Table Of Content

Tarascon Pocket Cardiologica Timothy Wm. Smith, DPhil, MD, FACC, FHRS Associate Professor of Medicine Director, Cardiac Electrophysiology Laboratory Washington University School of Medicine Saint Louis, Missouri Duane S. Pinto, MD, MPH, FACC, FSCAI Assistant Professor of Medicine, Harvard Medical School Associate Director, Interventional Cardiology Section Director, Cardiology Fellowship Training Program Beth Israel Deaconess Medical Center Boston, Massachusetts 15161_FMxx_Final.indd 1 02/12/11 11:47 AM World Headquarters Jones & Bartlett Learning 5 Wall Street Burlington, MA 01803 978-443-5000 [email protected] www.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com. 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Production Credits Executive Publisher: Christopher Davis Senior Acquisitions Editor: Nancy Anastasi Duffy Associate Editor: Laura Burns Production Assistant: Sarah Burke Marketing Manager: Rebecca Rockel Manufacturing and Inventory Control Supervisor: Amy Bacus Composition: Cenveo Cover Design: Kate Ternullo/Kristin Parker Cover Image: © Courtesy of National Library of Medicine Printing and Binding: Cenveo Cover Printing: Cenveo ISBN: 978-1-4496-1516-1 6048 Printed in the United States of America 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 15161_FMxx_Final.indd 2 02/12/11 11:47 AM Tarascon Pocket Cardiologica Contents Contributors ix Contraindications 32 Preparation 33 SeCtIoN I DIAgNoStICS AND Exercise 33 evALuAtIoN 2 ECG Interpretation 34 Evaluation of Functional 1 Introduction: Signs and Status and Prognosis 34 Symptoms of Cardiovascular Pharmacologic Stress Testing 35 InDtirsoedausceti on 33 Imaging 36 Goals of Evaluation and 6 Cardiac Imaging 37 Treatment 3 Introduction 37 Symptoms 4 Transthoracic Signs and Syndromes 5 Echocardiography (TTE) 37 Organization of this Book 6 Transesophageal echocardiography (TEE) 40 2 the Physical examination Cardiac Radionuclide Imaging 42 IAJHnuoretgtfare uotrrhldtia aeuSrl co HVPtueieunonalndsor seut sE xPaumlsiantaiotino n(J VP) 77778 CCaarrTImddoiimaaagcco igCMnrgoaa mpg(ChnpMyeu tt(RiCec)rT iRz) eesdo nance 4465 Heart Murmurs 9 7 Cardiac Catheterization 3 elIWRTRenheechteacrTta odorhEtdori oCndIucssgGica en t tt rghOhiWdo euetani h toEEv peCgleu eErsGtca?C ?t pr GWoh c yha ardt iAorger a m: 1111121115 TACIICnnaenoodtcngmnrihdoictponrd aAagliutiqinrcicnauoagtdnpeitioisshoicon ygan rtsia opnhsy 44454459902888 bRRAICE Yourself 18 8 the electrophysiology Study 53 Introduction 53 4 AmIHECnvbootelnrutnotelidtarn/u tuLMocoorotouiynops ine tME oCxrogitnne Mignt odo renidnit g o ring 33330000 RBTaeracc(hdFoyiyrgcdcuaaerrdredd Eii8aal-ess1c )t rograms 555556 Monitoring 31 9 Perioperative Cardiac Implantable Loop Recorder 31 evaluation 59 Goals of Evaluation 59 5 eCIInngdt rSeioctxdareeutrsicocstni iTossene fs oStrit nErgeC sGs testing 333222 FSuunrPgcritocicoaenl daRuli rsCekas fp o arc Nitoyn cardiac 6600 15161_FMxx_Final.indd 3 02/12/11 11:47 AM iv Contents 10 Preventive Cardiology 65 Tricuspid Regurgitation 137 GRMRIniieeisstnACfAFtkkioherans oorAFrolsmt am aSdsieD-lcpspss HrPJte eseuoNoyrslmcgflrpiCsii n nefiReMTm cVgrnchiiotse I pteeId Ikn n lrni Eetad fis sxpici pcvyara etaetsinsio:o sdn n s 6666655569 16 InIOPMTfnherrotegecrCMDIdsnarotiiaaeafidnafiouenpnuigescsutyicdnafmi tstne oitD iossgiseoouu ti nnMsEnask d nteofEaioo dsonnCcrotndd r ac sCi otarC ocedrlmardiiinrtiamdtii csiifsoat o nilrs l y 111111344434990123 Prophylactic Therapy 144 SeCtIoN II CArDIovASCuLAr Antibiotic Prophylactic SyNDroMeS 74 Regimens 145 11 I sIACCPcsarnlhhcaingrnehsodizmensn mmSiaiificcte ic ac tSHaa bHttlelai’eesoaba nrAlVre tanto DArfgDi niaAiisnsgnneeaitgnaa iAassnn eeag ina 877777555066 17 BrISAnaVintd r(I(CuymoBBsaodrrp nraauNurdddcolhutyysdiyccceoetaat n FhiDrro