Ebook Challenging concepts in cardiovascular medicine - A case based approach with expert commentary: Part 1

(BQ) Part 1 the book Challenging concepts in cardiovascular medicine - A case based approach with expert commentary presents the following contents: Coronary heart disease, the endocardium and valvular heart disease, the myocardium and cardiomyopathy.

Challenging Concepts in Cardiovascular Medicine: A Case-Based Approach with Expert Commentary Forthcoming titles in the Challenging Concepts in series Anaesthesia (Edited by Dr Phoebe Syme, Dr Robert Jackson, and Dr Timothy Cook) Emergency Medicine (Edited by Dr Sam Thenabadu, Dr Fleur Cantle, and Dr Chris Lacy) Neurosurgery (Edited by Mr Robin Bhatia and Mr Ian Sabin) Obstetrics and Gynaecology (Edited by Dr Natasha Hezelgrave, Dr Danielle Abbott, and Professor Andrew Shennan) Oral and Maxillofacial Surgery (Edited by Mr Matthew Idle and Group Captain Andrew Monaghan) Respiratory Medicine (Edited by Dr Lucy Schomberg and Dr Elizabeth Sage) Challenging Concepts in Cardiovascular Medicine: A Case-Based Approach with Expert Commentary Edited by Aung Myat SpR Cardiology and NIHR Clinical Research Fellow West Midlands Deanery and The Rayne Institute, St Thomas’ Hospital, King’s College London, UK Shouvik Haldar SpR Cardiology and Electrophysiology Research Fellow London Deanery and The National Heart & Lung Institute, Royal Brompton Hospital, Imperial College London, UK Simon Redwood Professor of Interventional Cardiology and Honorary Consultant Cardiologist King’s College London and Guy’s and St Thomas’ NHS Foundation Trust London, UK 1 Great Clarendon Street, Oxford OX2 6DP Oxford University Press is a department of the University of Oxford It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide in Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries Published in the United States by Oxford University Press Inc., New York © Oxford University Press, 2011 The moral rights of the author have been asserted Database right Oxford University Press (maker) First published 2011 All rights reserved No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this book in any other binding or cover and you must impose this same condition on any acquirer British Library Cataloguing in Publication Data Data available Library of Congress Cataloguing in Publication Data Data available Typeset in Slimbach by Cenveo, Bangalore, India Printed in Italy on acid-free paper by L.E.G.O S.p.A.—Lavis TN ISBN 978–0–19–969554–6 10 Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations The authors and the publishers not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding FOREWORD The authors are to be congratulated on producing an innovative and informative text on the management of common cardiovascular conditions By presenting facts through the vehicle of a series of case presentations the text comes alive and has relevance and immediacy for anyone having to deal with patients with heart disease Rather than cite references to publications in the conventional way, the authors provide up to date commentaries on the published evidence with additional, personalized opinions from an impressive array of distinguished specialists from around the UK with each case representing a virtual ‘grand round’ on a particular topic Although not exhaustive, the book covers most of the clinical presentations that are likely to be encountered by a trainee in their day-to-day practice, whether in the A & E department, on the wards or in the catheterization laboratory Not only does it provide invaluable reading for the relatively inexperienced cardiologist, it also serves as a highly palatable update for those of us who have been around somewhat longer In a modern clinical practice setting dominated by guidelines, protocols and directives it is refreshing to encounter a text that brings all aspects of case management together in such an informative and entertaining way I can thoroughly recommend it to all cardiologists, whether established or in training, as well as any healthcare professional wishing to keep abreast of modern, evidencebased management of heart disease Professor Peter Weissberg Medical Director, British Heart Foundation This page intentionally left blank A REVIEW FROM THE BRITISH CARDIOVASCULAR SOCIETY There are many books published in cardiovascular medicine but few that offer a practical patient based approach The authors should be congratulated for producing a highly readable, unique, and memorable educational experience suitable for a wide audience: medical students, trainees, trained cardiologists, allied professionals, and GPs This book presents 25 ‘real world’ cases of the common, and some not so common, cardiac diagnoses Each scenario, written by a Specialist Registrar, follows