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For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure.
Arterial hypertension, coronary heart disease and heart fail ure are the commonest cardiovascular conditions to present in clinical practice. Over the past few years it has become in creasingly clear that they are closely and causally interrelated and that their relationship can have a significant bearing on prognosis. Epidemiological studies have shown that arterial hypertension is one of the most important risk factors for de veloping heart failure. Only one in four patients with hyper tension is adequately managed, and in 50% of cases, the hypertension has not been recognised or treated. Patients with pre-existing hypertension who go on to suffer an acute myocardial infarction have usually not previously had typi cal angina symptoms, the infarct territory is larger, life threatening arrhythmias are commoner and hence in-hospi tal mortality and long-term prognosis are markedly worse. The presence of raised blood pressure in the post-infarct phase doubles the risk of manifest heart failure. The close relationship between hypertension, coronary heart disease and heart failure makes the choice of therapeu tic strategy particularly important. Agents and classes of agents that have prognostic value in all three conditions should be considered first, as synergy might result in addi tional benefits. In such patients, this sort of therapeutic deci sion-making might have further advantages. The use of these agents may prevent complications which are not yet clinically obvious (such as heart failure).
This open access book presents a comprehensive overview of dilated cardiomyopathy, providing readers with practical guidelines for its clinical management. The first part of the book analyzes in detail the disease’s pathophysiology, its diagnostic work up as well as the prognostic stratification, and illustrates the role of genetics and gene-environment interaction. The second part presents current and future treatment options, highlighting the importance of long-term and individualized treatments and follow-up. Furthermore, it discusses open issues, such as the apparent healing phenomenon, the early prognosis of arrhythmic events or the use of genetic testing in clinical practice. Offering a multidisciplinary approach for optimizing the clinical management of DCM, this book is an invaluable aid not only for the clinical cardiologists, but for all physicians involved in the care of this challenging disease.
In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.
Engaging science writing that bravely approaches a new frontier in medical science and offers a whole new way of looking at the deep kinship between animals and human beings. Zoobiquity: a species-spanning approach to medicine bringing doctors and veterinarians together to improve the health of all species and their habitats. In the tradition of Temple Grandin, Oliver Sacks, and Neil Shubin, this is a remarkable narrative science book arguing that animal and human commonality can be used to diagnose, treat, and ultimately heal human patients. Through case studies of various species--human and animal kind alike--the authors reveal that a cross-species approach to medicine makes us not only better able to treat psychological and medical conditions but helps us understand our deep connection to other species with whom we share much more than just a planet. This revelatory book reaches across many disciplines--evolution, anthropology, sociology, biology, cutting-edge medicine and zoology--providing fascinating insights into the connection between animals and humans and what animals can teach us about the human body and mind.
Research centering on blood flow in the heart continues to hold an important position, especially since a better understanding of the subject may help reduce the incidence of coronary arterial disease and heart attacks. This book summarizes recent advances in the field; it is the product of fruitful cooperation among international scientists who met in Japan in May, 1990 to discuss the regulation of coronary blood flow.
Diagnosis and Management of Hypertrophic Cardiomyopathy is aunique, multi-authored compendium of information regarding thecomplexities of clinical and genetic diagnosis, natural history,and management of hypertrophic cardiomyopathy (HCM)—the mostcommon and important of the genetic cardiovasculardiseases—as well as related issues impacting the health oftrained athletes. Edited by Dr. Barry J. Maron, a world authority on HCM, and withmajor contributions from all of the international experts in thisfield, this book provides a single comprehensive source ofinformation concerning HCM. Recent advances in the field arediscussed, including the importance of left ventricular outflowtract obstruction, the use of implantable defibrillators for theprevention of sudden death in young people, definition of thegenetic basis for HCM and its role in clinical diagnosis and riskstratification, the development of more precise strategies forassessing the level of risk for sudden death among all patientswith HCM, and the evolution of invasive interventions for heartfailure symptoms, such as surgical management and its alternatives(alcohol septal ablation and dual-chamber pacing). Key Features: Contributions from all experts in the field,representing diverse viewpoints regarding this heterogeneousdisease and related issues in athletes Information to dispel misunderstandings regarding issuesassociated with HCM and cardiovascular disease in athletes The only comprehensive source of information available on thetopic
Pathophysiology of Heart Failure brings together leading basic scientists and clinicians, presenting new approaches to this complex problem, involving cardiomyopathic processes and ischemia perfusion injury. The result is a synthesis of state-of-the-art information on molecular biology, cellular physiology and structure-function relationships in the cardiovascular system. The role which excess intracellular calcium plays in the genesis of cardiac dysfunction is described as a fundamental mechanism underlying heart failure; one which may lead to improved prevention and treatment. Audience: Clinical and experimental cardiologists will find the book a helpful source of ideas and inspiration.
Many noteworthy advances in our knowledge of the pericardium, its functions and diseases and their relation to heart failure have been made since the first edition of this book appeared in 1981; and no other book that covers in detail the physiology and pathophysiology has since been published. The first edition was favourably received, and I have frequently been asked to write a new edition. My own knowledge in the years that have passed since then, and my clinical and research experience in the field of the subject have both increased. For all these reasons, I decided that the second edition was overdue. The long time that has elapsed between editions necessitated rewriting, rather than simply revising, most of the text. For the same reason, many of the figures are new. Most of the references I have cited appeared in the literature after 1981, but I have retained a number of earlier ones, either because they are classics or, in my opinion, have not yet been bettered. It is my hope that the new edition will be a useful resource for clinicians called upon to manage patients with pericardial disease and for physiologists when the pericardium is relevant to their investigations. I make no apology for the in-depth treatment of the pericardial physiology and pathophysiology throughout the book, for they are the foundation on which diagnosis, hemodynamic and imaging studies, and management must rest.