Practical Cardiology: Evaluation and Treatment of Common Cardiovascular Disorders

462 Pages·2020·16.911 MB·English

by  Ragavendra R. Baliga, Kim A. Eagle

Ragavendra R. Baliga
Kim A. Eagle
Editors
Practical Cardiology
Evaluation and Treatment of
Common Cardiovascular Disorders
Third Edition
123
Practical Cardiology
Ragavendra R. Baliga • Kim A. Eagle
Editors
Practical Cardiology
Evaluation and Treatment of Common
Cardiovascular Disorders
Third Edition
Editors
Ragavendra R. Baliga Kim A. Eagle
Division of Cardiovascular Medicine University of Michigan Health System
The Ohio State University Wexner Cardiovascular Center
Medical Center Ann Arbor, MI
Columbus, OH USA
USA
ISBN 978-3-030-28326-1 ISBN 978-3-030-28328-5 (eBook)
https://doi.org/10.1007/978-3-030-28328-5
© Springer Nature Switzerland AG 2020
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is
concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction
on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not
imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and
regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed
to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty,
express or implied, with respect to the material contained herein or for any errors or omissions that may have been
made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Contents
1 Chest Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Sharon Roble
2 Dyspnea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Fernando J. Martinez, Mei Lan K. Han, and Keith D. Aaronson
3 Palpitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Ruchika D. Husa
4 Edema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Mashhood A. Kakroo, Peter V. Vaitkevicius, and Ragavendra R. Baliga
5 Syncope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Ragavendra R. Baliga, Michael Lehmann, and Ruchika D. Husa
6 Primary Prevention of Coronary Artery Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Kavita Sharma, Melvyn Rubenfire, and Eric R. Bates
7 Secondary Prevention of Coronary Artery Disease . . . . . . . . . . . . . . . . . . . . . . . . . 75
Kavita Sharma, Claire Duvernoy, and Melvyn Rubenfire
8 Stable Angina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Sharon Roble
9 Unstable Angina/Non-ST Elevation Myocardial Infarction . . . . . . . . . . . . . . . . . . 99
Jason Evanchan
10 Acute ST Elevation Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111
Satya Shreenivas and Scott Lilly
11 Primary Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125
Kenneth A. Jamerson
12 Approach to Secondary Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135
J. Brian Byrd, John D. Bisognano, and Robert D. Brook
13 Heart Failure due to Left Ventricular Systolic Dysfunction . . . . . . . . . . . . . . . . . .149
Brent C. Lampert, David B. S. Dyke, and Todd M. Koelling
14 Paroxysmal Supraventricular Tachycardia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177
Hakan Oral and Fred Morady
15 Atrial Fibrillation and Atrial Flutter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185
Toshimasa Okabe, Aman Chugh, Frank Pelosi Jr, and Fred Morady
16 Ventricular Tachycardia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .197
Frank Bogun and Fred Morady
17 Bradycardia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .213
Eric D. Good and Krit Jongnarangsin
v
vi Contents
18 Infective Endocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .225
Ragavendra R. Baliga and Sunil K. Das
19 Mitral Regurgitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .245
Jim X. Liu and Viren Patel
20 Aortic Regurgitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .255
Viren Patel and Jim X. Liu
21 Mitral Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .263
Vincent E. Brinkman
22 Aortic Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .271
Anna M. Booher, Michael J. Shea, and G. Michael Deeb
23 Tricuspid/Pulmonary Valve Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .281
Vincent E. Brinkman
24 Acute Pericarditis/Pericardial Effusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .289
Elina Yamada, Mani A. Vannan, and Mauro Moscucci
25 Pericardial Constriction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .297
Elina Yamada, Julie A. Kovach, and Richard L. Prager
