Cardiology in Family Practice (eBook)

Cardiology in Family Practice 3
Preface 5
Series Editor’s Introduction 7
References 7
Contents 9
Chapter 1: Stable Angina 13
Definition and Pathophysiology 13
Pathophysiology 13
Diagnosis 14
Signs and Symptoms 14
The Electrocardiogram 15
Differential Diagnosis 16
Stress Testing 16
Treatment 17
Aspirin 17
Antianginals: Nitrates 18
Antianginals: ß-Blockers 19
Antianginals: Calcium Channel Blockers 19
Antianginals: Ranolazine 20
Blood Pressure Control 20
Angiotensin-Converting Enzyme Inhibitors 20
Cholesterol Reduction 21
Cigarette Smoking 22
Diet 23
Diabetes 23
Exercise 24
Education 24
Revascularization 25
References 27
Chapter 2: Acute Coronary Syndromes 31
Definition 31
Pathophysiology 31
Diagnosis 32
Signs and Symptoms 32
The Electrocardiogram 33
Cardiac Biomarkers 34
ST Elevation Myocardial Infarction 35
Thrombolytic Therapy 35
Thrombolytic Agents 37
Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction 37
Coronary Stenting 38
Adjunctive Therapies in STEMI 39
Aspirin 39
Thienopyridines 39
Glycoprotein IIb/IIIa Receptor Antagonists 40
Anticoagulants 41
Nitrates 42
Beta Blockers 42
Lipid-Lowering Agents 43
Angiotensin-Converting Enzyme Inhibitors 43
Calcium Channel Blockers 44
Antiarrhythmic Therapy 44
Non-ST Elevation Myocardial Infarction 45
Antiplatelet Therapy 46
Anticoagulant Therapy 47
Direct Thrombin Inhibitors 48
Glycoprotein IIb/IIIa Antagonists 48
Interventional Management 48
Complications of Acute Myocardial Infarction 50
Postinfarction Ischemia 50
Ventricular Free Wall Rupture 51
Ventricular Septal Rupture 51
Acute Mitral Regurgitation 51
Right Ventricular Infarction 52
Cardiogenic Shock 53
Epidemiology and Pathophysiology 53
Initial Management 53
Reperfusion Therapy 55
References 57
Chapter 3: Arrhythmias 63
Introduction 63
Arrhythmia Diagnosis 63
Basic Principles 63
Classification of Arrhythmias 64
Rhythm Diagnosis 64
Atrial Fibrillation 65
Etiology and Pathophysiology 65
Clinical Features 67
Therapy 67
Supraventricular Tachycardia 73
Sinus Tachycardia 73
Focal (Ectopic) Atrial Tachycardia 74
Multifocal Atrial Tachycardia 75
AV Nodal Reentry Tachycardia 75
Atrioventricular Reciprocating Tachycardia 76
Wolff–Parkinson–White Syndrome 76
Therapy 79
Junctional Tachycardia 79
Ventricular Tachycardia 80
Torsade de Pointes 82
Long QT Syndrome 83
Arrhythmogenic Right Ventricular Dysplasia 84
Brugada Syndrome 85
Bradycardias 85
Sinus Node Dysfunction 85
Heart Block 86
References 89
Chapter 4: Hypertension 93
Etiology and Pathophysiology 93
Diagnosis 94
Therapy 95
Compelling Indications 97
References 99
Chapter 5: Congestive Heart Failure 103
Definition and Epidemiology 103
Pathophysiology 104
Diagnosis 106
Therapy 108
Treatment Goals 108
General Measures 108
Pharmacologic Therapy 109
Diuretics 109
Nitrates 110
Angiotensin-Converting Enzyme Inhibitors 111
Angiotensin Receptor Blockers 111
Aldosterone Antagonists 112
Beta Blockers 113
Hydralazine 114
Nesiritide 114
Digoxin 115
Inotropic Agents 115
Arrhythmias 116
Cardiac Resynchronization 117
Overview 118
Diastolic Heart Failure 119
Definition 119
Epidemiology 119
Etiology and Diagnosis 119
Management 120
References 121
Chapter 6: Valvular Diseases 124
Aortic Stenosis 124
Etiology and Pathophysiology 124
Clinical Features 125
Treatment 126
Aortic Regurgitation 127
Etiology and Pathophysiology 127
Clinical Features 128
Treatment 128
Mitral Stenosis 129
Etiology and Pathophysiology 129
Clinical Features 130
Therapy 131
Mitral Regurgitation 132
Etiology and Pathophysiology 132
Clinical Features 133
Therapy 134
Tricuspid Valve Disease 135
Etiology and Pathophysiology 135
Diagnosis and Treatment 136
References 136
Chapter 7: Pericardial Diseases 139
Acute Pericarditis 139
Etiology and Pathophysiology 139
Clinical Features 139
Therapy 140
Cardiac Tamponade 141
Etiology and Pathophysiology 141
Clinical Features 141
Therapy 142
Constrictive Pericarditis 143
Etiology and Pathophysiology 143
Therapy 144
References 144
Chapter 8: Prevention of Bacterial Endocarditis 146
References 148
Chapter 9: Hyperlipidemia 149
Screening 150
Risk Categories 151
Very High Risk 151
High Risk 151
Moderately High risk 151
Moderate Risk 151
Low Risk 153
Risk Factors 153
Metabolic Syndrome 154
Therapy 154
Lipid-Lowering Drugs 156
References 158
Index 160