaneously curbing waste. In sum, the basic theme of Huchison’s treatise: do it once and do it right.

Winter 2014 from Elsevier

CARDIAC IMAGING. The Case Review Series. Second Edition. Gautham Reddy. Robert Steiner. Christopher Walker. Saunders.

Cardiac Imaging

Image courtesy of Elsevier.

It is long-established that the best way to train medical doctors is via an interactive process; the idea is to wade into actual case studies, sort through symptoms and chart the markers that point to concrete diagnosis. Here, Reddy (University of California, San Francisco) and co-authors have created a go-to text that tests the reader on the fine-points of cardiac radiography. Cardiac Imaging examines the deep core of the topic via a standard ‘case-study’ structure that places the radiologist at the center of a clinical setting where they are directed on how to reach differential diagnosis by recognizing the patterns that coincide with the onset of disease. This edition is relevant for its depth as it explores the burgeoning sub-specialty of cardiac radiology, CT and CT angiography. Well-developed case-studies pose difficult questions and continually challenge the physician to sort through many “gray areas” as they work toward establishing diagnosis and outlining treatment. Designed for those physicians preparing for certification or recertification in cardiac imaging.

Of Related Interest

CARDIAC ELECTROPHYSIOLOGY: FROM CELL TO BEDSIDE. Douglas Zipes. Jose Jalife. Saunders.

Cardiac Electrophysiology

Image courtesy of Elsevier.

Zipes (Indiana University) and Jalife (University of Michigan) have created a universal text that outlines the whole of cardiac electrophysiology, examining every aspect of this burgeoning sub-specialty. Topics of coverage include the Structural and Molecular Bases of Ion Channel Function; the Biophysics of Cardiac Ion Channel Function; the Cell Biology of Cardiac Impulse Initiation; Models of Cardiac Excitation; Neural Control of Cardiac Electrical Activity; and the Mechanisms of Arrhythmia (among others). Exhaustive in tone and breadth, the goal of the text is to promote a complete understanding of the electrical labyrinth that controls cardiac function so that physicians can strive toward individualized assessment and effective treatment.

CORONARY STENTING: A Companion To Topol’s Textbook of Interventional Cardiology. Matthew Price. Saunders.

During the last 20 years, the use of stenting to reopen blocked arteries has revolutionized cardiac medicine and saved thousands of lives along the way – this procedure that allows the practitioner to intervene during an event without having to expose the patient to the risk-laden trauma of open-heart surgery. Price’s treatise serves as a companion to Topol’s Textbook of Interventional Cardiology (by Dr. Eric Topol of Scripps Clinic), detailing the most recent advances in stenting.  This volume teems with new and vital data, including: advances in drug-eluting stent design; analysis of recent clinical trials examining the comparative effectiveness of coronary stents; percutaneous revascularization of diabetics who present with left-main occlusion; and the use of intravascular ultrasound and optical coherence tomography in stent implantation. In addition to the wealth of information contained in Coronary Stenting, the book is notable for its well-thought-out design: Templated chapters and the deliberate use of illustrations never fail to take the reader into account; the whole point behind the layout is to allow information to be located without the undue waste of time. Coronary Stenting speaks to a split demographic – appropriate for both the classroom and the practicing clinician.

TEXTBOOK OF CLINICAL ECHOCARDIOGRAPHY. Catherine Otto. Saunders.

Echocardiography is one of the most important non-invasive examinations that clinicians have at their disposable, allowing them to accurately diagnose heart abnormalities. In turn, Catherine Otto is a veritable master at echocardiography interpretation – a physician with immense skill who has the all-too-rare ability to write for the classroom. In Textbook of Clinical Echocardiography (now in its 5th edition), Dr. Otto presents an in depth study on how to use echocardiography on the front lines of diagnosis. Accordingly, one of the most relevant aspects of this new edition is Dr. Otto’s presentation on how to use advanced techniques (the contrast echo; the 3D echo; and the intraoperative transesophageal echo) to paint a living picture of the mechanical-actions of the heart. As Dr. Otto notes, these examinations give radiologist and clinician the first opportunity to peer through the walls of the heart and evaluate functionality on many distinct levels. To this end, Dr. Otto reviews ASE guidelines for echocardiographic assessment, providing updated tables of measurement that document the normal perimeters of function. Finally, this 5th edition is notable for the way Dr. Otto outlines just what steps physicians should take when echo results prove inconclusive. As the Textbook of Clinical Echocardiography demonstrates, the speed at which a clinician applies echocardiography can mean the difference between negative or positive patient outcomes. Thus, doctors at all levels of the spectrum would be well-served to become intimately familiar with the echocardiographic process – this process that is both cost-effective and cutting edge, deserving of a place at the forefront of the diagnostic landscape.

Of Related Interest

VALVULAR HEART DISEASE: A COMPANION TO BRAUNWALD’S HEART DISEASE. 4th Edition. Catherine Otto. Robert Bonow. Saunders.

Catherine Otto is a renowned expert on the nuances of valvular abnormalities, and this volume (co-written with Dr. Robert Bonow) serves as a companion to Braunwald’s Heart Disease, surveying the most recent clinical advances in diagnosis and treatment of vavle problems. The new edition is chock full of important information that physicians will need to have at hand in order to competently treat a component of heart disease that will become all the more prevalent given the aging population. New chapters offer a 3-dimensional review of the aortic and mitral valves; a review of genetic risk factors that increase the likelihood of calcified valve disease; how to assess risk for patients facing valve replacement surgery; image-guided trans-catheter valve treatments; and, most importantly, a discussion of how to know it’s the right time to recommend valve replacement surgery to an ailing patient. Otto and Bonow’s treatise will prove indispensable to cardiologists, internists and primary care providers as it brings the broad-mindedness of the classroom/research lab to the clinical setting.

by John Aiello

CARDIOLOGY SECRETS. 4th Edition. Glenn N. Levine. Saunders.

