Interventional Cardiology: 900 Questions: An Interventional Cardiology Board Review PDF
Preview Interventional Cardiology: 900 Questions: An Interventional Cardiology Board Review
900 Questions: An Interventional Cardiology Board Review 900 Questions: An Interventional Cardiology Board Review EDITORS Debabrata Mukherjee, MD AssociateProfessorofMedicine Director,CardiacCatheterizationLaboratories GillFoundationProfessorofInterventionalCardiology GillHeartInstituteandDivisionofCardiovascularMedicine UniversityofKentucky Lexington,Kentucky Leslie Cho,MD Director,Women’sCardiovascularCenter MedicalDirector,PreventiveCardiologyandRehabilitation DepartmentofCardiovascularMedicine ClevelandClinicFoundation Cleveland,Ohio DavidJ. Moliterno, MD ProfessorandVice-ChairmanofMedicine Chief,CardiovascularMedicine JeffersonMorrisGillProfessorofCardiology GillHeartInstituteandDivisionofCardiovascularMedicine UniversityofKentucky Lexington,Kentucky DonnaA.Gilbreath ManagingEditor GillHeartInstituteandDivisionofCardiovascularMedicine UniversityofKentucky Lexington,Kentucky AcquisitionsEditor:FrancesR.DeStefano ManagingEditor:NicoleDernoski ProjectManager:JenniferHarper SeniorManufacturingManager:BenjaminRivera MarketingManager:AngelaPanetta ArtDirector:RisaClow ProductionServices:LaserwordsPrivateLimited,Chennai,India Printer:VictorGraphics,Inc. ©2007byLIPPINCOTTWILLIAMS&WILKINS,aWoltersKluwerbusiness 530WalnutStreet Philadelphia,PA19106USA LWW.com Allrightsreserved.Thisbookisprotectedbycopyright.Nopartofthisbookmaybe reproducedinanyformorbyanymeans,includingphotocopying,orutilizedbyany informationstorageandretrievalsystemwithoutwrittenpermissionfromthecopyright owner,exceptforbriefquotationsembodiedincriticalarticlesandreviews.Materials appearinginthisbookpreparedbyindividualsaspartoftheirofficialdutiesasU.S. governmentemployeesarenotcoveredbytheabove-mentionedcopyright. Weappreciatethatevenwiththebestofeffortsfromtheauthors,editors,and publishersthatsomeofthequestionsoranswersinthistextbookmayneedrefinement. So,too,whiletheobjectwastocarefullydesigneachquestionwithasinglebestanswer, somequestionsmaybemorecontroversialthanintendedormayhavemorethanone reasonableresponse.Withthesepointsinmindandwithourhopestocontinually improvethisbookwithfutureeditions,commentsregardingthisfirsteditionare welcomedandcanbesenttoDr.DebabrataMukherjee([email protected])orDr. DavidMoliterno([email protected]). PrintedintheUSA LibraryofCongressCataloging-in-PublicationData 900questions:aninterventionalcardiologyboardreview/editors, DebabrataMukherjee...[etal.]. p.;cm. ISBN-13:978-0-7817-7349-2 ISBN-10:0-7817-7349-0 1.Heart—Diseases—Treatment—Examinations,questions,etc.2.Cardiovascular system—Diseases—Treatment—Examinations,questions,etc.I.Mukherjee,Debabrata. II.Title:Ninehundredquestions. [DNLM:1.CardiovascularDiseases—ExaminationQuestions.2.Cardiovascular Diseases—therapy—ExaminationQuestions.WG18.2Z99912007] RC683.8.N5642007 616.1(cid:1)20076—dc22 2006027893 Carehasbeentakentoconfirmtheaccuracyoftheinformationpresentedandto describegenerallyacceptedpractices.However,theauthors,editors,andpublisherarenot responsibleforerrorsoromissionsorforanyconsequencesfromapplicationofthe informationinthisbookandmakenowarranty,expressedorimplied,withrespecttothe currency,completeness,oraccuracyofthecontentsofthepublication.Applicationofthis informationinaparticularsituationremainstheprofessionalresponsibilityofthe practitioner. Theauthors,editors,andpublisherhaveexertedeveryefforttoensurethatdrug selectionanddosagesetforthinthistextareinaccordancewithcurrentrecommendations andpracticeatthetimeofpublication.However,inviewofongoingresearch,changesin governmentregulations,andtheconstantflowofinformationrelatingtodrugtherapyand drugreactions,thereaderisurgedtocheckthepackageinsertforeachdrugforanychange inindicationsanddosageandforaddedwarningsandprecautions.Thisisparticularly importantwhentherecommendedagentisaneworinfrequentlyemployeddrug. SomedrugsandmedicaldevicespresentedinthispublicationhaveFoodandDrug Administration(FDA)clearanceforlimiteduseinrestrictedresearchsettings.Itisthe responsibilityofthehealthcareprovidertoascertaintheFDAstatusofeachdrugordevice