Chapter |
Summary
| |
Chapter 01: The Morphology of the Electrocardiogram
Antonio Bayés Luna, Hein Wellens, Marek Malik |
The 12-lead electrocardiogram (ECG) is the single most commonly performed investigation. Almost every hospitalized patient will undergo electrocardiography, and patients with known cardiovascular disease will do so many times. |
Chapter 02: Cardiac Ultrasound
Jos Roelandt, Raimund Erbel |
Cardiac ultrasound is a sophisticated imaging modality that has made unique contributions to our understanding of cardiac disease. It allows the cardiologist to observe the heart and to obtain an integrated non-invasive assessment of its structure, function and haemodynamics by simply manipulating a transducer without exposing the patient to any risk. |
|
Chapter 03: Cardiovascular Magnetic Resonance
Dudley J. Pennell, Frank E. Rademakers, Udo P. Sechtem
|
This chapter summarizes the contemporary clinical role of cardiovascular magnetic resonance (CMR) in clinical cardiology. A number of techniques are described which can be applied widely in the cardiovascular system, and these include assessment of morphology and dynamic function, blood flow, ventricular volumes and mass, myocardial interstitial abnormality, and the response to stress. |
|
Chapter 04: Cardiovascular Computerized Tomography
Pim J. Feyter, Stephan Achenbach
|
The high prevalence of coronary artery disease with its associated high morbidity and mortality rates provides a strong stimulus for the development of a non-invasive diagnostic modality to image the coronary arteries. |
|
Chapter 05: Nuclear Cardiology
Philipp A. Kaufmann, Paolo G. Camici, S. Richard Underwood
|
Non-invasive images of the myocardium that reflect myocardial perfusion can be obtained either by using conventional nuclear medicine radiopharmaceuticals and cameras or by positron emission tomography (PET). Myocardial perfusion scintigraphy (MPS) with thallium-201- and/or technetium-m99-labelled sestamibi and tetrofosmin, in combination with single photon emission computerized tomography (SPECT), is a robust and well validated technique for the identification of myocardial ischaemia and infarction with high sensitivity and specificity. |
|
Chapter 06: Invasive Imaging and Haemodynamics
Christian Seiler, Carlo Di Mario
|
Right- and left-sided cardiac pressure, oxygen and ventricular volume measurements together with coronary angiography are the basis for the functional and structural characterization of the majority of heart diseases. |
|
Chapter 07: Genetics of Cardiovascular Diseases
Silvia G. Priori, Carlo Napolitano, Stephen Humphries, Maria Cristina Digilio, Paul Kotwinski, Bruno Mario
|
Molecular genetics is progressively entering clinical practice and it is affecting patients' management. Most of our current knowledge derives from the application to molecular diagnosis of the findings of the pivotal studies that have unveiled the genes that cause the so-called monogenic diseases. |
|
Chapter 08: Clinical Pharmacology of Cardiovascular Drugs
Aroon Hingorani, Patrick Vallance, Raymond MacAllister
|
Rational use of drugs to treat cardiovascular disease requires an appreciation of the key principles of clinical pharmacology and specific knowledge about individual therapies. Amongst the medical disciplines, cardiovascular medicine has been in the vanguard of the development of an expanding evidence base upon which to base therapeutic decisions. |
|
Chapter 09: Prevention of Cardiovascular Disease: Risk Factor Detection and Modification
Joep Perk, Annika Rosengren, Jean Dallongeville
|
The prevention of cardiovascular disease (CVD) is of major importance because CVD is expected to remain the leading cause of premature death in Europe in the coming decades. The prevalence of symptomatic disease is still increasing. Can this be prevented in clinical practice? What is the role of the physician in preventive cardiology? |
|
Chapter 10: Hypertension
Sverre E. Kjeldsen, Henrik M. Reims, Robert Fagard, Giuseppe Mancia
|
Hypertension, usually defined as persistent blood pressure at 140/90 mmHg or higher, affects about a quarter of the adult population in many countries and particularly in Western societies. Hypertension is a risk factor for most, if not all, cardiovascular diseases and renal failure. |
|
Chapter 11: Diabetes Mellitus and Metabolic Syndrome
Francesco Cosentino, Lars Rydén, Pietro Francia
|
This chapter reviews an evidence-based approach to diagnosis and treatment of diabetes mellitus and metabolic syndrome according to the most recent scientific evidence, recommendations of the European Society of Cardiology, and world-wide institutional guidelines. |
|
Chapter 12: Acute Coronary Syndromes: Pathophysiology, Diagnosis and Risk Stratification
Christian W. Hamm, Christopher Heeschen, Erling Falk, Keith A.A. Fox
|
Acute coronary syndrome (ACS) is the clinical manifestation of the critical phase of coronary artery disease. Based on ECG and biochemical markers it is distinguished from ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina. |
