50 cases in clinical cardiology : a problem solving approach

253 Pages·2014·20.1 MB·English

by  Luthra

50 Cases in
Clinical Cardiology

50 Cases in
Clinical Cardiology
A Problem Solving Approach
Atul Luthra MBBS MD DNB
Diplomate
National Board of Medicine
Physician and Cardiologist
New Delhi, India
www.atulluthra.in
[email protected]
Foreword
JPS Sawhney
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50 Cases in Clinical Cardiology: A Problem Solving Approach
First Edition: 2014
ISBN 978-93-5152-110-5
Printed at
Dedicated to
My Parents
Ms Prem Lata Luthra
and
Mr Prem Prakash Luthra
Who guide and bless me
from heaven

Foreword
With the widespread availability of sophisticated cutting-edge technology, the
clinician’s approach towards the diagnosis of heart disease has undergone a
paradigm shift. These days, it is not uncommon for the patient to be wheeled into
the ECHO-room or even the cath-lab, without anyone taking a medical history
or even caring to place a stethoscope over the patient’s precordium. This is not a
good sign since history-taking along with clinical examination should continue
to occupy their rightful place in the practice of bedside cardiology. Moreover, a
wealth of information is available in simple diagnostic modalities such as the
ECG and X-ray chest, which should be interpreted in the light of clinical data.
I must compliment Atul Luthra for this brilliant compilation of a wide variety
of real-world clinical situations, encountered during the practice of cardiology.
He has elegantly discussed each case and solved the clinical problem in a
meticulous way. The section on discussion incorporates a bewildering array of
high-quality ECG strips, X-ray films and ECHO images. Students preparing for
their examinations, resident doctors working in cardiac units and clinicians
involved in heart-care are bound to benefit from this book. I wish Atul and his
excellent book, all the best.
JPS Sawhney
Chief of Clinical Cardiology
Chairman, Department of Cardiology
Sir Ganga Ram Hospital, New Delhi, India
www.preventivecardiology.in

Preface
Present-day cardiology is replete with a bewildering array of sophisticated
investigative techniques, that have eclipsed the art of arriving at a diagnosis
on the bedside of the patient. Yet, a relevant medical history and a meticulous
physical examination are indispensable tools to mentally construct a plausible
clinical diagnosis. Further, simple but informative investigations such as
electrocardiography (ECG), chest radiography (X-ray) and echocardiography
(ECHO), have withstood the test of time in clinical cardiology. Moreover, they are
cost-effective in resource-sensitive settings and can be performed at the patient’s
bedside.
It gives me immense pleasure to proudly present 50 Cases in Clinical
Cardiology: A Problem Solving Approach, a compilation of real-world situations
in clinical cardiology. Each case is introduced with a brief history and findings
on physical examination. The clinical problem is then discussed analytically
and ultimately solved with the aid of one or more simple bedside investigations.
The case concludes with pertinent management issues along with some recent
advances in diagnostics and therapeutics pertaining to that clinical entity. The
text is suitably complemented by impressive illustrations of ECG strips, chest
X-rays and ECHO images.
I have tried to incorporate most clinical situations encountered in heart clinics
and cardiology ward-rounds, but there might be some omissions. Nevertheless,
I sincerely hope that the wealth of clinical material on cardiac symptoms, physical
signs and auscultatory findings, will rekindle the romance between the clinician
and clinical cardiology. This book should be most useful for cardiology students
preparing for examinations, resident doctors working in cardiac units as well as
for physicians involved in the care of heart patients.
Atul Luthra