26 Abdominal Aortic Aneurysms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .303
Venkataramu Krishnamurthy, David M. Williams, James C. Stanley,
Gilbert R. Upchurch Jr, and John E. Rectenwald
27 Acute Aortic Dissection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .323
Anna M. Booher, David M. Williams, Kim Allen Eagle, and G. Michael Deeb
28 Lower Extremity Ischemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .331
Katherine A. Gallagher, John E. Rectenwald, James B. Froehlich,
and Peter K. Henke
29 Pulmonary Embolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .349
John G. Weg, Melvyn Rubenfire, and Gbemiga Sofowora
30 Pulmonary Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .365
Veronica Franco
31 Simple Congenital Cardiac Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .379
Timothy B. Cotts and Albert P. Rocchini
32 Complex Congenital Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .395
Timothy B. Cotts
33 Perioperative Evaluation and Management of Patients Undergoing
Noncardiac Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .411
Ajay Vallakati, Ragavendra R. Baliga, and Kim Allen Eagle
34 Complementary and Alternative Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .429
Cynthia Thaik, Mauro Moscucci, Sara L. Warber, and Keith D. Aaronson
35 Cardio-Oncology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .447
Elina Yamada
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .453
Contributors
Keith D. Aaronson, MD, MS Division of Cardiovascular Medicine, University of Michigan
Medical School, Cardiac Transplant Service, Ann Arbor, MI, USA
Ragavendra R. Baliga, MD, MBA, FACP, FRCP, FACC Department of Internal Medicine,
The Ohio State University Wexner Medical Center, Columbus, OH, USA
Eric R. Bates, MD Division of Cardiovascular Diseases, Department of Internal Medicine,
University of Michigan Cardiovascular Center, Ann Arbor, MI, USA
John D. Bisognano, MD, PhD Division of Cardiology, Department of Medicine, University
of Rochester Medical Center, Rochester, NY, USA
Frank Bogun, MD Division of Cardiovascular Medicine, Michigan Medicine, University of
Michigan, Ann Arbor, MI, USA
Anna M. Booher, MD Traverse Heart and Vascular, Traverse City, MI, USA
Vincent E. Brinkman, MD The Ohio State University Wexner Medical Center, Columbus,
OH, USA
Heart and Vascular Center at Memorial Health, Marysville, OH, USA
Robert D. Brook, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
J. Brian Byrd, MD Michigan Medicine Cardiology Clinic/Cardiovascular Center, University
of Michigan Medical School, Ann Arbor, MI, USA
Aman Chugh, MD Division of Cardiology, Department of Internal Medicine, University of
Michigan, Ann Arbor, MI, USA
Timothy B. Cotts, MD Division of Pediatric Cardiology, Department of Pediatrics, University
of Michigan, Ann Arbor, MI, USA
Sunil K. Das, MD University of Michigan Health System, Ann Arbor, MI, USA
G. Michael Deeb, MD Department of Surgery, Michigan Medicine, University of Michigan,
Ann Arbor, MI, USA
Claire Duvernoy, MD VA Ann Arbor Healthcare System, University of Michigan, Ann Arbor,
MI, USA
David B. S. Dyke, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Kim Allen Eagle, MD Department of Internal Medicine/Cardiovascular Disease, Michigan
Medicine, Albion Walter Hewlett Professor of Internal Medicine, Samuel and Jean Frankel
Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA
Jason Evanchan, DO Division of Cardiovascular Medicine, The Ohio State University
Wexner Medical Center/Heart and Vascular Center, Columbus, OH, USA
vii
viii Contributors
Veronica Franco, MD Division of Cardiovascular Diseases, Co-Director Pulmonary Vascular
Disease Program, Section of Advanced Heart Failure and Transplantation, The Ohio State
University Wexner Medical Center, Columbus, OH, USA
James B. Froehlich, MD, MPH University of Michigan Medical School, Ann Arbor, MI,
USA
Katherine A. Gallagher, MD Michigan Medicine, University of Michigan, Ann Arbor, MI,
USA
Eric D. Good, DO Genesys Regional Medical Center, Ann Arbor, MI, USA
Mei Lan K. Han, MD Division of Pulmonary and Critical Care, University of Michigan, Ann
Arbor, MI, USA
Peter K. Henke, MD Section of Vascular Surgery, Department of Surgery, University of