Re-released during the spring of 2013 by Saunders, Cardiology Secrets (in this convenient pocket-size format) has been designed for physicians to use ‘on the fly’ in the clinical setting. Here, Dr. Levine (Professor of Medicine, Baylor College of Medicine; Director of the Cardiac Care Unit, Michael E. DeBakey Medical Center, Houston) stitches together the leading voices in cardiology to create a stand-out reference that can be used by both the student in the classroom and by the practicing clinician in the course of patient consultations. In essence, Cardiology Secrets ( now in its 4th edition ) serves as a mini-library on cardiac disease, with up-to-date discussion of myriad topics, including arrhythmias; valvular heart disease; congestive heart failure; acute coronary syndromes (with erudite discussion of chest pain and approaches physicians might employ to properly assess cause and determine treatment). There is also broad and relevant discussion of the diagnostic tools available to clinicians in addition to ‘when-and-why’ analysis of implementation (this section includes an incisive chapter on Bedside Hemodynamic Monitoring – a procedure that provides a real-time glimpse of heart-function). Going further, Levine has included a summary of the patient examination – an often over-looked segment of the process that allows the physician a hands-on opportunity to fact-find. Cardiology Secrets is noted for its breadth of coverage and for its ability to present material in a logical and well-ordered fashion – aspects that make the text appropriate for use by doctors in the midst of rounds or patient evaluations. Purposeful use of graphs and illustrations stress key points and outline difficult-to-grasp concepts in an attempt to build a general reference that merges perfectly with the ever-evolving clinical landscape.

Of Related Interest

HOSPITALIZATION FOR HEART FAILURE – AN ISSUE OF HEART FAILURE CLINICS. Mihai Gheorghiade. Savina Nodari. Elsevier.

This text provides relevant discussion of one the most complicated and controversial subjects confronting the front-lines of medicine – that being: What should be done to alleviate symptoms for patients who present in acute decompensated heart failure? And what practical steps should physicians take to mitigate adverse events immediately following hospital discharge? Dr. Gheorghiade and Dr. Nodari tackle this subject with flair and insight – their book offering readers an up-to-date reference that refuses to skirt difficult issues (while carefully refraining from the impulse to preach from the pulpit). As the authors teach us, there is no pat answer for this ever-expanding problem. Instead, doctors must use the sum of the tools at their disposable and proceed on a ‘case-by-case’ basis to accomplish their ultimate mission of effective and humane treatment.

by John Aiello

INTERVENTIONAL CARDIOLOGY. Principles and Practice. George D. Dangas. Carlo Di Mario. Nicholas Kipshidze. Wiley Blackwell. 2nd Edition.

Interventional Cardiology

Image courtesy of Wiley Blackwell.

Medical science books from Wiley Blackwell standout because of their crossover nature – although often  designed as primary texts for the classroom setting, many of these books serve a dual purpose, serving the professional clinician equally well.

And that is exactly the case with the newly revised Interventional Cardiology. Here, the authors have created a consummate reference delineating the principles and practice for catheter-based treatment of heart disease. Topics of coverage include a review of basic anatomy; imaging; applying percutaneous coronary intervention to the clinical setting and to the presentation of different disease processes; clinical trials in coronary disease; interventional pharmacology; structural heart disease; pulmonary hypertension; valvular heart disease; and vascular disease and the interventionalist (to cite random highpoints).

This second edition is remarkable for the way it captures the relevant advancements that have taken place in this area of medicine over he last decade. Readers will note the depth of information that Dangas and co-authors present, forsaking cursory and superficial mention in favor of radical and deep analysis. In sum, this book is meant to serve the practicing clinician on a continuing basis. To this end, the authors remain careful to not only discuss procedures, but also apply them to the laboratory.

As previously noted, Wiley Blackwell’s editorial focus in terms of reference books is cross-over in nature as the publisher builds teaching texts that hold immediate relevance to the experienced physician. Accordingly,  Interventional Cardiology can be used by professors teaching the fine points of catheter-based cardiac procedures in advanced programs while it’s simultaneously serving the clinician preparing for certification or re-certification in the field. Finally, the cutting-edge element to the presentation of data provides for a seamless transition to the laboratory, offering  concrete direction to the physician in the midst of patient care.

In addition to use in the clinical and classroom settings,  Interventional Cardiology is recommended to all health science libraries for its reference value as a benchmark in cardiac-based literature.

Also of Note From Wiley Blackwell Science

MEDICAL SCHOOL AT A GLANCE. Rachel Thomas. Wiley Blackwell.

MEDICAL ETHICS, LAW AND COMMUNICATION AT A GLANCE. Edited by Patrick Davey. Anna Rathmell. Michael Dunn. Charles Foster. Helen Salisbury. Wiley Blackwell.

The At A Glance series from Wiley Blackwell is a unique arm of the publisher’s medical education catalog, developed in direct collaboration with students. As such, the content of these publications is reviewed by students with the editorial focus firmly on the student-reader. Thus, the information is imparted in a way that best suits how the professional-in-training learns. What follows is a line of books that succeeds because it gives students what they need the way they want it.

Medical School At A Glance is a slim yet outstanding text that tells the new arrival to med-school not only how to survive, but how to thrive. Here, the reader is presented with an outline on what to expect inside and outside of the classroom. Topics of coverage include an introduction to medical training; developing habits conducive to true retention of data; how to behave in the clinical setting; how to approach and interact with patients; and how to examine patients.

Thomas has done an exemplary job at providing an insider’s view of the hallowed halls of the typical medical school, delivering this priestly knowledge in clear and concise prose via short chapters that  convey important information without ever intimidating or overwhelming her reader.

In turn, this is a book that any new or prospective medical school student cannot do without. Simply, anyone considering embarking on a career in the field needs to read this volume first to assess whether they are actually suited for the challenges that lie ahead.

Medical Ethics, Law and Communication follows along the same lines as Medical School At A Glance, with Davey and co-editors providing a no-nonsense overview of how to avoid potential minefields in the profession.

In this bifurcated manual, the young doctor is given a primer on how to resolve ethical issues and avert medical-based legal action. The first section of the book is dedicated to an analysis of the ethical and legal principles that pertain to common issues encountered in the clinical setting. Issues examined include confidentiality; organ donation and transplantation; consent; battery and assault; reproduction; mental health; public health; and care of the elderly patient.

Section two is dedicated to effective communication. Topics in this part of the book include talking about sex; breaking bad news; how to listen; how to ask relevant questions; how to build effective relationships; and how to deal with anger and aggression.

Like the Thomas volume, Medical Ethics features a well-honed narrative – telling the reader what they need to know, opening doors into subjects that should naturally motivate further independent research. In sum, no prospective or practicing health care provider can afford to be without this resource.

by John Aiello

HEART FAILURE: MOLECULES, MECHANISMS AND THERAPEUTIC TARGETS, No. 274. Novartis Foundation. John Wiley.

