Braunwald: Heart Disease: A Textbook of Cardiovascular Medicine, 6th ed., Copyright © 2001 W. B. Saunders Company Part I - GENERAL CONSIDERATIONS OF CARDIOVASCULAR DISEASE - Global Burden of Cardiovascular Disease - Economics and Cardiovascular Disease Part II - EXAMINATION OF THE PATIENT - The History - Physical Examination of the Heart and Circulation - Electrocardiography - Exercise Stress Testing - Echocardiography - Radiology of the Heart and Great Vessels - Nuclear Cardiology 10 - Newer Cardiac Imaging Modalities: Magnetic Resonance Imaging and Computed Tomography 11 - Cardiac Catheterization 12 - Coronary Angiography and Intravascular Ultrasonography 13 - Relative Merits of Cardiovascular Diagnostic Techniques Part III - NORMAL AND ABNORMAL CARDIAC FUNCTION 14 - Mechanisms of Cardiac Contraction and Relaxation 15 - Assessment of Normal and Abnormal Cardiac Function 16 - Pathophysiology of Heart Failure 17 - Clinical Aspects of Heart Failure: High-Output Failure; Pulmonary Edema 18 - Treatment of Heart Failure: Pharmacological Methods 19 - Treatment of Heart Failure: Assisted Circulation 20 - Heart and Heart-Lung Transplantation 21 - Management of Heart Failure 22 - Genesis of Cardiac Arrhythmias: Electrophysiological Considerations 23 - Management of the Patient with Cardiac Arrhythmias 24 - Cardiac Pacemakers and Cardioverter-Defibrillators 25 - Specific Arrhythmias: Diagnosis and Treatment 26 - Cardiac Arrest and Sudden Cardiac Death 27 - Hypotension and Syncope Part IV - HYPERTENSIVE AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASE 28 - Systemic Hypertension: Mechanisms and Diagnosis 28 - Systemic Hypertension: Mechanisms and Diagnosis 29 - Systemic Hypertension: Therapy 30 - The Vascular Biology of Atherosclerosis 31 - Risk Factors for Atherosclerotic Disease 32 - Primary and Secondary Prevention of Coronary Heart Disease 33 - Lipid-Lowering Trials 34 - Coronary Blood Flow and Myocardial Ischemia 35 - Acute Myocardial Infarction 36 - Unstable Angina 37 - Chronic Coronary Artery Disease 38 - Percutaneous Coronary and Valvular Intervention 39 - Comprehensive Rehabilitation of Patients with Coronary Artery Disease 40 - Diseases of the Aorta 41 - Peripheral Arterial Diseases 42 - Extracardiac Vascular Interventions Part V - DISEASES OF THE HEART, PERICARDIUM, AND PULMONARY VASCULAR BED 43 - Congenital Heart Disease in Infancy and Childhood 44 - Congenital Heart Disease in Adults 45 - Acquired Heart Disease in Children 46 - Valvular Heart Disease 47 - Infective Endocarditis 48 - The Cardiomyopathies and Myocarditides 49 - Primary Tumors of the Heart 50 - Pericardial Diseases 51 - Traumatic Heart Disease 52 - Pulmonary Embolism 53 - Pulmonary Hypertension 54 - Cor Pulmonale Part VI - MOLECULAR BIOLOGY AND GENETICS 55 - Principles of Cardiovascular Molecular Biology and Genetics 56 - Genetics and Cardiovascular Disease Part VII - CARDIOVASCULAR DISEASE IN SPECIAL POPULATIONS 57 - Cardiovascular Disease in the Elderly 58 - Coronary Artery Disease in Women 59 - Cardiovascular Disease in Athletes 60 - Medical Management of the Patient Undergoing Cardiac Surgery 61 - General Anesthesia and Noncardiac Surgery in Patients with Heart Disease Part VIII - CARDIOVASCULAR DISEASE AND DISORDERS OF OTHER ORGAN SYSTEMS 62 - Hemostasis, Thrombosis, Fibrinolysis, and Cardiovascular Disease 63 - Diabetes Mellitus and the Cardiovascular System 64 - The Heart in Endocrine Disorders 65 - Pregnancy and Cardiovascular Disease 66 - Rheumatic Fever 67 - Rheumatic Diseases and the Cardiovascular System 68 - Cardiovascular Abnormalities in HIV-Infected Individuals 69 - Hematological-Oncological Disorders and Cardiovascular Disease 70 - Psychiatric and Behavioral Aspects of Cardiovascular Disease 71 - Neurological Disorders and Cardiovascular Disease 72 - Renal Disorders and Cardiovascular Disease MD Consult information may not be reproduced, retransmitted, stored, distributed, disseminated, sold, published, broadcast or circulated in any medium to anyone, including but not limited to others in the same company or organization, without the express prior written permission of MD Consult, except as otherwise expressly permitted under fair use provisions of U.S. Copyright Law. Subscriber Agreement Braunwald: Heart Disease: A