Michigan, Ann Arbor, MI, USA
Cardiovascular Center, Ann Arbor, MI, USA
Ruchika D. Husa, MD, MS Heart and Vascular Institute, Denver, CO, USA
Kenneth A. Jamerson, MD Michigan Medicine Hypertension Clinic/Cardiovascular Center,
University of Michigan, Ann Arbor, MI, USA
Krit  Jongnarangsin, MD Cardiovascular Center, Michigan Medicine, University of
Michigan, Ann Arbor, MI, USA
Mashhood A. Kakroo, MD Department of Internal Medicine, University of Cincinnati
Medical Center, Cincinnati, OH, USA
Todd M. Koelling, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Julie A. Kovach, MD Department of Cardiovascular Medicine, University of Toledo Medical
Center, Toledo, OH, USA
Venkataramu  Krishnamurthy, MBBS Department of Radiology, Michigan Medicine,
University of Michigan, Ann Arbor, MI, USA
Brent C. Lampert, DO, FACC Division of Cardiovascular Medicine, The Ohio State
UniversityWexner Medical Center, Columbus, OH, USA
Michael Lehmann, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Scott Lilly, MD, PhD Division of Cardiology, Department of Medicine, The Ohio State
University Wexner Medical Center, Columbus, OH, USA
Jim X. Liu, MD Division of Cardiovascular Medicine, Department of Internal Medicine, The
Ohio State University Wexner Medical Center, Columbus, OH, USA
Fernando J. Martinez, MD, MS Division of Pulmonary and Critical Care Medicine, Weill
Department of Medicine, New York-Presbyterian Hospital, Weill Cornell Medical Center,
New York, NY, USA
Fred Morady, MD Division of Cardiology, Department of Internal Medicine, University of
Michigan, Ann Arbor, MI, USA
Mauro Moscucci, MD Department of Medicine, Sinai Hospital of Baltimore, Baltimore,
MD, USA
Toshimasa  Okabe, MD Division of Cardiovascular Medicine, Department of Internal
Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
Hakan Oral, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Contributors ix
Viren Patel, MD Division of Cardiovascular Medicine, Department of Internal Medicine,
The Ohio State University Wexner Medical Center, Columbus, OH, USA
Frank Pelosi Jr, MD Division of Cardiology, Department of Internal Medicine, University of
Michigan, Ann Arbor, MI, USA
Richard L. Prager, MD Department of Cardiac Surgery, University of Michigan, Ann Arbor,
MI, USA
John E. Rectenwald, MD Division of Vascular Surgery, Department of Surgery, University
of Wisconsin, Madison, WI, USA
Sharon Roble, MD OhioHealth Heart and Vascular Physicians, Mansfield, OH, USA
Albert  P.  Rocchini, MD Division of Pediatric Cardiology, Department of Pediatrics,
C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA
Melvyn Rubenfire, MD University of Michigan Hospitals-Michigan Medicine, Ann Arbor,
MI, USA
Kavita Sharma, MD OhioHealth Heart and Vascular Physicians, Delaware, OH, USA
Michael J. Shea, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
Satya Shreenivas, MD The Christ Hospital Heart and Vascular Center, Cincinnati, OH, USA
Gbemiga  Sofowora, MBCHB Division of Cardiovascular Diseases, The Ohio State
University Wexner Medical Center, Columbus, OH, USA
Stoneridge Medical Services, Dublin, OH, USA
James C. Stanley, MD Cardiovascular Center, Michigan Medicine, University of Michigan,
Ann Arbor, MI, USA
Cynthia Thaik, MD Holistic Healing Heart Center, Burbank, CA, USA
Gilbert R. Upchurch Jr, MD Department of Surgery, University of Florida College of
Medicine, Gainesville, FL, USA
Peter V. Vaitkevicius, MD Oakwood Medical Center, Internal Medicine/Cardiovascular
Disease, Dearborn, MI, USA
Ajay Vallakati, MD Division of Cardiovascular Diseases, Department of Internal Medicine,
The Ohio State University Wexner Medical Center, Columbus, OH, USA
Mani A. Vannan, MBBS, FACC Piedmont Heart Institute, Atlanta, GA, USA
Sara L. Warber, MD Department of Family Medicine, University of Michigan Medical
School, Ann Arbor, MI, USA
John G. Weg, MD Department of Internal Medicine, University of Michigan Health Center,
Ann Arbor, MI, USA
David M. Williams, MD Department of Radiology, Michigan Medicine, University of
Michigan, Ann Arbor, MI, USA
Elina Yamada, MD Michigan Medicine Cardiovascular Center, University of Michigan, Ann
Arbor, MI, USA
Chest Pain 1
Sharon Roble
Definition and Scope of Problem cardiogenic shock to relatively “low-risk” unstable angina.