Heart failure continues to be the primary cause of death in the developed world – the usual byproduct of worsening heart function, years of hypertension and impaired blood flow. In this book, leading scientists explore the basis of cardiac growth, as well as in depth analysis of the mechanisms of cardiac function and dysfunction. In addition, readers will be treated to deep discussion of burgeoning therapies for different types of cardiac disease and ways that science might better work towards marrying theory to the practical application of more efficient therapies. In Heart Failure, the goal is to reveal how the circuitry of the cell is altered during cardiac failure; from here, researchers can begin to create different treatment therapies that might better attack “targets” within the heart in order to reduce a patient’s symptoms. Readers will note the cutting-edge tone of this volume as it boldly tackles the topic of stem cell research in the study of cardiac physiology: The outline of possibilities for the regeneration of cardiac tissue that a decade ago sounded like pure science fiction today give millions hope for a healthier future.

Recommended to cardiac researchers dedicated to unlocking the mechanisms of heart failure and its lethal progression. The broad-sweeping tone of this text makes it appropriate for both laboratory researchers and field clinicians who treat patients directly – this record of the most up-to-date analysis on ways that science might look to reduce the harsh impact of heart disease.

by John Aiello

HANDBOOK OF THE VULNERABLE PLAQUE. Ron Waksman and Patrick W. Serruys. Taylor and Francis.

This ground-breaking handbook addresses the new research that has been done in the field of cardiology regarding “vulnerable plaque.” For generations, doctors had believed that heart attack and stroke were by-products of plaque build-up along an artery wall snaking its way through the heart or brain. It was believed that over time this fatty build-up would clog arteries and obstruct blood flow, ultimately starving the body for oxygenated blood, thus causing either a brain or heart attack. However, new research has shown that this phenomenon is responsible for only 30% of all heart attacks. Now, researchers think “vulnerable plaque” is just as much a threat to heart health. Vulnerable Plaque is a type of build-up caused by several reactions within the body of a cell (reactions that cause inflammation, fat absorption and clotting). Over time and when combined with other factors such as hypertension, the outer “shell” of this distinct type of plaque can rupture and spill into the blood stream, causing a clot to form and shut down an artery; the probable result is heart attack and tissue death.

Handbook offers a definitive study of this phenomenon, offering the cardiologist insight into how to evaluate heart-sick patients and determine if vulnerable plaque is indeed at the core of their disease. Waksman and Serruys have written a book that is not so much a student text but instead a manual designed for the practicing physician to use in the course of evaluating and treating patients who present with such complicating factors. Accordingly, the authors have provided a “road-map” of sorts, first defining vulnerable plaque and its construction/origins, and then moving into how it is detected and what types of patients are likely to present with this type of condition. The goal of the writers (and they have attained it beautifully) is to illuminate a relatively new concept in the world of cardiology and then take the physician through identification and treatment options.

Recommended for all cardiologists and internists who treat patients with heart disease (and those who are at high risk for heart disease). Also recommended to Health Science libraries as a reference text in cardiology. As previously noted, this material is written more for the practicing physician than the medical student.

A PRACTICAL APPROACH TO CARDIAC ANESTHESIA. Frederick A. Hensley. Donald E. Martin. Glenn P. Gravlee. Lippincott, Williams and Wilkins.

This manual is meant for the practicing anesthesiologist, nurse anesthetist, cardiologist and cardiac surgeon, surveying practical methods of anesthesia as they relate to the cardiac patient. Well-written and expertly detailed, the third edition of Practical Cardiac provides medical scientists with a first-rate reference guide that has been designed to be used – in the office and in the operating room. Simply, this text is about bringing information to the doctor so that he can apply it to the patient in the direct course of treatment.

There are many outstanding features which separate Practical Cardiac from other similar handbooks, but it’s best feature is in its outline format, a feature that allows the reader to answer questions quickly and logically and thoroughly – an in depth analysis of a complex subject matter in a simple to use package.

In the world of medicine, the idea of anesthesia isn’t very glamorous — not when it’s compared to the work of cardiac surgeons whose very hands nurse the diseased heart back to health. However, the way that a patient is anesthetized is paramount to whether they will survive surgery. Accordingly, Practical Cardiac investigates these concepts in deep detail, examining how the anesthesiologist should approach the management of different kinds cardiac patients, exploring treatment options from converse angles. Readers will be enriched on many different levels, by information on pain management and by the very useful data that’s provided on new drugs now being used on cardiac-compromised individuals. Analysis of cardiac transplantation, circulatory support and organ preservation is also offered, with smart use of diagrams and graphs to support the authors’ point of view.

We would recommend this manual to all physicians involved in surgically treating cardiac patients. Moreover, it is a logical choice as a teaching text in the field, for it affords anesthesiology students a comprehensive and easy to use tool that brings the most up-to-date information to the classroom (and to the operating room). Would be further recommended to all Health Science libraries as a general reference text.

Order from booksmd.com or go to Lippincott, Williams and Wilkins.

CARDIAC PACEMAKERS STEP BY STEP. S. Serge Barold. Roland X. Stroobandt. Alfons F. Sinnaeve. Blackwell Futura.

The hard-core traditional medical community may resent this text — because of its simplified design (and these oh-so-creative graphics!) that strive to teach the basics of cardiac pacing to those new to the field. However, the charm of this text is in its readability and in the smooth and quick-moving approach it employs. Why does medicine need be dull and stale and stagnate? The authors here say it doesn’t – and they’ve come up with a fresh perspective. Wonderful full-color diagrams and illustrations take the reader ‘step-by-step’ through the foundations of heart pacing, teaching the subject from its basic beginnings – the idea here is to take a doctor with foundational knowledge of electrocardiography and expand on that knowledge so the non-cardiologist can competently care for patients with pacemakers. Well-designed, well-written, with astute use of diagrams to illustrate all written analysis, Cardiac covers many topics (including the function of DDD pacemakers and the diagnosis of tachycardias).

Recommended as a teaching text for advanced medical students who are proceeding to a clerkship in cardiology. Also recommended to Health Science libraries as general reference text.

Order from booksmd.com or go to blackwellpublishing.com.

CLINICAL, INTERVENTIONAL AND INVESTIGATIONAL THROMBOCARDIOLOGY. Edited by Richard C. Becker and Robert A. Harrington. Taylor and Francis.