|
Chapter 13: Management of Acute Coronary Syndromes
Eric Boersma, Frans de Werf, Felix Zijlstra
|
Optimal treatment of patients presenting with an acute coronary syndrome aims at immediate relief of ischaemia and the prevention of serious adverse events, including death, myocardial (re)infarction and life-threatening arrhythmias. |
|
Chapter 14: Chronic Ischaemic Heart Disease
Filippo Crea, Paolo G. Camici, Raffaele De Caterina, Gaetano A. Lanza
|
The coronary circulation serves the purpose of matching myocardial oxygen supply and consumption. A transient mismatch results in myocardial ischaemia, followed by left ventricular dysfunction and ECG changes, with or without angina. Four major clinical syndromes can be identified among patients presenting with chronic ischaemic heart disease. Stable angina is caused by critical epicardial coronary artery stenoses, responsible for stress-induced ischaemia. |
|
Chapter 15: Management of Angina Pectoris
Kim Fox, Henry Purcell, John Pepper, William Wijns
|
The aims of treatment of chronic stable angina are to minimize or abolish symptoms and also to improve prognosis by preventing myocardial infarction and death. Major advances have been made in antianginal treatment since organic nitrates were first used clinically over a century and a quarter ago. Current drugs may afford prophylaxis as well as relief of symptoms and several agents appear to modify the underlying atherosclerotic disease process and improve prognosis. |
|
Chapter 16: Myocardial Disease
Otto M. Hess, William McKenna, Heinz-Peter Schultheiss, Roger Hullin, Uwe Kühl, Mathias Pauschinger, Michel Noutsias, Srijita Sen-Chowdhry
|
Diseases of the myocardium can be divided into three different forms: primary myocardial disease (the cardiomyopathies), inflammatory myocardial disease (myocarditis) and secondary myocardial diseases. There is a large overlap between the three different forms. |
|
Chapter 17: Pericardial Disease
Bernhard Maisch, Jordi Soler-Soler, Liv Hatle, Arsen D. Ristic
|
The diagnosis of acute pericarditis is based on the clinical presentation (chest pain, pericardial friction rub) and typical ECG changes. Echocardiography is essential for the detection of pericardial effusion and for the determination of its physiological significance, signs of constriction, concomitant heart disease or paracardial pathology. A substantial proportion of patients classified as having 'idiopathic' pericarditis have disease that is the result of either viral or autoreactive pericarditis. |
|
Chapter 18: Tumours of the Heart
Mary N. Sheppard, Annalisa Angelini, Mohammed Raad, Irina Savelieva
|
Primary tumours of the heart are rare. Metastases are the most frequent tumours of the heart. Symptoms are very variable and can be the result of either local or systemic effects. Imaging with echocardiography and magnetic resonance plays an important role in diagnosis. Histology is important in determining tumour type with a role for endomyocardial biopsy in presurgical diagnosis. |
|
Chapter 19: Congenital Heart Disease in Children and Adults
John E. Deanfield, Robert Yates, Vibeke E. Hjortdal
|
This chapter describes the enormous progress that has been made in the diagnosis, investigation and management of patients with congenital cardiac malformations. Nomenclature, aetiology and incidence are considered as well as common presenting features. |
|
Chapter 20: Pregnancy and Heart Disease
Patrizia Presbitero, Giacomo G. Boccuzzi, Christianne J.M. Groot, Jolien W. Roos-Hesselink
|
Heart disease, though rare, can be present or discovered during pregnancy because of haemodynamic overload of the heart particulary during the third trimester when cardiac output doubles. |
|
Chapter 21: Valvular Heart Disease
Alec Vahanian, Bernard Iung, Luc Pierard, Robert Dion, John Pepper
|
Valvular heart disease (VHD), although not as common as coronary disease, heart failure or hypertension, is an important, and challenging, clinical entity. |
|
Chapter 22: Infective Endocarditis
Werner G. Daniel, Frank A. Flachskampf
|
This protean disease, whose salient features have been known for centuries, continues to pose major diagnostic and therapeutic challenges. Infective endocarditis predominantly affects cardiac valves and leads to local destruction with subsequent regurgitation. |
|
Chapter 23: Heart Failure: Epidemiology, Pathophysiology and Diagnosis (Part I)
John McMurray, Michel Komajda, Stefan Anker, Roy Gardner
|
The term 'heart failure' describes the common clinical syndrome arising when delivery of oxygen to the metabolizing tissues is impaired because of defective function of the heart as a pump (or, rarely, by extracardiac disorders). |
|
Chapter 24: Management of Chronic Heart Failure
Karl Swedberg, Bert Andersson, Christophe Leclercq, Marko Turina
|
Chronic heart failure (CHF) is common, disabling, dangerous and costly. However, during the last 10–15 years, management of CHF has improved dramatically, with evidence-based therapy being able to reduce both morbidity and mortality, improving symptoms as well as cost-effectiveness. |