Textbook of Cardiovascular Medicine, 6th ed., Copyright © 2001 W. B. Saunders Company Heart Disease A TEXTBOOK OF CARDIOVASCULAR MEDICINE 6th EDITION Edited by EUGENE BRAUNWALD M.D., M.D. (hon), Sc.D. (hon), F.R.C.P. Vice President for Academic Programs, Partners HealthCare System Distinguished Hersey Professor of Medicine Faculty Dean for Academic Programs at Brigham and Women;cqs Hospital and Massachusetts General Hospital Harvard Medical School Boston, Massachusetts DOUGLAS P. ZIPES M.D. Distinguished Professor of Medicine, Pharmacology, and Toxicology Director, Krannert Institute of Cardiology Director, Division of Cardiology Indiana University School of Medicine Attending Physician University Hospital, Wishard Memorial Hospital, and Roudebush Veterans Affairs Hospital Indianapolis, Indiana PETER LIBBY M.D. Mallinckrodt Professor of Medicine Harvard Medical School Chief, Cardiovascular Medicine Brigham and Women;cqs Hospital Boston, Massachusetts W.B. SAUNDERS COMPANY A Harcourt Health Sciences Company Philadelphia London New York St. Louis Sydney Toronto MD Consult L.L.C. http://www.mdconsult.com Bookmark URL: /das/book/view/29208265/924/1.html/top MD Consult information may not be reproduced, retransmitted, stored, distributed, disseminated, sold, published, broadcast or circulated in any medium to anyone, including but not limited to others in the same company or organization, without the express prior written permission of MD Consult, except as otherwise expressly permitted under fair use provisions of U.S. Copyright Law. Subscriber Agreement Braunwald: Heart Disease: A Textbook of Cardiovascular Medicine, 6th ed., Copyright © 2001 W. B. Saunders Company W.B. SAUNDERS COMPANY A Harcourt Health Sciences Company The Curtis Center Independence Square West Philadelphia, Pennsylvania 19106 Library of Congress Cataloging-in-Publication Data Heart disease: a textbook of cardiovascular medicine[edited by] Eugene Braunwald, Douglas P. Zipes, Peter Libby.--6th ed. p. cm. Includes bibliographical references and index. ISBN 0-7216-8561-7 1. Heart--Diseases. 2. Cardiovascular system--Diseases. I. Braunwald, Eugene. II. Zipes, Douglas P. III. Libby, Peter. [DNLM: 1. Heart Diseases. 2. Cardiovascular Diseases. WG 210 H43445 2001] RC681. H36 2001 616.1'2--dc21 00-025391 Editor-in-Chief: Richard Zorab Developmental Editor: Lynne Gery Manuscript Editors: Sue Reilly, Anne Ostroff Production Manager: Frank Polizzano Illustration Specialist: Rita Martello Book Designer: Karen O'Keefe Owens Heart Disease: A Textbook of Cardiovascular Medicine 0-7216-8549-8 (Single Volume) 0-7216-8561-7 (2-Volume Set) 0-7216-8562-5 (Volume 1) 0-7216-8563-3 (Volume 2) 0-8089-2258-0 (International Edition) Copyright © 2001, 1997, 1992, 1988, 1984, 1980 by W.B. Saunders Company. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher. Printed in the United States of America. Last digit is the print number: MD Consult L.L.C. http://www.mdconsult.com Bookmark URL: /das/book/view/29208265/924/2.html/top MD Consult information may not be reproduced, retransmitted, stored, distributed, disseminated, sold, published, broadcast or circulated in any medium to anyone, including but not limited to others in the same company or organization, without the express prior written permission of MD Consult, except as otherwise expressly permitted under fair use provisions of U.S. Copyright Law. Subscriber Agreement Braunwald: Heart Disease: A Textbook of Cardiovascular Medicine, 6th ed., Copyright © 2001 W. B. Saunders Company To: Elaine, Karen, Allison, and Jill Joan, Debra, Jeffrey, and David Beryl, Oliver, and Brigitte MD Consult L.L.C. http://www.mdconsult.com Bookmark URL: /das/book/view/29208265/924/3.html/top MD Consult information may not be reproduced, retransmitted, stored, distributed, disseminated, sold, published, broadcast or circulated in any medium to anyone, including but not limited to others in the same company or organization, without the express prior written permission of MD Consult, except as otherwise expressly permitted under fair use provisions of U.S. Copyright Law. Subscriber Agreement Braunwald: Heart Disease: A Textbook of Cardiovascular Medicine, 6th ed., Copyright © 2001 W. B. Saunders Company Contributors DAVID H. ADAMS M.D. Associate