Complications of Myocardial Infarction: Clinical Diagnostic Imaging Atlas with DVD (Cardiovascular Emergencies: Atlas and Multimedia)

295 Pages·2008·64.91 MB·English

by  Stuart J. Hutchison MD FRCPC FACC FAHA FASE FSCMR FSCCT

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COMPLICATIONS OF MYOCARDIAL INFARCTION: ISB3N: 978-1-4160-5272-2
CLINICAL DIAGNOSTIC IMAGING ATLAS
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Th e Publisher
Library of Congress Cataloging-in-Publication Data
Hutchison, Stuart J.
Complications of myocardial infarction : clinical diagnostic imaging atlas with DVD / Stuart J. Hutchison.—
1st ed.
p. ; cm.—(Cardiovascular emergencies : atlas and multimedia series)
Includes bibliographical references.
ISBN 978-1-4160-5272-2
1. Myocardial infarction—Complications—Atlases. 2. Cardiovascular system—Imaging—Atlases.
I. Title. II. Series.
[DNLM: 1. Myocardial Infarction—complications—Atlases. 2. Myocardial Infarction—diagnosis—
Atlases. 3. Diagnostic Techniques, Cardiovascular—Atlases. WG 17 H978c 2009]
RC685.I6H88 2009
616.1′2075—dc22 2008018561
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Project Manager: Rachel Miller
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Illustration Direction: Ceil Nuyianes
Multimedia Producer: Bruce Robison
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Last digit is the print number: 9 8 7 6 5 4 3 2 1
To Noel Keith and Cindy Hutchison, for the immeasurable gift s of love and time.
To Keith Radley Hutchison (1957–1997)
and Richard Ross Hutchison (1936–2005)—memor esto.
To my father, J. Lawrence Hutchison, surely one of the most natural physicians I have ever known. Gracious and studious,
open-minded and strictly honest, progressive and tenacious when someone needed him to be, he taught a great many by example. In
an era when medicine lost its way, he practiced it as it was always meant to be—a calling.

Foreword
I am very pleased and honored to introduce the book titled Com- book documents all the imaging modalities available today to
plications of Myocardial Infarction: Clinical Diagnostic Imaging illustrate all the aspects of the complications of acute myocardial
Atlas written by Dr. Stuart Hutchison. Dr. Hutchison is the sole infarction.
author of this outstanding book, which deals with the complica-
tions of acute myocardial infarction. This text-atlas describes not I have been involved in the studies of acute coronary syndromes
only the myriad potential complications of acute myocardial for over three decades and have never encountered a book as
infarction but also their pathophysiology, epidemiology, diagno- clinically useful as this one. Sincerest congratulations to Dr.
sis, and management. It also describes the process of remodeling, Hutchison on such an outstanding book.
diagnosis of the ischemic-infarcted myocardium, and the poten-
tial therapies for prevention of remodeling. Thus, although the Kanu Chatterjee, mb, frcp, facc, fccp, macp
focus of this work is on the application of the latest imaging Ernest Gallo Distinguished Professor of Medicine
modalities for timely and accurate diagnosis, it also provides Chatterjee Center for Cardiac Research
up-to-date information for various aspects of prevention and University of California, San Francisco
therapy of the complications of acute myocardial infarction. This San Francisco, California
vii

Preface
Th e principal responsibility and the purpose of coronary care is Some complications of infarction, such as most degrees of heart
to minimize the complications of myocardial infarction and failure, are managed solely within the realm of the CCU, but
thereby the loss of patients’ lives and their burden of symptoms. others require timely mobilization of the cardiac surgery, cardiac
Th e coronary care unit (CCU) is an endlessly challenging, inevi- anesthesia, and critical care services. Interservice cooperation and
tably purposeful, always humbling, and defi nitely satisfying venue coordination are oft en best exemplifi ed by the management of
for practicing medicine, for teaching from within, and for con- such emergent cases.
tinuing to learn both about the nature of disease and about the
relevance of medical technology and therapeutics. My sustained interest in the complicated cases of myocardial
infarction is based on their indisputable and dominant relevance
Patients don’t die of myocardial infarctions—they die of compli- to the dedication and professionalism of CCU physicians, nurses,
cations of infarction. Th e large majority of cases of myocardial and trainees. Th e highest-risk cases are simply the ones in which
infarction evolve well, without complication, and remain low-risk our impact, relevance, and contribution are the greatest. It is my
throughout. A minority of patients, though, develop complica- hope that by review of chapters that emphasize the relation of
tions and become at risk of death, thereby representing the most coronary anatomy to pathology and associated pathophysiology
signifi cant CCU cases—the ones faced with the highest risk, and and also the anatomic and physiologic basis of imaging, the reader
the ones wherein prompt recognition of complications and their will learn the background of and gain a handle on the reality of
adept management do save lives—the rationale, and raison d’être, these most important of CCU cases.
of the CCU. Th e complicated cases of infarction become the
focus, justifi cation, and purpose of CCU professionals. Although In this book and its companion DVD, I have tried to present a
the algorithmic management of coronary syndromes has hugely systematic and integrated approach to the complications of
advanced the management of patients with coronary syndromes, infarction and to off er a complementary case-based approach
the management of patients with complications of myocardial with each chapter. Th e chapters and cases in the book present still
infarctions remains individualized, discretionary, and both taxing images, and the DVD off ers the respective dynamic images; thus,
and validating of clinical skill and dedication, in success and it is a true companion to the book’s content.
defeat. Th e ablest of clinical teams relentlessly focus on anticipat-
ing complications of infarction. Stuart J. Hutchison, MD
ix