This fine new study by Becker (Duke University) and Harrington (Duke University) examines the study of the human heart in full detail and from multiple perspectives. Here, the authors have compiled the latest data in a text that explores the latest thinking and advancements in the field of cardiovascular disease. These discussions include analysis of coagulation factors and clot formations, an overview of genetic determinants relating to thrombosis, atherosclerosis and its risk factors, the pharmacodynamics of antithrombotic agents (including warfarin and heparin), precutaneous intervention therapies in myocardial infarction, and cost-effective drug selection in cardiovascular treatment (to name but a few of the most outstanding segments). Clinical Interventional is authoritative in both scope and vision, and presents the practicing physician with a one-stop reference in which the latest clinical, scientific and research data is contained (including treatment options related to drug therapy and assist-device alternatives).

Recommended to all cardiologists and internists as an in-office reference. Also should be included in all Health Science libraries as a general reference text.

by John Aiello

Springer Synonymous With Science

HEART RATE AND RHYTHM. Molecular Basis, Pharmacological Modulation and Clinical Implications. Onkar Tripathi. Ursula Ravens. Michael Sanguinetti (Editors). Springer.

In this exemplary study from Springer, readers are treated to an in depth discourse on “the complicated molecular and cellular mechanisms” that distinguish “normal and pathophysiological cardiac rhythms.” During the course of any given year, countless new textbooks are published on cardiology; however, due to its breadth and exhaustive tone, Heart Rate reigns as one of the year’s best. Here, physicians are presented with an acute review of how changes in heart rate can be used as a marker to assess patients in the clinical setting. Topics of coverage include Normal Cardiac Rhythm and Pacemaker Activity; Cardiac Ion Channels and Heart Rate/Rhythm; Heart Rate Variability – Molecular Mechanisms and Clinical Implications; Cardiac Development and Anatomy; Mechanisms of Acquired Arrhythmia; Post-infarction Remodeling and Arrhythmogenesis; Calmodulin Kinase II Regulation of Heart Rhythm and Disease; Mechanisms of Inherited Arrhythmia; the Short QT Syndrome; Genetics and Atrial Fibrillation; and Drugs and Cardiac Arrhythmia. What’s best about Heart Rate is that the text does not only serve as a research summary of the latest on the nuances of arrhythmia. Instead, the writers also extend their treatise to practicing clinicians and ways that the information can be used to better treat patients. Noted for its clear delineation of complex data; with skilled use of illustrations and graphs that re-enforce key points chapter-by-chapter.

by John Aiello

ASYMPTOMATIC CARTOID ARTERY STENOSIS. Risk Stratification and Management. Editors: Issam D. Moussa. Tatjana Rundek. JP Mohr. Informa Healthcare.

Even with recent advances in cardiology, the specter of stroke remains a huge concern as science looks for ways to forestall the effects of this often fatal brain event. The challenge becomes all the greater when patients succumb to stoke without displaying symptoms that might inspire a trip to the doctor.

Moreover, nearly 8 out of every 10 atheroembolic strokes strike without warning, often resulting in paralysis or death. In this one-of-a-kind text, Moussa and co-writers set forth to bring medicine to the threshold of a deeper understanding of why strokes occur (in addition to outlining the things physicians can collectively do to treat stroke victims).

To accomplish their mission, the authors examine Asymptomatic Carotid Artery Stenosis (CAS) in detail, further offering discussion of ways that doctors can identify patients who are at risk to sustain a stroke but who have no pre-stroke symptoms. Topics of coverage include the epidemiology of CAS; the pathobiology of the Asymptomatic Carotid Artery plaque; Cerebrovascular Anatomy & Physiology; the mechanisms of first-ever Ischemic Stroke in patients with CAS; candidates for preventative screening measures; diagnosis and clinical evaluations of patients with CAS; primary medical therapies for CAS patients; risk stratification of CAS patients; evaluation of carotid stenosis to determine disease severity; the role of carotid and cerebral angiography in the management of individuals with asymptomatic carotid disease; carotid endarterectomy in patients with carotid artery disease; carotid artery stenting to treat carotid artery disease; and the outlook for future care.

This text compiles the latest thinking on the subject of CAS by leading national experts who are all preaching the same basic mantra. As the authors teach us, a large portion of strokes occur in patients who present without having experienced tell-tale warning signs, thus making it necessary for clinicians to be able to identify high-risk individuals and proceed with appropriate testing. The idea is to manage risk through preventative procedures – a literal pre-emptive strike meant to stop a stroke before the flow of blood to the brain is impeded.

This text is noted for its clarity and for its cutting-edge tone, as its contributors confront a somewhat controversial area of medical science with authority and vigor – this compendium of the latest research in the area of CAS diagnosis and long-term management.

Recommended to all clinicians on the ‘frontlines’ and charged with treating patients at high risk of suffering a stroke. In addition, this book would make a fine choice as a class text in advanced cerebrovascular programs.

by John Aiello

AORTIC ANEURYSMS. Pathogenesis and Treatment. Gilbert R. Upchurch. Enrique Criado. Springer.

This book sets the bar for identification/diagnosis and treatment of various forms of aortic disease, including aneurysms. Here, Upchurch and Criado discuss advancements in the surgical treatment of aortic disease (with stent grafts for aortic aneurysm repair now becoming the go-to option). As the authors note, the increase in life expectancy has made aortic aneurysms a much more common occurrence. Accordingly, the onus is now on physicians at all levels to diagnose and manage elderly patients who present in the throes of aortic distress. In Aortic Aneurysms, the authors offer a comprehensive summary of the the ever-changing landscape of aneurysm treatment, with special attention given to aneurysms of the descending thoracic and abdominal aorta. Also note the pertinent discussion of endovascular aortic repair (in addition to review of improvements in stent graft design).

This is a benchmark reference which should be required reading for all cardiologists and all cardiac and thoracic surgeons – noted for its clear style and erudite examination of management and treatment of aortic disease and aortic aneurysms.

Further Reading From The Springer Cardiology Shelf

CARDIOVASCULAR DISEASE IN AIDS. Second Edition. Editors: Giuseppe Barbaro. Frank Boccara. Forward by Paul R. Skolnik. Springer.