plannedforuseintheirclinicalpractice. Topurchaseadditionalcopiesofthisbook,callourcustomerservicedepartmentat (800)638-3030orfaxordersto(301)223-2320.Internationalcustomersshouldcall (301)223-2300. VisitLippincottWilliams&WilkinsontheInternet:atLWW.com.Lippincott Williams&Wilkinscustomerservicerepresentativesareavailablefrom8:30amto6pm, EST. 10 9 8 7 6 5 4 3 2 1 ‘‘Tomyparents,fortheirinfinitepatience,love,andunderstanding,who continuetobemysourceofinspiration,andtomywonderfulwife, Suchandra,forherloveandsupport’’ DebabrataMukherjee ‘‘ToNathanielandBenjamin,mysonsandsuppliersoflife’simportant questions,andtoJudith,mywifeandpartnerinfindingtheanswers’’ DavidJ.Moliterno Preface Insightfulquestionshavebeenusedthroughtheagesasa themiscellaneousremainingareas coveredbytheboard metrictoassessone’sknowledge,butwhencoupledwith examination,includingperipheralvasculardisease,ethics, carefully delivered answers they can become a powerful statistics,andepidemiology,aswellasachapterdirected teaching tool. This book of questions and annotated atimprovingtest-takingskills. answers covering the field of interventional cardiology Also essential to the quality and appropriateness of is meant to serve as a helpful resource for individuals thequestionsandannotatedanswersistheexpertiseofthe preparingfortheinterventionalcardiovascularmedicine chapterauthors.Wearefortunatetohaveassembledthe board examination as well as for clinicians who wish to ‘‘who’swhoofacademicinterventionalcardiology’’.The performanin-depthself-assessmentonindividualtopics 59 contributing authors from leading medical centers or the full spectrum. The book has many key features, around the world have over 4,600 articles cited in whichwebelievewillmakethereadersuccessfulinpassing PubMed. We are greatly indebted to these authors who theboardsandimprovingclinicalpractice. arerecognizedbothfortheirinterventionalexpertiseand Offoremostimportance,theareascoveredarerele- fortheirteachingskills.Intheend,thetruevalueofthis vantnotonlytotheday-to-daypracticeofinterventional textbook is not only the relevance of the questions, the cardiology, but have also been patterned in scope and outstanding quality of the authors, butalso the value of contenttotheactualboardexamination.Thebookbegins the annotated answers. The text includes 910 questions withseveralchaptersdedicatedtotheanatomyandphys- and 254 figures and tables. The corresponding answers iology associated with interventional cardiology and the havebeenappropriatelydetailedtoproviderelevantfacts pathobiology of atherosclerosis and inflammation. This andinformationaswellasup-to-datejournalcitations. corresponds to the 15% of the board examination tar- Thepracticeofinterventionalcardiologyisexciting, getingmaterialinbasicscience.Thesubsequentchapters rewarding, and a privilege each of us enjoys. Likewise, focusontheessentialinterventionalpharmacotherapyof it has been our privilege to work with the superb antiplatelets, anticoagulants, and other commonly used contributors,ourcolleaguesininterventionalcardiology, medications in the catheterization laboratory and out- aswellastheeditorialteamattheUniversityofKentucky patient setting for patients with atherosclerosis. These and Lippincott Williams and Wilkins. It is our personal chapterscorrespondtothenext15%oftheboardscenter- hope that you will enjoy this book and that it will be a ing on pharmacology. A similar-sized 15% of the board valuableresourcetoyouinpassingtheboardexamination examination is directed toward imaging, and the book and providing the highest quality care possible to your includesspecificchaptersonradiationsafety,catheteriza- patients. tionlaboratoryequipmentandtechnique,contrastagents, andintravascularultrasound.Thetwolargestareasofthe DEBABRATAMUKHERJEE,MD examination, each covering25%of thecontent, include LESLIECHO,MD case selection–management and procedural techniques. DAVIDJ.MOLITERNO,MD Thereviewbookdedicates25chapterstocomprehensively covertheseareas. Finally,wehaveincludedchapters for vii Contributors RobertJ.Applegate,MD SorinJ.Brener,MD Director,CardiovascularTrainingProgram AssociateProfessorofMedicine WakeForestUniversitySchoolofMedicine DepartmentofMedicine Winston-Salem,NorthCarolina