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This title discusses the magnitude of the problem of angina pectoris. The author also goes on to describe the characteristics and clinical profile of patients with angina in a contemporary population. The different types and multiple mechanisms of angina pectoris are described, while the clinical presentation, typical and atypical features and complications (MI, HF) and clinical management and outcomes are evaluated. The author also evaluates the various antianginal therapies used in special populations: the elderly, post revascularised patients, patients with LVSD or HF, patients with CKD, patients with diabetes.
This book is intended for general cardiologists and other physicians involved in the care of patients with chronic stable angina (CSA). The goal of this book is to update clinicians on recent data on the medical management of patients with CSA. Ischemic heart disease remains a major public health problem. Chronic stable angina is the initial manifestation of ischemic heart disease in approximately one half of patients. Stable coronary artery disease is generally characterized by episodes of reversible myocardial demand/supply mismatch, related to ischaemia or hypoxia, which are usually inducible by exercise, emotion or other stress and reproducible—but, which may also be occurring spontaneously. Such episodes of ischaemia/hypoxia are commonly associated with transient chest discomfort (angina pectoris). The aim of the management of CSA is to reduce symptoms and improve prognosis. The management of these patients encompasses lifestyle modification, control of coronary artery disease risk factors, evidence-based pharmacological therapy and patient education. All patients with stable angina should be offered optimal medical treatment, defined as one or two anti-anginal drugs as necessary, plus drugs for secondary prevention of cardiovascular disease. Regarding the role of revascularization, randomised trials provide compelling evidence that myocardial revascularisation by coronary artery bypass grafting or by percutaneous coronary intervention improves symptoms of angina relative to continued medical treatment.
Angina pectoris with normal coronary arteriograms is a common entity which has puzzled cardiologists almost since the advent of coronary arteriography. Despite major advances in the understanding of the pathophysiology of angina in recent years and a multitude of studies on the subject, the cause and mechanisms underlying the syndrome of angina with normal coronary arteries remain unknown. Indeed, results of investigations are controversial and speculation still prevails regarding the nature of the so called `Syndrome X'. Almost every important aspect of Syndrome X has been tackled in the book and the reader is exposed not only to the cardiologists' opinion, but also to the authoritative views of the gastroenterologists, gynaecologists and psychiatrists, extremely well represented in this monograph. The book deals with `cardiologists' Syndrome X' and not the metabolic entity termed `Syndrome X'. The possible connection between the two, however, is discussed. Angina with Normal Coronary Arteries: Syndrome X contributes to the understanding of Syndrome X and helps clinicians manage their Syndrome X-patients better and investigators to open new avenues for research.
This handbook provides a quick, portable, algorithm-based guide to diagnosis and management of common problems seen in adult patients. Written by experienced primary care practitioners, the book emphasizes efficient decision making necessary in the fast-paced realm of the medical office. It covers general considerations such as the physical examination, care of special populations, and pain management and palliative care. It also focuses on common symptoms and disorders by system, including endocrine, respiratory, cardiac, orthopedic, neurologic, genitourinary, and gynecologic. For each disorder, symptoms, red flags, algorithms for differential diagnosis, related symptoms and findings, laboratory workup, treatment guidelines, and clinical pearls are discussed. Handbook of Outpatient Medicine is a valuable resource for primary care physicians, residents, and medical students.
This book presents a thorough review of coronary angioscopy, ranging from instructions on its use to the latest advances. Starting with the structure and fundamental principles of angioscopy, it shows readers how to apply the image to comprehensive care of coronary-artery patients. Plentiful color photos and illustrations will enable readers to investigate and classify plaques and thrombi and to evaluate coronary stent- and drug-based therapies. The authors are leading researchers on angioscopy. This book offers the perfect guide not only for new clinicians but also for cardiologists who have already adopted this technique for medical examination and treatment. Angioscopy is a unique medical technique for visualizing the interior of blood vessels and helps physicians not only to diagnose the pathology but also to measure the effectiveness of Percutaneous coronary intervention (PCI) or antiarteriosclerotic drugs. Furthermore, the recently developed molecular angioscopy approach allows us to observe Low-density lipoprotein (LDL) oxide, collagen, and macrophages, and is rapidly growing in importance.
In this greatly enlarged and thoroughly updated edition of his much praised Cardiac Markers, Alan Wu and his contributors focus on the use of markers in the practice of cardiology and-for the first time-on the use of natriuretic peptides for congestive heart failure. Here, leading international authorities in clinical chemistry and laboratory medicine, cardiology, emergency medicine, and the in vitro diagnostics industry describe the state-of-the-art uses of cardiac markers when treating coronary artery disease, and discuss in detail how they may be optimally used in a clinical setting. Comprehensive and cutting-edge, Cardiac Markers, Second Edition offers physicians a complete guide to the use of cardiac markers in clinical practice and clinical laboratorians a close-up view of the new markers now becoming standard.
