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Access to the eBook is limited to the first individual who redeems the PIN, located on the inside cover of this book, at expertconsult.inkling.com and may not be transferred to another party by resale, lending, or other means. 2020_PC CARDIOLOGY SECRETS To Lydia, who inspires me to try to be a better husband, friend, and person. SIXTH EDITION CARDIOLOGY SECRETS GLENN N. LEVINE, MD, FACC, FAHA Professor of Medicine, Baylor College of Medicine Chief, Cardiology Section Michael E. DeBakey VA Medical Center Houston, Texas, USA Elsevier 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 CARDIOLOGY SECRETS, SIXTH EDITION ISBN: 978-0-323-82675-4 Copyright © 2023 by Elsevier, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notice Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Previous editions copyrighted 2018, 2014, 2010, 2001, and 1995 Library of Congress Control Number: 2021946008 Senior Content Strategist: Marybeth Thiel Content Development Specialist: Casey Potter Director, Content Development Manager: Ellen M. Wurm-Cutter Publishing Services Manager: Shereen Jameel Senior Project Manager: Karthikeyan Murthy Design Direction: Bridget Hoette Printed in India Last digit is the print number: 9 8 7 6 5 4 3 2 1 In memory of our most beloved Gabby, the best companion ever. “You think dogs will not be in heaven? I tell you, they will be there long before any of us”. –Robert Louis Stevenson CONTRIBUTORS Suhny Abbara, MD Neal Barshes, MD, MPH Chief, Cardiothoracic Imaging Associate Professor of Surgery Department of Radiology Michael E. DeBakey Department of Surgery Professor, Department of Radiology Baylor College of Medicine UT Southwestern Medical Center Houston, Texas, USA Dallas, Texas, USA Luc M. Beauchesne, MD, FRCPC, FACC Richa Agarwal, MD Cardiologist, Adult Congenital Heart Disease Program Associate Professor of Medicine University of Ottawa Heart Institute Division of Cardiology Ottawa, Ontario, Canada Duke University School of Medicine Jeffrey S. Berman, MD Durham, North Carolina, USA Cardiology Fellow Ali M. Agha, MD Department of Medicine, Division of Cardiology Department of Cardiology Baylor College of Medicine Baylor College of Medicine Houston, Texas, USA Houston, Texas, USA Sheilah Bernard, MD David Aguilar, MD, MSc Associate Professor of Medicine Professor of Medicine Section of Cardiology, Department of Medicine Division of Cardiovascular Medicine Boston Medical Center University of Kentucky College of Medicine Boston, Massachusetts, USA Lexington, Kentucky, USA Gilad Birnbaum, MD Rami Akhrass, MD Department of Medicine Regional Director Section of Cardiology Department of Thoracic and Cardiovascular Surgery Baylor College of Medicine Cleveland Clinic Houston, Texas, USA Cleveland, Ohio, USA Yochai Birnbaum, MD Mahmoud Al Rifai, MD, MPH Professor Cardiology Fellow Department of Medicine Department of Medicine-Cardiology Section of Cardiology Baylor College of Medicine Baylor College of Medicine Houston, Texas, USA Houston, Texas, USA Eric Awtry, MD Fernando Boccalandro, MD, FACC, FSCAI Associate Professor of Medicine Pro-Care/Odessa Heart Institute Section of Cardiology Director, Cardiovascular Laboratory Boston University School of Medicine; Medical Center Hospital Associate Chief for Clinical Affairs Department of Cardiology Section of Cardiology Associated Clinical Professor Boston Medical Center Texas Tech University Health Science Center Boston, Massachusetts, USA Department of Internal Medicine Faisal G. Bakaeen, MD Odessa, Texas Professor Michael Boone, DO Department of Thoracic and Cardiovascular Surgery Resident, Department of Family Medicine Cleveland Clinic Waco Family Health Center Cleveland, Ohio, USA Waco, Texas, USA Gary J. Balady, MD Stephen Boone, MD, FACEP Director, Non Invasive Cardiovascular Laboratories Assistant Professor Section of Cardiology Department of Emergency Medicine Boston Medical Center Assistant Professor Professor of Medicine Department of Internal Medicine Boston University School of Medicine Baylor College of Medicine Boston, Massachusetts, USA Houston, Texas, USA vi CONTRIBUTORS vii Sanket Borgaonkar, MD Kim A. Eagle, MD Chief Fellow, PGY-VII Albion Walter Hewlett Professor of Internal Medicine Department of Cardiology Department of Internal Medicine Baylor College of Medicine University of Michigan Houston, Texas, USA Ann Arbor, Michigan, USA Biykem Bozkurt Lothar Faber, MD, FESC, FACC Professor Professor Mary and Gordon Cain Chair and Professor of Home Office Medicine Schuerhornweg 36 Director, Winters Center for Heart Failure Bielefeld, Germany Research at Baylor College of Medicine Savitri Fedson, MA, MD Medical Care Line Executive Professor DeBakey VA Medical Center Center for Medical Ethics and Health Policy Houston, Texas, USA Baylor College of Medicine; Arzu Canan, MD Professor Assistant Professor Department of Medicine Department of Radiology, Cardiothoracic Imaging Michael E. DeBakey VA Medical Center UT Southwestern Medical Center Houston, Texas, USA Dallas, Texas, USA