oddmynriism cciDfa uaDDissntii ossicorootndrrio)dde nrees rr ss ooff 111444666 12 Acute Coronary Syndromes 82 Impulse Propagation) 147 Introduction 82 Therapy 149 Signs and Symptoms 82 TPDRrhiiesayUakgs AtniSmc/otaNesrlaSnt EitTtci xEfi aTMcemasI titniionangt i foonr 88882234 18 taIMCcnlehtarTTcysoaahasdccairuhhfinrcyychitsaaayimrrottrrinhhhso nmyyott foihh af mm s iiaass 111155550001 13 Heart Failure 107 Supraventricular Acute Decompensated Tachycardias (SVTs) 151 Heart Failure 107 Ventricular Tachycardias Chronic Heart Failure and (VTs) 156 Cardiomyopathy 109 Reading the ECG in Advanced Therapeutic Tachycardia 157 Management of HF 114 Therapies for SVT 159 Therapies for VT/VF 159 14 CaInrtdrioodmucytoipona thy 111177 Antiarrhythmic Drugs 160 Ischemic Cardiomyopathy 117 19 Syncope 168 Dilated Cardiomyopathy 117 Definition and Incidence 168 Hypertrophic The Problem of Diagnosing Cardiomyopathy 119 Syncope 168 Restrictive Cardiomyopathy 120 Possible Causes of Syncope 168 Peripartum Cardiomyopathy Evaluation of Syncope 171 (PPCM) 121 Algorithm for Evaluating and Treating Syncope 174 15 valvular Heart Disease 123 Introduction 123 20 Sudden Cardiac Arrest 176 Aortic Stenosis (AS) 124 Introduction 176 Aortic Regurgitation (AR) or Epidemiology 176 Aortic Insufficiency (AI) 127 Mechanism and Substrate 176 Mitral Stenosis (MS) 130 Therapy 178 Mitral Regurgitation (MR) 132 Prevention 179 15161_FMxx_Final.indd 4 02/12/11 11:47 AM Contents v 21 Adult Congenital Heart Carotid Artery Stenting 226 Disease 181 Vertebrobasilar insufficiency 226 Introduction 181 AAVACCTTreettcoyarrtnyaaDCAiirnaaotnarruesrncvlotlif psoteeocStehaogirnutecciisitytlepotc iair Lsonst otirL ienca f (o(eDSs u lEnTFo sieelDnaGo faipfo odenlreAtlftn fohso caS)etsc ettlhec a ) DpeA trs todeG arfiralet ealc a t ts 111111118888888811355679 26 PuDPHPECDTlhalhhiiemeasetyfieHCctghsrosnoltyanoiantrirpcpp toosyaXaeiysh csor-lr tay in tyrFifiserac idocHin nyoEfai sydol vtPoipigioanguoernlgynlaur m s mata eotn inndoas nri oy n 222222222223222222788889077 Therapeutic Procedures 191 Single Ventricle Physiology SeCtIoN III CArDIovASCuLAr and the Fontan Surgery 194 tHerAPeutICS 232 Eisenmenger Syndrome 197 27 Coronary revascularization 233 Other Lesions 198 Introduction 233 Other Issues in ACHD 200 Percutaneous Coronary Intervention 233 22 PeAArnciuacttaeor mPdeyia roilc fD atirhsdeoi tPridse reircsa rdium 222000222 Recfoorm Rmeevnadsceudl aGruizidaetliionne s 235 Treatment 204 28 Pacemaker therapy 238 Cardiac Tamponade 205 Introduction 238 Constrictive Pericarditis 207 Indications for Permanent Pacemaker (PPM) 238 23 Peripheral Arterial Indications for Temporary LOPSaouetnwhrbARDidecpereir sltrhnr a eeLeEaveraerxilinasa satAaesllrn re lAD/tC mUAeriostrprimeeyttpry aeDmi easPrrioelsye E ne ar(Dix aPnpPtisAdshrAee DeeD mr)a asilte y 222220011191139 PCITnralotacePCPIusmerarbosrmopcmliogefiilagnamrsckaagnhaeotm ottirneoio mo BdntPni a iPnPan sogMangif ccd IoMMsme f m oop sdalatek n set resd 222244349012 24 A ortic Disease and Pacemakers 243 Mesenteric Ischemia 216 Transvenous Pacemaker Aortic Dissection 216 Implantation 244 Aortic Intramural Hematoma 219 Complications Penetrating Aortic Ulcer 219 Post-Implantation 245 Abdominal Aortic Aneurysm (AAA) 219 29 Cardiac resynchronization TMTrheeosaretamnctieecnr Aitc o rAtritce Arinael uDriyssemas e 222222122 DEffyofsHersc eHytanser caoth frFr tRao Finelsuay yrialneun crdhe rC oonnizgaetsiotniv e 222444777 25 Carotid Disease 223 Left Ventricular Pacing Introduction 223 Lead Implantation 249 Symptomatic Carotid AV Optimization 250 Disease 223 Indications for Cardiac Asymptomatic Carotid Resynchronization Therapy 250 Disease 224 Right Bundle Branch Block 251 Medical Therapy 225 Other Indicators of Carotid Revascularization 225 Dyssynchrony 251 