This manual from Barbaro and Boccara uses its original voice to examine the impact of AIDS on the cardiovascular system. Now in its second edition, Cardiovascular Disease takes an in depth tour through this ever-evolving subject. Here, the authors look at how different courses of treatment for AIDS have different results on heart-health (for example, in developed countries, researchers saw a 30% reduction in HIV-related cardiomyopathy – a likely result of mitigating opportunistic infections after successful implementation of antiretroviral therapy). As readers move through the layered chapters of this bold and incisive text, it becomes apparent that AIDS has created a multiplicity of challenges for physicians striving to protect patients from overt cardiac collapse – their ultimate goal to bolster the immune system (and the body’s natural ability to ward off infection) without further weakening the patient’s cardiac foundation. Contains the most recent data on the subject, making it appropriate for the classroom (as well as the practicing physician and researcher on the frontlines of patient treatment).

Of Related Interest

INTEGRATED CARDIOTHORACIC IMAGING WITH MDCT. Editors: M. Remy-Jardin. J. Remy. Springer.

The future as it relates to the treatment of heart disease will owe as much to the radiologist as it will to the clinician and surgeon. In this 4-part text, the authors take a comprehensive look at the “development of fast scanning techniques” as a means to examine the chest for abnormality and disease. Readers will note that the ‘guts’ of this book are contained in section 4, which explains in vast detail the various applications of integrated cardiothoracic imaging (with discussion of both cardiac-based and thoracic disorders, in addition to pericardial disease and a summary of ways these techniques can be used for pulmonary-function evaluations). Noted for its authoritative tone, which speaks to clinician, radiologist and researcher with equal dexterity.

THE AORTA. Structure, Function, Dysfunction, and Diseases. Editors: Harisios Boudoulas and Christodoulos Stefanadis. Informa Healthcare.

The aorta serves as the work-horse of the human heart, serving as the largest blood vessel in the body charged with transporting oxygenated blood in this ever-so-complicated chain of circulation. Here, Boudoulas and Stefanadis have built a tremendous resource that will give advanced medical students and practicing physicians alike a better understanding of cardiac disease. Like its title implies, The Aorta completely dissects this indispensible vessel, discussing its embryology, anatomy and susceptibility to disease (with intense focus on aortic aneurysms, aortic dissections, intramular hematoma, congenital heart diseases and aortic trauma). Aside from their analysis of how to effectively diagnose and treat cardiac conditions borne in the aorta, the authors also instruct clinicians on how to use the aorta as a ‘barometer’ that can accurately predict the likelihood of future cardiovascular events. Clearly researched and impeccably presented, The Aorta should play the center-stage of every cardiologist’s reference shelf.

by John Aiello

VENTRICULAR ARRHYTHMIAS AND SUDDEN CARDIAC DEATH. Mechanism, Ablation, and Defibrillation. Editors: Paul Wang. Henry Hsia. Amin Al-Ahmad. Paul Zei. Blackwell Futura. This volume provides new and cutting-edge summarization of a form of heart disease which kills hundreds of thousands of people world-wide each year. Here, Wang and co-editors present the most recent data on ventricular arrhythmias and the phenomenon of sudden death, with coverage of the mechanisms of ventricular tachycardia and ventricular fibrillation; etiologies and clinical syndromes; various pharmacologic therapies; and major treatment options (including cardiac ablation, surgery and implantable defibrillators).  In this text, the authors have built a resource that outlines how to diagnose and correct ventricular tachyarrhythmias, teaching physicians at all levels how to interpret the nuances of the human heart in order to draw a clear picture of how to best treat the ailing patient.

Recommended to practicing cardiologists and internists as well as instructors in the university classroom; noted for its focus, organization and depth.

Of Related Interest

CARDIAC RESYNCHRONIZATION THERAPY. Second Edition. Cheuk-Man Yu. David L. Hayes. Angelo Auricchio. Blackwell.  Here, Yu and co-writers have created the authoritative reference on cardiac pacing for heart failure patients. Topics of coverage include the epidemiology of heart failure and associated conduction disorders; pharmacologic treatments to manage heart failure; electrical activation sequence; the most recent echocardiographic techniques for the assessment of cardiac resynchronization therapy (CRT); the anatomy of the coronary sinus; implantation techniques for CRT; device-based patient management; on-going trials likely to reshape the future of CRT; and considerations for CRT in the pediatric population (to cite random highpoints). This title is noted for providing up-to-date analysis on the whole of CRT while simultaneously examining sociological topics (health economics) in order to paint a comprehensive picture for internists to reference in the daily course of patient treatment.

Remarks On Medicine: Salute To Doctor Kanu Chatterjee

Master Cardiac Clinician Retires From University of California

Kanu Chatterjee was hired as a Professor of Medicine at the University of California, San Francisco (UCSF) in 1975. And since then, he’s taken the world of cardiology by storm – elevating the physical examinations of patients to an art form while riding his insatiable thirst for knowledge toward better treatments for patients locked in the throes of heart failure.

And now, after having dedicated some 50 years to furthering the possibilities for patient care, Dr. Chatterjee has retired. On June 30, 2009, Chatterjee officially vacated his post at the University that he has called home for over three decades, bequeathing his place to the throngs of students to whom he has dedicated so much of his life.

Reserved, with a deliberate and poetic nature, Chatterjee is known through-out the world as a physician of supreme skill and compassion, known as a man who carefully balances the quality of his patients’ lives against medical intervention. No matter what situation he’s confronted with, Chatterjee never loses sight of the fact that his patients are individuals and not just “case studies” to be memorialized in the next research paper.

In clinical circles, Chatterjee’s prowess in examining patients is celebrated: Over the course of his career, he has demonstrated the uncanny ability to hear what is happening inside the human heart by using a combination of his stethoscope and his hands – diagnosing cardiac disease by tracing the nuanced sound of blood as its passes through its grand labyrinth of veins and arteries.

Chatterjee, who was born and educated in India, has truly been tireless in his dedication to the advancement of cardiac medicine, pioneering vital drug-studies that documented the benefit of ACE inhibitors and vasodilators in the long-term treatment of heart failure. In addition, he has written over 300 articles and 95 book chapters on the treatment of various forms of heart disease, receiving countless awards and citations for his work along the way.

Yet, above all else, Professor Chatterjee is revered for the energy he invested in his students –the thoughtful and respectful demeanor he displayed in the classroom came to influence multiple generations of physicians who now will spread his unique vision as a healer via their own lives and careers.