CaseWesternReserveUniversity; StaffPhysician DepartmentofCardiovascularMedicine JosephBabb,MD ClevelandClinicFoundation ProfessorofMedicine Cleveland,Ohio DepartmentofInternalMedicine,CardiologyDivision BrodySchoolofMedicine IvanP.Casserly,MD EastCarolinaUniversity; Director,CardiacCatheterizationLaboratories AssistantProfessorofMedicine PittCountyMemorialHospital CardiologyDivision Greenville,NorthCarolina UniversityofColorado; DirectorofInterventionalCardiology DenverVAMedicalCenter ThomasM.Bashore,MD Denver,Colorado ProfessorofMedicine DivisionofCardiovascularMedicine; LeslieCho,MD Director,FellowshipTrainingProgram Director,Women’sCardiovascularCenter andAdultCongenitalandValvularDiseaseProgram MedicalDirector,PreventiveCardiology DukeUniversityMedicalCenter andRehabilitation Durham,NorthCarolina DepartmentofCardiovascularMedicine ClevelandClinicFoundation MatthewC.Becker,MD Cleveland,Ohio FellowinCardiovascularDisease DepartmentofCardiovascularMedicine AntonioColombo,MD ClevelandClinicFoundation ChiefofInvasiveCardiology Cleveland,Ohio Universita` Vita-Salute andSanRaffaeleScientificInstitute andColumbusHospitals DeepakL.Bhatt,MD Milan,Italy AssociateProfessorofMedicine Staff,Cardiac,Peripheral,andCarotidIntervention DepartmentofCardiovascularMedicine HaroldL.Dauerman,MD ClevelandClinicFoundation ProfessorofMedicine Cleveland,Ohio UniversityofVermont; Director,CardiovascularCatheterizationLaboratories FletcherAllenHealthCare DavidC.Booth,MD Burlington,Vermont EndowedProfessorMedicine GillHeartInstituteand StevenR.Daugherty,PhD DivisionofCardiovascularMedicine UniversityofKentucky; AssistantProfessorofPsychology ChiefofCardiology AssistantProfessorofPreventiveMedicine LexingtonVAMedicalCenter RushMedicalCollege Lexington,Kentucky Chicago,Illinois ix x Contributors StephenG.Ellis,MD HussamHamdalla,MD ProfessorofMedicine AssistantProfessorofMedicine DepartmentofCardiovascularMedicine GillHeartInstituteand ClevelandClinicLernerCollegeofMedicine DivisionofCardiovascularMedicine CaseWesternReserveUniversity; UniversityofKentucky Director,CardiacCatheterizationLaboratories Lexington,Kentucky ClevelandClinicFoundation RobertA.Harrington,MD Cleveland,Ohio ProfessorofMedicine Director,CardiovascularClinicalTrials NezarFalluji,MD,MPH Co-Director,CardiovascularResearch ClinicalInstructor DukeClinicalResearchInstitute GillHeartInstitute DepartmentofMedicine,DivisionofCardiology DivisionofCardiovascularMedicine DukeUniversityMedicalCenter UniversityofKentucky Durham,NorthCarolina Lexington,Kentucky HowardC.Herrmann,MD ProfessorofMedicine DavidP.Faxon,MD CardiovascularDivision DirectorofStrategicPlanning UniversityofPennsylvaniaSchoolofMedicine; DepartmentofMedicine Director,InterventionalCardiologyandCardiac BrighamandWomen’sHospital; CatheterizationLaboratories ProfessorofMedicine HospitaloftheUniversityofPennsylvania DepartmentofMedicine Philadelphia,Pennsylvania HarvardMedicalSchool Boston,Massachusetts L.DavidHillis,MD ProfessorandViceChair JoelA.Garcia,MD DepartmentofInternalMedicine UniversityofTexasSouthwesternMedicalCenter InterventionalCardiologyandResearchFellow Dallas,Texas DepartmentofCardiology UniversityofColorado AliceK.Jacobs,MD Denver,Colorado ProfessorofMedicine DepartmentofMedicine,SectionofCardiology ThomasGehrig,MD BostonUniversitySchoolofMedicine; Director,CardiacCatheterizationLaboratories CardiologyFellow andInterventionalCardiology DivisionofCardiovascularMedicine BostonMedicalCenter DukeUniversityMedicalCenter Boston,Massachusetts Durham,NorthCarolina JohnLynnJefferies,MD,MPH BernardGersh,MB,ChB,DPhil AssistantProfessor ProfessorofMedicine AdultandPediatricCardiology CardiologyDiseases BaylorCollegeofMedicine MayoClinicCollegeofMedicine DivisionsofAdultCardiovascularDiseases Rochester,Minnesota andPediatricCardiology TexasChildren’sHospital TexasHeartInstituteatSt.Luke’sEpiscopalHospital JohnC.Gurley,MD,MBA Houston,Texas ProfessorofMedicine HaniJneid,MD Director,InterventionalCardiologyFellowship GillHeartInstitute DivisionofCardiology DivisionofCardiovascularMedicine MassachusettsGeneralHospital UniversityofKentucky andHarvardMedicalSchool Lexington,Kentucky Boston,Massachusetts
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