the patient pathway through their presenting complaint, history, examination findings, investigation and treatment options Along the way, there are highlighted sections of ‘clinical tips’ to aid the diagnosis and ‘learning points’ These ‘learning points’ range from basic facts to the ever important evidence base and this is where this book excels With the growing evidence base from clinical trials, with all their acronyms to remember, and increasing number of clinical guidelines, the authors pick out, and summarise, those relevant to the case in hand This information becomes far easier to remember simply by association with the case In addition a distinguished expert in the relevant field adds an ‘expert commentary’ and a ‘final word’ after the case discussion to complete the tutorial I am sure the information held in each of these case scenarios will be recalled frequently in clinical practice and beyond The British Cardiovascular Society, through its education strategy, supports the delivery of high quality education and this book, through its knowledge based learning, certainly provides that It comes highly recommended by the Society Dr Sarah Clarke Vice President Education and Research British Cardiovascular Society This page intentionally left blank PREFACE Cardiovascular medicine in the 21st Century continues to be a dynamic and continually evolving landscape with high impact journals rapaciously churning out trial after landmark trial, alongside the emergence of novel translational techniques and discoveries at the cellular level We as healthcare professionals must critically appraise and selectively plunder this evidence base and apply it to everyday clinical practice so that we can give our patients the very best possible care biomedical science will allow Local, national and international guidelines help, as the expert consensus of opinion leaders and the advice of our colleagues and peers on the ground We have tried to encapsulate this contemporary scheme of patient-focussed care, with its foundation supported by guidelines and an evidence base, in this publication We present 25 real-world clinical scenarios, each aiming to provide the reader with an holistic approach to dealing with a variety of challenging concepts in cardiovascular medicine It has been our deliberate intention to include detailed reviews centred around individual cases which we may all encounter either in the emergency department, outpatient clinic, catheterisation laboratory or on the coronary care unit Indeed we have tried to avoid presenting a compendium of the rare, weird or wonderful Each case has been written by a UK Specialty Trainee(s) and is punctuated by “Learning Points”, “Clinical Tips,” and “Landmark Trial Summaries” These highlighted boxes are embedded in the main body of the case text and should help to aid memory and provoke thought We have then sought the peer review of an internationally-renowned Expert for each of the clinical scenarios and have asked them to provide a narrative as the case proceeds in the form of “Expert Comments” boxes These should provide the reader with a unique insight into how today’s opinion leaders deal with the very same clinical scenarios we all manage day in and day out We very much hope this text will appeal, first and foremost, to all specialty trainees in cardiology and to some degree those in acute and general internal medicine Allied to this our aim has been to make this book stimulating, transferable, and accessible to all those with an interest in cardiovascular medicine so in that respect general practitioners (particularly those with a specialist interest in cardiology), clinical electrophysiologists, specialist cardiac nurses and physicians’ assistants may all find the content applicable to their everyday practice It is now standard practice to explore the management of clinical scenarios both in specialist training post interviews and fellowship exams We would therefore expect our junior colleagues preparing to navigate these career milestones to find this text particularly relevant too We, the Editors, very much hope you enjoy the read Aung Myat Shouvik Haldar Simon Redwood ... horizons in management Case 16 Paroxysmal atrial fibrillation 16 5 Case 17 Ventricular tachycardia in a ‘normal’ heart 17 5 Case 18 Dual-chamber vs single-chamber pacing: the debate continues 18 3 Case 19 ... stenosis atrial septal aneurysm AS ASA ASCS ASD ASH AST ATP AV AVNRT AVR BACR agitated saline contrast study atrial septal defect asymmetric septal hypertrophy aspartate aminotransferase Acute Treatment... Emergency atrial fibrillation American Heart Association alkaline phosphatase alanine aminotransferase acute myocardial infarction aldosterone-producing adenoma activated protein C resistance aortic