15161_FMxx_Final.indd 5 02/12/11 11:47 AM vi Contents 30 Implantable Defibrillator Internal Jugular Vein therapy 253 Catheters 295 Introduction 253 Subclavian Vein Catheters 296 Clinical Trials of ICDs for Femoral Vein Catheters 297 Primary and Secondary Complications 298 Prevention of SCD Coding 299 and Indications 254 References 299 Implantation Techniques/ IIPCCeDDrLDTMi roeFIFaonpauTuntedn ebaTr crPegalrtesletiosaiotmgvhicnnaeoee g/tomniP toteei nnnr giatp /nr odc edure 222265567913 35 ArICETTtneeqoedccunABrihhicitrrpannrataamiieltcqq iriLnheuuoiiadnineenalit s elcff L oo aAiPrrntr lietRFaoe eancrmdisea iomal rlLae ilnn ote rs 333333000000000014 31 Management of Atrial Complications 304 Fibrillation and Flutter 264 Coding 305 Introduction 264 References 305 Therapy Modalities 264 Urgent/Immediate Treatment 36 right Heart Atroiaf lA FFl utter 226790 CPCrooancttehradeiutnrederi cifzoaart itRoioingnsh t 330069 32 Catheter Ablation Heart Catheterization 309 of Arrhythmias 272 References 311 Introduction 272 The Catheters 272 37 urgent temporary Pacing 312 Energy Sources 273 38 Cardioversion 314 Cryothermal Energy 273 Risks 314 Elective Cardioversion 314 00 references 274 Urgent Cardioversion 315 00 Further reading 283 39 Pericardiocentesis 316 Etiologies of Pericarditis SeCtIoN Iv SuPPLeMeNt: BeSIDe Associated with Large ProCeDureS 286 Pericardial Effusions 316 33 the Seldinger technique Indications 316 for vascular Access 287 Contraindications 316 Tips 290 Complications 316 Equipment 317 34 Central venous Technique 317 ICnCodanVCitcteehrannaetotiitnruoeadnsrli s CciV zafaeaotntrithoo iCeonutenssen ro tsfr a l 229922 LCRaeobfdPeoienrrreaginct ocareryds iAanl aFllyusidis of 333222111 Catheter Placement 292 40 I ntra-aortic Balloon Equipment 292 Pump Support 322 General Technique for Indications 322 Central Line Placement Contraindications 322 in All Locations 293 Operating the Intra-aortic Balloon Pump (IABP) 322 15161_FMxx_Final.indd 6 02/12/11 11:47 AM Contents vviiii SeCtIoN v SuPPLeMeNt: CArDIAC Index 333 eMergeNCIeS 324 Code Algorithms 381 41 Hypertensive emergencies 325 Basic Life Support for Diagnosis 325 Medical Professionals 381 Etiology 325 Advanced Cardiac References 326 Life Support 382 References 386 42 Shock 327 43 D iagnosing the Wide Complex tachycardia 330 References 332 15161_FMxx_Final.indd 7 02/12/11 11:47 AM 15161_FMxx_Final.indd 8 02/12/11 11:47 AM ■ ConTribuTors Suzanne v. Arnold, MD, MHA Andre Dejam, MD, PhD Fellow in Cardiovascular Medicine Clinical Fellow in Medicine Department of Medicine, Department of Medicine, Division Cardiovascular Division of Cardiology Washington University School Beth Israel Deaconess of Medicine Medical Center St. Louis, Missouri Boston, Massachusetts Nathalie Bello, MD Jennifer giuseffi, MD Clinical Fellow in Medicine Cardiology Fellow Department of Medicine, Department of Medicine, Division Division of Cardiology of Cardiology Beth Israel Deaconess Vanderbilt University Medical Center Nashville, TN Boston, Massachusetts Faizul Haque, MD Anjan Chakrabarti, MD Staff Cardiologist Clinical Fellow in Medicine John Muir Hospital Department of Medicine, Walnut Creek, CA Division of Cardiology Beth Israel Deaconess Susan Joseph, MD Medical Center Assistant Professor of Medicine Boston, Massachusetts Department of Medicine, Cardiovascular Division Daniel H. Cooper, MD Washington University School Assistant Professor of Medicine of Medicine Department of Medicine, Staff Cardiologist Cardiovascular Division Barnes-Jewish Hospital Washington University School St. Louis, Missouri of Medicine Staff Cardiac Electrophysiologist Andrew J. Krainik, MD Barnes-Jewish Hospital Staff Cardiologist St. Louis, Missouri Missouri Baptist Medical Center St. Louis, Missouri ix 15161_FMxx_Final.indd 9 02/12/11 11:47 AM