In sum, Chatterjee’s story is about a man on a singular and solitary path, his story about a man following a calling – like a poet or a priest, there seems to have been no other choice as to what profession he would pursue. Simply, Kanu Chatterjee was called to be a doctor, the evidence of this fact found in the stories of the many patients he helped guide past the emotional peaks and valleys that mark our passage across this invisible bridge that connects life to death.

by John Aiello

Mayo Clinic Cardiology

MAYO CLINIC CONCISE TEXTBOOK OF CARDIOLOGY. Edited by Joseph G. Murphy. Informa Health Care.

This magnificently crafted textbook from the Mayo Clinic, now in its third edition, sets a true benchmark in the study of cardiology. Even after decades of concentrated research and the investment of billions of dollars, cardiovascular disease continues to strike over one million Americans each year as medicine struggles for a more effective way to mitigate its devastating toll. Accordingly, the Mayo Clinic Concise Textbook of Cardiology (edited by Joseph G. Murphy) provides medical students of varying levels with both a thorough and contemporary exploration into the great labyrinth of the human cardiovascular system. Topics of coverage include signs and signals of heart disease; primary symptoms; and guidelines to diagnosis/treatment (as clinicians are taught how best to approach patient evaluation and the long-term management of symptoms). Murphy’s text is noted for its ability to distill vast amounts of information into sharp, digestible, ‘bite-sized’ portions. Ultimately, the Mayo Clinic Concise Textbook of Cardiology presents readers with a readily accessible manual that grafts the latest discoveries in cardiovascular medicine into a seamless narrative which extends from classroom to examination table with equal precision.

by John Aiello

HURST’S THE HEART. Manual of Cardiology. 11th edition. Robert A. O’Rourke. McGraw Hill.

This pocket-sized manual provides comprehensive analysis of the many conditions that afflict the heart, offering the most recent data on diagnosis and treatment of coronary disease. The fact that Hurst’s has been around for so many years has made it a “standard” in the field, and many cardiologists have now made it an integral part of their in-office libraries. As soon as you see and survey this material, the reasons for Hurst’s place in medical publishing will become obvious.

As noted, Hurst’s offers full reportage on heart disease, with material on physical examination of the cardiac patient, interpreting electrocardiograms, non-invasive testing for myocardial ischemia, treatment of the elderly cardiovascular patient, management of arrhythmias, pacemakers, valve disease, dilated cardiomyopathy, myocardial infarction, treatment for heart failure and implantation of defibrillators (among many other topics).

What makes this title standout from other similar texts is the way it has been organized, with the authors going to great lengths to address everything the clinician is likely to encounter in the course of patient treatment. I presuppose that the reason behind presenting the material this way is to counsel the doctor to look for and anticipate complications that might not always be readily apparent on initial examination.

To this end, O’Rourke and his co-writers make a point of linking and building chapters in a logical chain (data on physical examination moves into electrocardiograms; data on the elderly patient moves into an examination on how to evaluate and manage heart failure) — a well-rounded and cogent presentation that paints a clear and illuminating picture of the human heart. Well-placed charts and graphs further serve to illustrate key points and clarify sometimes complicated material (such as evaluating ST-Segment-Elevation in myocardial infarction).

In short, Hurst’s serves as a sharply-developed manual that completely addresses all facets of heart disease in clear and vibrant terms, never losing sight of its absolute focus: to assist doctors in the day-to-day treatment of patients with coronary disease.

In addition to being a vital selection for Cardiologists, Internists, Primary Care Physicians and Emergency Room personnel, it is highly recommended to all Health Science libraries as a general reference text.

Snapshot On Medicine: The Doctor’s Perspective

I.

Northern California is fortunate to have available to it some of the best medical care in the country, including Stanford Medical Center, St. Francis Hospital, U.C. Davis Medical Center, California Pacific Medical Center, and the esteemed University of California, San Francisco Medical Center. UCSF, located atop Parnassus Avenue on the edge of the city’s famed Haight-Ashbury district, is world renowned for many of its departments, including the cutting edge care in cardiology research and treatment it offers.

UCSF’s cardiology staff is comprised of many of the most accomplished doctors in  the United States. These doctors all work in what is commonly referred to as a “teaching hospital ” — a facility where physicians double as instructors, teaching the practice of medicine to interns, nurses and fellows while simultaneously treating patients in a state-of-the-art medical center.

Cardiologist Kanu Chatterjee has been a Professor of Medicine at the University since 1975. Reserved, with a deliberate and poetic nature, Chatterjee is known through out the world as a physician of supreme skill and compassion, carefully balancing the quality of his patients’ lives against treatment options. No matter what situation he is confronted with, Chatterjee never seems to lose sight of the fact that his patients are each individuals and not just “case studies;” because of this absolute dedication to his profession, Chatterjee’s opinion is routinely sought by patients and colleagues from across the globe.

Chatterjee, who was born and educated in India, has written over 300 articles and 95 book chapters on the treatment of heart disease. He has received countless awards during his distinguished 40 year career, and serves on the review boards for many professional journals. Further, his thoughtful and respectful demeanor in the classroom has influenced multiple generations of physicians who continue to spread his unique vision as a healer through the work of their own careers.

During the last 15 years Chatterjee, along with fellow cardiologists Teresa De Marco, William Grossman, and the recently retired William Parmley, has also been active in promoting the work of the “Foundation for Cardiac Research.” This non-profit organization is committed to furthering treatment options for various forms of heart disease, with a specific emphasis on congestive heart failure and vascular maladies.

The mission of the Foundation, and the impact it has had on Bay Area and surrounding communities, is seen first hand during the one hour television special, “A Change of Heart.” The program, produced by Foundation Board Member William Criswell, is currently slated to be rebroadcast on ABC affiliates throughout the northern portion of the state in February; it tracks the treatment of several heart patients from UCSF, recording their reflections in the face of serious illness. The documentary is of note because it exemplifies the hands-on approach Chatterjee, Parmeley and De Marco take towards their patients — not only prescribing pills and administering clinical tests — but also helping to guide them past the emotional peaks and valleys that accompany this struggle between life and death.

This interview with Doctor Chatterjee was conducted at his offices on the UCSF campus in April of 2003.

Tell me a bit about your background.

I was born in India, in an area that is now known as Bangladesh. I attended Medical College in Calcutta, and graduated in 1956, and then served as House Physician at Burnpur Hospital in India from 1957 through 1963. After that, I was trained at various hospitals in London, where I remained until 1971. That’s when I came to the United States to become the Clinical Director of the Myocardial Infarction Research Unit at Cedars-Sinai Medical Center in Los Angeles. I stayed there until 1975, and then came to work at UCSF with William Parmley.