|
Chapter 25: Pulmonary Hypertension
Nazzareno Galiè, Gerald Simonneau
|
Pulmonary hypertension (PH) is a pathophysiological condition characterized by an increase in pulmonary arterial pressure at rest or during exercise. Clinical conditions with PH are classified in five categories according to similar pathological, pathophysiological and therapeutic characteristics. |
|
Chapter 26: Cardiac Rehabilitation
Stephan Gielen, Dirk Brutsaert, Hugo Saner, Rainer Hambrecht
|
Cardiovascular diseases are widely regarded as the most relevant preventable cause of premature death. Prevention should be promoted in two different clinical situations: (1) in apparently healthy individuals to prevent the development of overt atherosclerosis and the related complications/ischaemic events and (2) in patients with documented cardiovascular disease to retard further disease progression. |
|
Chapter 27: Bradycardia
Lukas Kappenberger, Cecilia Linde, William D. Toff
|
Bradycardia can present considerable diagnostic and therapeutic challenges to the physician. Bradycardia per se is often a benign observation , but in the context of symptoms suggestive of low cardiac output, may need careful attention and diagnostic accuracy. |
|
Chapter 28: Supraventricular Tachycardia
Jerónimo Farré, Hein J.J. Wellens, José A. Cabrera, Carina Blomström-Lundqvist
|
Paroxysmal supraventricular tachycardia (SVT) is a common arrhythmia in the emergency room, the outpatients' clinic and the electrophysiology laboratory. While its natural history is often benign in terms of life expectancy, the quality of life of patients suffering paroxysmal SVT is frequently poor. Non-paroxysmal forms of SVT are less frequent. |
|
Chapter 29: Atrial Fibrillation: Epidemiology, Pathogenesis and Diagnosis
Harry J.G.M. Crijns, Maurits A. Allessie, Gregory Y.H. Lip
|
The most important threats patients with atrial fibrillation (AF) face are stroke and heart failure. Furthermore, quality of life is diminished due to AF symptoms as well as frequently associated cardiovascular diseases like hypertension, heart failure, coronary artery and valvular disease. |
|
Chapter 30: Atrial Fibrillation: Treatment
Etienne Aliot, Christian de Chillou, Pierre Jaïs, S. Bertil Olsson
|
The main goals of atrial fibrillation (AF) treatment are to reduce symptoms, prevent thromboembolism, and prevent morbidity and mortality. There are three fundamental approaches to the management of AF: rate control, rhythm control, and antithrombotic therapy. |
|
Chapter 31: Syncope
Michele Brignole, Jean-Jacques Blanc, Richard Sutton
|
This chapter summarizes the evidence base which supports accepted standards provided by the Guidelines for the Management (Diagnosis and Treatment) of Syncope of the European Society of Cardiology. |
|
Chapter 32: Ventricular Tachycardia
Lars Eckardt, Pedro Brugada, John Morgan, Günter Breithardt
|
Ventricular arrhythmias are the major cause of morbidity and mortality in patients with structural heart disease, but can also be a mechanism of sudden death in patients with structurally normal hearts (e.g. channelopathies such as long or short QT syndrome, Brugada syndrome). Infrequently, they can be generated by mechanisms that are amenable to curative catheter ablation. |
|
Chapter 33: Sudden Cardiac Death and Resuscitation
Stefan H. Hohnloser, Alessandro Capucci, Peter J. Schwartz
|
Sudden cardiac death (SCD) continues to be a leading cause of death in Western countries, most often caused by ventricular tachyarrhythmias, such as ventricular tachycardia or fibrillation, in the setting of structural heart disease. Risk stratification for SCD remains a major challenge despite the development of new non-invasive risk assessment methods, i.e. baroreflex testing, assessment of microvolt T-wave alternans. |
|
Chapter 34: Diseases of the Aorta and Trauma to the Aorta and the Heart
Christoph A. Nienaber, Axel Haverich, Raimund Erbel
|
Both chronic and acute diseases of the aorta, including trauma, are attracting increasing attention both in the light of an ageing Western population and with the advent of modern diagnostic modalities and therapeutic options to manage aortic pathology. |
|
Chapter 35: Peripheral Arterial Occlusive Disease
Giancarlo Biamino, Andrej Schmidt, Iris Baumgartner, Dierk Scheinert, Marco Roffi, Felix Mahler
|
The management of patients with peripheral arterial occlusive disease (PAD) has to be planned in the context of natural history, epidemiology of disease, and apparent risk factors predicting deterioration. The ankle-brachial index (ABI) to date has proved to be the most effective, accurate and practical method of PAD detection. |
|
Chapter 36: Venous Thromboembolism
Sebastian M. Schellong, Henri Bounameaux, Harry R. Büller
|
In this chapter, deep vein thrombosis and pulmonary embolism are discussed as manifestations of the same disease process. Despite the steadily growing use of medical thromboprophylaxis, pulmonary embolism remains the third most frequent cause of cardiovascular mortality. |