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A Practical Approach to Cardiovascular Medicine To my mother, Masoumeh Toti, for her continuous support and love. and To my mentor, Irv Weissman, for being a true role model and a source of inspiration. [R.A.] To my wife Mabel, for bringing so much love and joy to my life. [M.P.] To my wonderful wife Gloria and to my beautiful daughters Catherine and Margaret. and To the memory of my loving parents Lillian and Samuel. [P.W.] A Practical Approach to Cardiovascular Medicine E DIT E D B Y Reza Ardehali MD PhD Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA Marco Perez MD Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA Paul Wang PhD Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA A John Wiley & Sons, Ltd., Publication This edition first published 2011 © 2011 by Blackwell Publishing Ltd Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing program has been merged with Wiley’s global Scientific, Technical and Medical business to form Wiley-Blackwell. Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988. 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, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by physicians for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. Library of Congress Cataloging-in-Publication Data A practical approach to cardiovascular medicine / edited by Reza Ardehali, Marco Perez, Paul Wang. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4051-8039-9 (pbk. : alk. paper) 1. Heart–Diseases–Handbooks, manuals, etc. 2. Cardiology–Handbooks, manuals, etc. I. Ardehali, Reza. II. Perez, Marco, M.D. III. Wang, Paul, Ph.D. [DNLM: 1. Cardiovascular Diseases–diagnosis. 2. Cardiovascular Diseases–therapy. 3. Cardiology–methods. WG 120] RC669.15.P727 2011 616.1'2–dc22 2010047389 A catalogue record for this book is available from the British Library. This book is published in the following electronic formats: ePDF 9781444393873; Wiley Online Library 9781444393897; ePub 9781444393880 Set in 9.5 on 12 pt Palatino by Toppan Best-set Premedia Limited 1 2011 Contents Contributors, viii List of Abbreviations, xi Foreword, xv Section I Preventive Cardiology Chapter 1 Prevention of Cardiovascular Disease, 3 Maulik Shah and Reza Ardehali Chapter 2 Dyslipidemia, 11 Karim Sallam and Reza Ardehali Chapter 3 Hypertension, 21 Christopher Woods and Richard Lafayette Section II Coronary Artery Disease Chapter 4 Stable Angina, 35 Joshua Lehrer and William F. Fearon Chapter 5 Unstable Angina and Non-ST Elevation Myocardial Infarction, 43 Joshua Lehrer and David P. Lee Chapter 6 ST-Elevation Myocardial Infarction, 53 Yen Tibayan v vi Contents Section III Heart Failure Chapter 7 Care of the Cardiomyopathic Patient, 69 Nicholas J. Leeper, Reza Ardehali, and Michael Fowler Chapter 8 Pulmonary Hypertension and Right Heart Failure, 81 Matthew T. Wheeler and Roham T. Zamanian Chapter 9 Heart Transplantation, 94 Jesus Almendral, Robert Maranda, and Sharon Hunt Section IV Valvular and Vascular Disease Chapter 10 Valvular Heart Disease, 119 Reza Ardehali and Ingela Schnittger Chapter 11 Diseases of the Aorta, 139 Michael Ho and David Liang Chapter 12 Peripheral Vascular Disease, 154 Andrew Wilson, Reza Ardehali, and John Cooke Section V Arrhythmias and Sudden Cardiac Death Chapter 13 Atrial Fibrillation and Flutter, 165 Marco Perez and Amin Al-Ahmad Chapter 14 Supraventricular Tachycardia, 177 Marco Perez and Paul Zei Chapter 15 Ventricular Tachycardia, 194 Jeffrey Hsing and Henry Hsia Chapter 16 Bradycardia, 204 Jeffrey Hsing and Paul Wang Chapter 17 Syncope, 212 Farheen Shirazi and Karen Friday Section VI Cardiovascular Disease in Special Populations Chapter 18 Congenital Heart Disease, 227 Patrick Yue Chapter 19 Cardiology Consultation and Management of Perioperative Complications, 239 Azar Mehdizadeh and Stanley G. Rockson Contents vii Chapter 20 Management of Pre- and Post-Cardiac Surgery Patients, 248 Mohammad Haghdoost and Ramin Beygui Section VII Specialized Testing and Therapeutics Chapter 21 Adult Advanced Cardiac Life Support, 263 Anurag Gupta and Amin Al-Ahmad Chapter 22 ECG Interpretation, 272 Marco Perez and Victor F. Froelicher Chapter 23 Transthoracic and Transesophageal Echocardiography, 283 Shahriar Heidary and Ingela Schnittger Chapter 24 Noninvasive Stress Testing, 293 Arvindh Kanagasundram and Victor F. Froelicher Chapter 25 Cardiac MRI and CT, 303 Chandra Katikireddy and Michael V. McConnell Chapter 26 Clinical Cardiac Hemodynamics, 326 Shirley Park and Euan Ashley Chapter 27 Percutaneous Interventions, 340 Aiden O’Loughlin and Alan Yeung Chapter 28 Pacemakers and ICD Troubleshooting, 360 Marco Perez and Paul Wang Chapter 29 Introduction to Electrophysiology Studies, 370 Ronald Lo and Henry Hsia Index, 381 Contributors Amin Al-Ahmad MD Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA William F. Fearon MD Jesus Almendral MD Michael Fowler MB FRCP Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA Reza Ardehali MD PhD Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA Karen Friday MD Euan Ashley MRCP DPhil Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA Victor F. Froelicher MD Ramin Beygui MD Anurag Gupta MD Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA John Cooke MD PhD Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA viii Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA Department of Internal Medicine Division of Cardiology Stanford University School of Medicine Stanford, CA, USA Mohammad Haghdoost MD Department of General Surgery Stanford University School of Medicine Stanford, CA, USA