How does the practice of medicine differ in India and Europe from the practice of medicine in America?

Well, there have been quite a lot of changes since I graduated medical school in India. At that time, in the 1950s, medicine was based on a clinical approach, and there just weren’t that many treatments available for most diseases. There also were very few diagnostic tests a doctor could use. But things have changed a great deal since that time, and now many of the same advanced treatments we commonly use here in the United States are used in India and in other similar countries. The main difference is the institutions offering these services are limited in number — there simply aren’t a lot of these facilities around.

I imagine in your nearly 30 years at UCSF, you have witnessed many changes here as well…

Oh yes! Many many changes. For example, in 1975 when I came here, there were only 4 beds in the Intensive Care cardiac unit. Now in less than 3 decades, we have more than 50 beds in critical care units throughout the hospital. This is an important change, in that it has increased the number of patients we’re able to help.

Obviously, this part of California is rich with many fine hospitals. What distinguishes UCSF?

I am very proud of this hospital and the things we have been able to do here. The Medical Center has regularly been ranked in the top 10 nationally, and this year it is ranked number 6 among all medical schools in the nation. I think there are many reasons for our high ranking, the biggest of which is our commitment to patient care. What we try to do here is blend medical research and the teaching of young doctors with excellent patient care. We are dedicated to this mission.

Of all the sub-specialties in medicine, why did you choose to pursue a career in cardiology?

Well, this goes back to my beginnings. As a student in medical school, I was very interested in cardiac physiology and in physical diagnosis. And there are actually only two sub-specialties — cardiology and neurology– that allow you to make a diagnosis with your stethoscope. Aside from these reasons, my father died of a disorder known as “heart block,” before pacemakers were available. And this event increased my interest in the field in that it made me want to look at what could be done and what could not be done in cardiology.

Aside from your work as a physician, you have also been quite active in the role of the Foundation for Cardiac Research during the past 15 years.

Yes, I am very grateful to the Foundation. Since it was founded in the late 1980s, it has provided vital support to the University, supporting research into heart disease and new approaches for treatment. The wonderful thing about the Foundation is that it supports fellows and junior faculty as well as faculty — it is literally supporting all the research being done in the field of cardiology at UCSF.

In what direction do you see cardiology treatment moving in the next ten years?

I think in the coming years we will begin to use research as a means to preventative medicine; this will most certainly be at the forefront of our thinking. Currently, we have made remarkable advances in treating the consequences of heart disease — an example is angioplasty and stent treatment — to substantially increase both the quality and the length of a patient’s life. I think in the future we are not only going to be looking at how to better treat heart disease, but we will also begin developing a multi-pronged attack to prevent it. The ultimate goal is prevention.

Your work schedule is almost legendary in medical circles, I’m talking about the way you’re able to treat patients and teach and then serve as a guest lecturer at hospitals all over the world. Where does your boundless energy come from and what keeps bringing you back for more?

I really do enjoy the whole aspect of the practice of medicine, and especially the practice of cardiology. I can think of no other profession that brings you so close to the patient. As a cardiologist, you are bound to have close contact with your patient and their family, you’re not just looking into the microscope as is the case with some other sub-specialties. I truly find it a blessing and a privilege to come into emotional contact with my patients and become involved in their ultimate well-being. I am also driven to pass on knowledge to other doctors. I shall never forget a conference I once chaired: of the six presenters, four were former students of mine. I was so proud of that. I can only think of one thing that can compare to that kind of a feeling, and that’s seeing a patient get better.(pauses) I guess the energy I have comes from my passion for my work. If I didn’t like it I wouldn’t do it. It’s just second nature now, after so many years it’s a part of me, of who I am, of my existence. My schedule is tough on my wife Docey though — she doesn’t see me much and this is frustrating for her. I am certainly grateful she has tolerated me and my schedule for so long. (laughs)

Looking forward, can you ever imagine a time when heart disease will actually be eradicated, or is it simply a natural part of our life & death process which will always exist in some form?

Well, there have been many great achievements in the treatment of heart disease during the past 20 or so years. We have been able to better treat patients after heart attack through agioplasty and stent procedures, with the rate of mortality markedly declining. And we have also made advances on prevention by better controlling cholesterol and high blood pressure with some new and more efficient medications (like the “statin” drugs used to treat elevated cholesterol levels) . However, I don’t think the problem will ever be eradicated in its entirety. But I think as life span increases, we will be able to delay the onset of heart disease. It has been projected that by the year 2050 the normal life span will be between 80 and 85, with a percentage of the population surpassing 100 years of age. The key to all of this is in better understanding the aging process and in perhaps being able to modify the aging process by regulating or delaying cell death. If this can be done, then heart disease will be delayed as part of the aging process itself.

by John Aiello

II.

Doctor Teresa De Marco, a Professor of Clinical Medicine and the Director of the UCSF Heart Failure and Pulmonary Hypertension Program, immigrated to the United States from Italy in 1967, earning degrees from UC Berkeley and the UC Irvine School of Medicine.

Since joining the UCSF faculty in 1989, De Marco has worked closely with Doctor Chatterjee, and her efforts have been at the forefront of the treatment of heart failure. De Marco’s major contribution in this area has been in “resynchronization therapy,” which uses a sophisticated form of pacemaker to improve the function of a failing heart. As the Medical Director of the Cardiac Transplantation Program at UCSF, De Marco’s research ultimately documented the fact that nerves are actually able to regenerate in a transplanted human heart, a discovery that radically improves the long-range outlook for transplant patients.

This interview with Doctor De Marco was conducted last April.

Several of your patients are featured prominently in the “Change of Heart” documentary that is set to be rebroadcast throughout the northern portion of the state in February 2004. One of these patients, Lonnie Smith of San Jose, has captured the thoughts of many as he continues to transcend his illness. Looking back, what impressed you most about Lonnie?

Lonnie was very tenacious, very determined to get well. When I first met him in the ICU, he was in bad shape. He was deathly ill. His body was full of fluid and he was in severe heart failure; the lack of blood flow was also affecting other organs, like his kidneys and liver. When I began treating him, we immediately became focused on increasing the blood flow (in his body) and reducing the fluid that had built up. Once we had Lonnie feeling and breathing better, we started to look at other procedures that would keep him feeling better. Unfortunately, because his heart was in such bad shape, we were forced to go to the next step, and we started looking at transplantation. The transplant we ended up doing allowed us to truly increase Lonnie’s quality of life.