Matthew J. Feinstein, MD, MSc Assistant Professor of Medicine Kelly N. Casteel, MD Assistant Professor Division of Cardiology, Department of Medicine Department of Benign Hematology Northwestern University Feinberg School of Medicine MD Anderson Cancer Center Chicago, Illinois, USA Houston, Texas, USA G. Michael Felker, MD, MHS Professor of Medicine Tiffany Chen, MD Division of Cardiology Assistant Professor of Clinical Medicine Duke University School of Medicine Division of Cardiovascular Medicine Durham, North Carolina, USA Hospital of the University of Pennsylvania Philadelphia, Pennsylvania, USA James J. Fenton, MD Clinical Associate Professor Leslie T. Cooper Jr., MD Pulmonary Medicine Elizabeth C. Lane, Ph.D. and M. Nadine Zimmerman, National Jewish Health Ph.D. Professor of Internal Medicine Denver, Colorado, USA Chair, Cardiovascular Department Jacksonville, Florida, USA Michael E. Field, MD Professor of Medicine Edmond M. Cronin, MB BCh BAO Department of Medicine Associate Professor Medical University of South Carolina Department of Medicine Charleston, South Carolina, USA Temple University Philadelphia, Pennsylvania, USA Scott D. Flamm, MD, MBA Professor of Radiology George D. Dangas, MD, Department of Radiology Professor of Medicine and Surgery Cleveland Clinic Director, Cardiovascular Innovation Cleveland, Ohio, USA Mount Sinai Hospital Icahn School of Medicine at Mount Sinai Lee A. Fleisher, MD New York, USA Professor Department of Anesthesiology and Critical Care Amish S. Dave, MD, PhD, FACC Perelman School of Medicine at the University Assistant Professor of Medicine of Pennsylvania Department of Cardiology Philadelphia, Pennsylvania, USA Houston Methodist Hospital Laura Flink Houston, Texas, USA The permanente medical group Ali E. Denktas, MD California, USA Professor of Medicine Marat Fudim, MD Department of Cardiology Assistant Professor of Medicine Baylor College of Medicine Division of Cardiology Houston, Texas, USA Duke University School of Medicine Durham, North Carolina, USA viii CONTRIBUTORS Sanjay Ganapathi, MD, DM Brian D. Hoit, MD Professor Professor of Medicine and Physiology and Biophysics Department of Cardiology Department of Medicine Sree Chitra Tirunal Institute for Medical Sciences and Case Western Reserve University; Technology Director of Echocardiography Trivandrum, India University Hospitals Cleveland Medical Center Cleveland, Ohio, USA Kathryn A. Gayle, MD Fellow Geoffrey D. Huntley, MD Department of Cardiovascular Medicine Fellow Vanderbilt University Medical Center Department of Cardiovascular Medicine Nashville, Tennessee, USA Mayo Clinic Rochester, Minnesota, USA Marie Gerhard-Herman, MD Associate Professor Aliza Hussain, MD Department of Medicine Fellow Physician Mass General Brigham Department of Medicine, Section of Cardiology Boston, Massachusetts, USA Baylor College of Medicine Houston, Texas, USA Casey Graziani, MD Fellow Scott E. Janus, MD Departments of Pulmonary and Critical Care Medicine Physician Baylor College of Medicine Department of Cardiology Houston, Texas, USA University Hospitals of Cleveland Cleveland, Ohio, USA Cindy Grines, MD Chief Scientific Officer Xiaoming Jia, MD Cardiovascular Institute Fellow, Department of Medicine Northside Hospital Baylor College of Medicine Atlanta, Georgia, USA Houston, Texas, USA Aakriti Gupta, MD Hani Jneid, MD, FACC, FAHA, FSCAI Cardiologist Associate Professor of Medicine Department of Cardiology Department of Cardiology Columbia University Irving Medical Center Baylor College of Medicine New York, New York, USA Houston, Texas, USA Gabriel B. Habib Sr., MD, FACC, FCCP, FAHA Jose A. Joglar, MD Professor of Medicine Professor of Internal Medicine Department of Medicine Department of Internal Medicine Baylor College of Medicine UT Southwestern Medical Center Houston, Texas, USA Dallas, Texas, USA Thomas A. Kent, MD Ihab Hamzeh, MD Robert Welch Chair Professor Associate Professor of Medicine Center for Genomic and Precision Medicine Department of Medicine Institute of Biosciences and Technology Baylor College of Medicine Texas A&M Health Science Center-Houston Houston, Texas, USA Adjunct Professor Sivadasanpillai Harikrishnan, MD, DM, DNB Stanley H. Appel Department of Neurology Professor Houston Methodist Hospital Department of Cardiology Houston, Texas, USA Sree Chitra Tirunal Institute for Medical Sciences and Umair Khalid, MD, FACC Technology Assistant Professor of Medicine – Cardiology Trivandrum, India Baylor College of Medicine Gustavo A. Heresi, MD, MS Houston, Texas, USA Director, Pulmonary Vascular and CTEPH Program Sarah Kohnstamm, MD Department of Pulmonary and Critical Care Medicine Clinical Assistant Professor Cleveland Clinic Department of Cardiovascular Medicine Cleveland, Ohio, USA Michigan Medicine Tomoya T. Hinohara, MD Ann Arbor, Michigan, USA Fellow, Department of Cardiology Nitin Kondamudi, MD Houston Methodist Hospital House Staff Houston, Texas, USA Division of Cardiology, Department of Internal Medicine University of Texas Southwestern Medical Center Dallas, Texas, USA