The common pathophysiologic process involves myocardial
Chest pain can be broadly defined as any discomfort in the oxygen supply-demand mismatch. This can be due to rupture
anterior thorax occurring above the epigastrium and below of an atherosclerotic plaque in an epicardial coronary artery
the mandible. However, pain of cardiac origin may be felt with resultant platelet aggregation, activation of the coagula-
primarily in the arms or jaw regions. Of the 110 million tion cascade, and thrombus formation or progressive narrow-
patients who presented to U.S. hospital emergency depart- ing and obstruction to coronary blood flow. Thus, treatment
ments in 2004 over six million were for the evaluation of and management strategies are similar.
chest pain syndromes [1].
History
Principal Causes
The history is the most important component of the evalua-
The principal causes of chest pain can be grouped as life- tion of chest pain. The history can be documented expedi-
threatening and non–life-threatening (Table 1.1). The principal tiously for most patients and will guide further diagnostic
life-threatening causes of chest pain include: acute coronary testing. In addition to detailed questioning about the nature
syndromes, aortic dissection, pulmonary embolism, and esoph- of the chest pain, the physician should elicit a history of prior
ageal perforation. The principal non–life-threatening causes myocardial infarction, coronary revascularization [coronary
are stable angina, pericarditis, gastrointestinal reflux disease artery bypass graft (CABG) or percutaneous transluminal
(GERD), esophageal spasm, musculoskeletal disorders, valvu- coronary angioplasty (PTCA)], and congestive heart failure
lar heart disease, and hypertrophic cardiomyopathy. When the (CHF) symptoms. All patients should be queried about the
patient with chest pain arrives in a medical facility, it is the major cardiovascular risk factors [diabetes, smoking, hyper-
responsibility of the medical personel to assess the risk and to cholesterolemia, family history of premature coronary artery
embark on an apprpriate treatment program. disease (CAD), and hypertension] and for a history or symp-
Acute coronary syndromes comprise a broad range of clin- toms of peripheral vascular disease. Illicit drugs such as
ical manifestations from acute myocardial infarction with cocaine may cause chest pain and myocardial infarction
more commonly in the younger population. All patients
should be asked about the associated symptoms of dyspnea,
Table 1.1 Principal causes of chest pain
diaphoresis, and nausea, as well as the response to nitroglyc-
Life-threatening Non–life-threatening
erin although esophageal pathology may also respond to
Acute coronary syndromes Stable angina
nitroglycerin (i.e., esophageal spasm).
Pericarditis
The interviewer should elicit the location, onset, duration,
Aortic dissection GERD/esophageal spasm
Pulmonary embolism Musculoskeletal character, intensity, and radiation of the chest pain. When
Esophageal rupture Valvular heart disease questioning the patient, the interviewer should use the term
Hypertrophic cardiomyopathy chest “discomfort” rather than chest “pain,” because many
GERD gastroesophageal reflux disease patients deny having “pain.” In fact, many patients emphati-
cally point out to the interviewer that the discomfort is not a
S. Roble (*) “pain.” For the purposes of discussion, this chapter retains
OhioHealth Heart and Vascular Physicians, Mansfield, OH, USA the traditional term chest “pain.”
e-mail: [email protected]
© Springer Nature Switzerland AG 2020 1
R. R. Baliga, K. A. Eagle (eds.), Practical Cardiology, https://doi.org/10.1007/978-3-030-28328-5_1