Nitroglycerin and other organic nitrates have been used for over a century in the treatment of angina pectoris. Millions of patients, throughout the world, have placed nitroglycerin tablets under the tongue and have experienced rapid and dramatic relief from the chest pain that frequently occurs as a manifestation of disease of the coronary arteries. The empirical observation of the safe use of nitrates for tile alleviation of the symptoms of angina have led to their widespread medical acceptance. The use of organic nitrates preceded any knowledge of their mechanism of action or their ultimate metabolic fate. Thus, more simply stated, although sub lingual nitrates helped the patients, little was known concerning what these drugs do to the body or what the body does to the drugs. A substantial number of investigators have focused on these questions especially during the last two decades. We now have considerably more insight into the pathways of degradation of organic nitrates and the relationship of the metabolic processes to the biological action of these agents. Similarly, considerable effort has been expended in understanding the mechanism of action of these agents directly on vascular smooth muscle and on cardiac work and performance. Finally, there is a more substantive understanding of the physiology of the coronary circulation as well as the" pathophysiologic manifestations of myocardial disease.
Clinical Lipidology, a companion to Braunwald's Heart Disease, is designed to guide you through the ever-changing therapeutic management of patients with high cholesterol levels. From basic science to pathogenesis of atherothrombotic disease, to risk assessment and the latest therapy options, this medical reference book offers unparalleled coverage and expert guidance on lipidology in a straightforward, accessible, and user-friendly style. Get authoritative guidance from some of the foremost experts in the field. Easily access key content with help from treatment algorithms. Access options and evidence-based solutions for every type of patient scenario, as well as the latest clinical guidelines and clinically relevant evidence on risk assessment, special patient populations, and therapy, including recently approved and experimental therapies. Remain at the forefront of the cardiology field with up-to-date chapters on treatment guidelines; diet, exercise, and weight loss; pharmacologic therapies such as statins, omega-3 fatty acids, and combination therapy; evolving targets of therapy such as PCSK9 inhibition, CETP inhibition, and inflammation Prepare for special patient populations such as children and adolescents; women and the elderly; transplant recipients; HIV patients; and those with chronic renal disease, familial hypercholesterolemia, other severe hypercholesterolemias, diabetes, or other metabolic syndromes. Take advantage of a format that follows that of the well-known and internationally recognized Braunwald's Heart Disease. Expert Consult eBook version included with purchase.
Encyclopedia of Pharmacy Practice and Clinical Pharmacy, Three Volume Set covers definitions, concepts, methods, theories and applications of clinical pharmacy and pharmacy practice. It highlights why and how this field has a significant impact on healthcare. The work brings baseline knowledge, along with the latest, most cutting-edge research. In addition, new treatments, algorithms, standard treatment guidelines, and pharmacotherapies regarding diseases and disorders are also covered. The book's main focus lies on the pharmacy practice side, covering pharmacy practice research, pharmacovigilance, pharmacoeconomics, social and administrative pharmacy, public health pharmacy, pharmaceutical systems research, the future of pharmacy, and new interventional models of pharmaceutical care. By providing concise expositions on a broad range of topics, this book is an excellent resource for those seeking information beyond their specific areas of expertise. This outstanding reference is essential for anyone involved in the study of pharmacy practice. Provides a ‘one-stop’ resource for access to information written by world-leading scholars in the field Meticulously organized, with articles split into three clear sections, it is the ideal resource for students, researchers and professionals to find relevant information Contains concise and accessible chapters that are ideal as an authoritative introduction for non-specialists and readers from the undergraduate level upwards Includes multimedia options, such as hyperlinked references and further readings, cross-references and videos
This book serves as a pocket-sized resource to aid with the diagnosis and management of cardiovascular disease in the inpatient setting. Containing up-to-date information from guidelines and clinical trials, this book is the only handbook-style reference on cardiac care designed specifically for the hospitalist. The first section of the book covers cardiac pathology with an emphasis on evidence-based and guideline-based approaches to patient care. Each chapter focuses on a specific cardiovascular disease state such as acute coronary syndrome, atrial fibrillation, pulmonary hypertension, and aortic disease. The second section examines the differential diagnoses and recommended workup for common cardiac chief complaints including chest pain, palpitations, syncope, and dyspnea. The third and final section discusses indications and interpretation of commonly used cardiac procedures and imaging modalities. This book provides a concise review over a broad range of cardiovascular disease states in an accessible handbook-style to aid with the care of these patients. The Handbook of Inpatient Cardiology is an essential resource for physician hospitalists caring for cardiac patients on the medical ward in addition to cardiology physicians and trainees, affiliate providers, and students.