Professor of Surgery, Harvard Medical School; Associate Chief, Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Massachusetts Medical Management of the Patient Undergoing Cardiac Surgery JOSHUA ADLER M.D. Assistant Clinical Professor of Medicine, University of California, San Francisco; Director, Ambulatory Practices, University of California, San Francisco, Medical Center, San Francisco, California General Anesthesia and Noncardiac Surgery in Patients with Heart Disease NADIR M. ALI M.D. Assistant Professor of Medicine, Baylor College of Medicine, Houston; Interventional Cardiologist, Clear Lake Regional Medical Center, Webster, Texas Hemostasis, Thrombosis, Fibrinolysis, and Cardiovascular Disease ELLIOTT M. 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M.D Professor of Pediatrics and Professor of Oncology, University of Rochester School of Medicine and Dentistry; Chief of Pediatric Cardiology, University of Rochester Medical Center and Children's Hospital at Strong, Rochester, New York Cardiovascular Abnormalities in HIV-Infected Individuals WILLIAM C LITTLE M.D Chief of Cardiology and Professor of Medicine, Wake Forest University School of Medicine, ... Herman and Aileen Tuchman Professor of Cardiovascular Medicine and Head, Section of Cardiovascular Medicine, University of Wisconsin-Madison Medical School, Madison, Wisconsin Coronary Artery Disease in Women URI ELKAYAM M.D Professor of Medicine and Director, Heart Failure Program, University of Southern California School of Medicine, Los Angeles, California Pregnancy and Cardiovascular Disease ANTHONY... 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Heart Association Professor of Medicine and Pediatrics, University of California, Los Angeles, School of Medicine, Division of Cardiology, Departments of Medicine and Pediatrics, UCLA Center for the Health Sciences, Los Angeles, California Physical Examination of the Heart and Circulation WILLIAM S PIERCE M.D Evan Pugh Professor of Surgery, The Pennsylvania State University College of Medicine; The Milton... of Medicine, Houston, Texas Traumatic Heart Disease JOHN A FARMER M.D Associate Professor, Section of Cardiology and Atherosclerosis, Department of Medicine, Baylor College of Medicine; Chief of Cardiology, Ben Taub General Hospital, Houston, Texas Lipid-Lowering Trials HARVEY FEIGENBAUM M.D Distinguished Professor of Medicine and Director, Echocardiography Laboratories, Indiana University School of. .. Bowman Gray Campus; Associate Chief of Professional Services, North Carolina Baptist Hospital, Winston-Salem, North Carolina Assessment of Normal and Abnormal Cardiac Function BRIAN F MANDELL M.D., Ph.D Clinical Professor of Medicine, Penn State University School of Medicine, Hershey, Pennsylvania; Associate Professor of Medicine, Ohio State University School of Medicine, Columbus, Ohio; Education... Hematological-Oncological Disorders and Cardiovascular Disease MICHAEL R BRISTOW M.D., Ph.D Professor of Medicine and Head, Division of Cardiology, University of Colorado Health Sciences Center, Denver, Colorado Treatment of Heart Failure: Pharmacological Methods; Management of Heart Failure HUGH CALKINS M.D Professor of Medicine, Johns Hopkins University; Director of the Arrhythmia Service and Clinical... R CHAITMAN M.D Professor of Medicine, Cardiology Division, St Louis University School of Medicine; Chief of Cardiology, St Louis University Hospital, St Louis, Missouri Exercise Stress Testing MELVIN D CHEITLIN M.D., M.A.C.C Emeritus Professor of Medicine, University of California, San Francisco; Former Chief of Cardiology, San Francisco General Hospital, San Francisco, California Cardiovascular Disease . Heede Professor of Cardiology and Professor of Internal Medicine, University of Virginia School of Medicine; Chief, Cardiovascular Division, Department of Internal Medicine, University of Virginia. Angina AGUSTIN CASTELLANOS M.D. Professor of Medicine, University of Miami School of Medicine; Director, Clinical Electrophysiology, University of Miami School of Medicine and Jackson Memorial Medical. Disease: A Textbook of Cardiovascular Medicine, 6th ed., Copyright © 2001 W. B. Saunders Company Part I - GENERAL CONSIDERATIONS OF CARDIOVASCULAR DISEASE 1 - Global Burden of Cardiovascular