How many transplants are done at UCSF per year?

Up until 1998, we did between 12 and 15 procedures each year. In 1998, this slowed down because we had a couple of our surgeons leave. However, Dr. Chuck Hoopes, formerly of Duke University, joined our staff this year. And with the addition of Dr. Hoopes as a surgeon, our goal is to once again do between 12 and 15 transplant procedures per year. Looking at the Bay Area as a whole, between 60 and 80 heart transplants are done amongst 3 programs, including Stanford University, UCSF and California Pacific Medical Center. In Sacramento, Sutter Medical Center also does some transplant procedures.

And how many transplant patients do you continue to follow today Dr. De Marco?

About 80 or 85.

What is the success rate and the probable life expectancy for the typical transplant patient?

The one year survival rate is 90%. At five years, it’s 70%; and at 10 years, it’s 50%. The longest living transplant patient that I am aware of has survived 21 years. The goal of the procedure is to improve a patient’s quality of life. Usually after transplant, one has increased exercise tolerance and can engage in the normal activities of life. But it’s important to remember that a transplant is an “end of the line” treatment to be used for heart disease patients who are out of alternatives. Heart transplant is not a cure, but instead a treatment to be considered when the patient is out of options.

What are the major obstacles facing a transplant patient?

During the first month following transplant, the primary trouble we run into tends to be with either infection, rejection of the donor heart, or technical problems with the procedure itself. These problems are sometimes long-term concerns as well, but rejection becomes less likely over time as the patient’s body becomes more tolerant of the donor heart. The main long term problem for transplant recipients is with coronary artery disease. After 5 years, 50% of transplant patients show evidence of coronary artery disease, with a progressive narrowing of blood vessels. We treat these events with angioplasty or by-pass surgery, but these procedures tend not to work well, and eventually we have to look at retransplantation. Another major long-term concern is with cancer. Patients are at an increased risk for some cancers because their immune systems have been suppressed as a result of transplantation.

Can you envision a time when cardiac medications will be so advanced as to make heart transplant procedures obsolete?

It’s happening right now. With the institution of medications like beta-blockers we have been able to forestall the need for transplant and in some cases avoid it altogether. However, I think we have actually reached a plateau with drugs, and will now start to look at other treatment options — like resynchronization therapy — to more effectively treat patients and avoid transplantation.

You have also remained active in the Foundation For Cardiac Research. What do you see as the primary role of the Foundation?

The Foundation’s role is to evaluate promising new areas of research that cardiologists can pursue. Funding for cardiac research is difficult to obtain, and the Foundation’s ability to fund research projects plays an important role in furthering a doctor’s ability to better treat patients.

And what would you cite as the most important advancements in cardiology treatment during the past decade?

One of the most important things to happen along these lines is the advent of “Thrombolytics” — or so-called “clot-busting” drugs — that actually work to dissolve a clot within an artery when someone is having a heart attack. In addition, doctors can also intervene through angioplasty and stent procedures: in short, we now have several different ways in which we can actually abort a heart attack and prevent heart muscle from dying. And by salvaging heart muscle, we avoid tissue death and prevent heart failure from developing.

For more information on the Division of Cardiology at UCSF, go to: ucsf.edu or foundationforcardiacresearch.org.

by John Aiello

Chatterjee In Print Review

HEART FAILURE: SCIENTIFIC PRINCIPLES AND CLINICAL PRACTICEPhillip A. Poole-Wilson; Wilson S. Colucci; Barry M. Massie; Kanu Chatterjee; Andrew J.S. Coats. Churchill-Livingstone. This first rate clinical text explores the medical implications of heart failure, written and edited by many of the leading cardiologists in the United States. The book is focused on clinical concepts, approaching the disease from the researcher’s point of view. Accordingly, the presentation is tailored to medical students and the general practitioner or internist, offering insightful commentary on the mechanics of heart failure and ways the medical professional might approach diagnosis and treatment. Doctor Chatterjee’s chapter, written in collaboration with Doctors Tony Chou and Stuart Hutchison, explores ways the physician can manage patients who are in acute heart failure. This is a major reference text meant to expand the over-all understanding of this category of coronary disease. Fine illustrations also. Invaluable to all college libraries and especially to university students in pursuit of certifications in cardiology.

To order go to amazon.com.

by John Aiello

A PRACTICAL APPROACH TO CARDIAC ANESTHESIA. Frederick A. Hensley. Donald E. Martin. Glenn P. Gravlee. Lippincott, Williams and Wilkins.

This manual is meant for the practicing anesthesiologist, nurse anesthetist, cardiologist and cardiac surgeon, surveying practical methods of anesthesia as they relate to the cardiac patient. Well-written and expertly detailed, the third edition of Practical Cardiac provides medical scientists with a first-rate reference guide that has been designed to be used – in the office and in the operating room. Simply, this text is about bringing information to the doctor so that he can apply it to the patient in the direct course of treatment.

There are many outstanding features which separate Practical Cardiac from other similar handbooks, but it’s best feature is in its outline format, a feature that allows the reader to answer questions quickly and logically and thoroughly – an in depth analysis of a complex subject matter in a simple to use package.

In the world of medicine, the idea of anesthesia isn’t very glamorous — not when it’s compared to the work of cardiac surgeons whose very hands nurse the diseased heart back to health. However, the way that a patient is anesthetized is paramount to whether they will survive surgery. Accordingly, Practical Cardiac investigates these concepts in deep detail, examining how the anesthesiologist should approach the management of different kinds cardiac patients, exploring treatment options from converse angles. Readers will be enriched on many different levels, by information on pain management and by the very useful data that’s provided on new drugs now being used on cardiac-compromised individuals. Analysis of cardiac transplantation, circulatory support and organ preservation is also offered, with smart use of diagrams and graphs to support the authors’ point of view.

We would recommend this manual to all physicians involved in surgically treating cardiac patients. Moreover, it is a logical choice as a teaching text in the field, for it affords anesthesiology students a comprehensive and easy to use tool that brings the most up-to-date information to the classroom (and to the operating room). Would be further recommended to all Health Science libraries as a general reference text.

Order from amazon.com or go to Lippincott, Williams and Wilkins.

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This entry was posted on June 28, 2013 by in Reference and tagged , , , .
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