Additional Information
Book Details
Abstract
This revised edition with additional topics, video tagging and audio tagging,
will be helpful for fi nal-year undergraduate medical students and postgraduate students of
General Medicine, Pediatrics, and Cardiology, not only for a better understanding and comprehension
of Clinical Cardiology, but also for a better preparation for their University and
DNB examinations.
This second edition has been thoroughly revised and updated with additional illustrations,
tables, fl owcharts, and video tagging to make it more lucid and understandable, for
the undergraduate medical students, besides postgraduates, and also for practicing clinical
physicians and cardiologists.
This revised edition with additional topics, video tagging and audio tagging ,
will be helpful for fi nal-year undergraduate medical students and postgraduate students of
General Medicine, Pediatrics, and Cardiology, not only for a better understanding and comprehension
of Clinical Cardiology, but also for a better preparation for their University and
DNB examinations.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Cover | Cover | ||
| Title page | iii | ||
| Copyright page | iv | ||
| Dedication | v | ||
| Preface to the Second Revised Edition | vii | ||
| Preface to Revised Reprint | ix | ||
| Preface to the Earlier Edition | xi | ||
| Contents | xiii | ||
| Abbreviations | xv | ||
| Portraits | xix | ||
| Part I - Basic Cardiac Anatomy and Physiology | 1 | ||
| Chapter 1 - Anatomy of the Heart | 3 | ||
| 1.1 - External Features of the Heart | 3 | ||
| 1.2 - The Chambers of the Heart | 5 | ||
| 1.3 - The Fibrous Skeleton of the Heart | 12 | ||
| 1.4 - The Valves of the Heart | 14 | ||
| References | 21 | ||
| Chapter 2 - Lymphatic System of the Heart | 23 | ||
| 2.1 - Lymphatic Channels | 23 | ||
| References | 24 | ||
| Chapter 3 - Venous Drainage of the Heart | 25 | ||
| Reference | 27 | ||
| Chapter 4 - Arterial Supply of the Heart | 29 | ||
| References | 37 | ||
| Chapter 5 - Nerve Supply of the Heart | 39 | ||
| References | 44 | ||
| Chapter 6 - Conduction System of the Heart | 45 | ||
| References | 49 | ||
| Chapter 7 - Ultrastructure of the Myocardium | 51 | ||
| References | 58 | ||
| Chapter 8 - Basic Electrophysiological Principles | 59 | ||
| References | 64 | ||
| Chapter 9 - Molecular Basis of Muscle Contraction | 65 | ||
| References | 67 | ||
| Chapter 10 - Cardiac Cycle | 69 | ||
| References | 74 | ||
| Part II - Cardiovascular History and Symptomatology | 75 | ||
| Chapter 11 - Cardinal Symptoms | 77 | ||
| 11.1 - Importance of History Taking | 77 | ||
| 11.1.1 - Chest Pain | 78 | ||
| 11.1.2 - Shortness of Breath/Dyspnea | 91 | ||
| 11.1.3 - Palpitation | 99 | ||
| 11.1.4 - Fatigue | 105 | ||
| 11.1.5 - Syncope | 105 | ||
| 11.1.6 - Common Causes of Syncope | 113 | ||
| References | 119 | ||
| Chapter 12 - Other Symptoms | 121 | ||
| References | 134 | ||
| Part III - General Physical Examination | 135 | ||
| Chapter 13 - General Physical Examination | 137 | ||
| 13.1 - General Build and Stature | 138 | ||
| 13.2 - Head and Neck | 150 | ||
| 13.3 - Spine, Skin, and Extremities | 170 | ||
| References | 196 | ||
| Chapter 14 - Arterial Pulse | 199 | ||
| References | 224 | ||
| Chapter 15 - Measurement of the Blood Pressure | 225 | ||
| 15.1 - Definition and Components of Arterial Blood Pressure | 225 | ||
| 15.2 - Determinants of Arterial Blood Pressure | 226 | ||
| 15.3 - Measurement of Arterial Blood Pressure (see also Flow chart Fig. 15.23 for Various Methods and Devices of Measurement of Arterial BP) | 227 | ||
| 15.3.1 - Direct Methods | 227 | ||
| 15.3.2 - Indirect Methods | 227 | ||
| 15.4 - Variable BP Recordings | 236 | ||
| 15.5 - Hypertension | 240 | ||
| References | 244 | ||
| Further Reading | 245 | ||
| Part IV - Jugular Venous Pulse | 247 | ||
| Chapter 16 - Jugular Venous Pulse Waves | 249 | ||
| 16.1 - History | 249 | ||
| 16.2 - Examination of Jugular Venous Pulse | 250 | ||
| 16.3 - Analysis of the Jugular Venous Pulsations | 253 | ||
| 16.4 - Abnormalities of the JV Waves | 254 | ||
| References | 262 | ||
| Chapter 17 - Venous Pressure and JVP in Arrhythmias and Conduction Defects | 263 | ||
| 17.1 - Estimation of Venous Pressure | 263 | ||
| References | 269 | ||
| Part V - Cardiovascular System Examination | 271 | ||
| Chapter 18 - Inspection of the Precordium | 273 | ||
| 18.1 - Introduction | 273 | ||
| 18.1.1 - Examination of the Chest | 274 | ||
| 18.1.2 - Examination of the Precordium | 279 | ||
| 18.1.3 - Examination of the Cardiovascular Pulsations | 280 | ||
| References | 292 | ||
| Chapter 19 - Palpation of the Precordium | 293 | ||
| 19.1 - Palpation of the Precordium | 294 | ||
| 19.1.1 - Examination of the Chest for Confirmation of the Shape and Distended Vessels | 294 | ||
| 19.1.2 - Palpation for Precordial Tenderness | 295 | ||
| 19.1.3 - Palpation of the Cardiovascular Pulsations, Sounds, Thrills, and Rubs | 295 | ||
| 19.1.3.1 - Palpation of the Cardiac Apex | 297 | ||
| 19.1.3.2 - Palpation of Left Parasternal Area | 304 | ||
| 19.1.3.3 - Palpation of Lower Left Sternal Area (Tricuspid Area) | 308 | ||
| 19.1.3.4 - Palpation of Aortic and Pulmonary Areas | 308 | ||
| 19.1.3.5 - Palpation of Sternoclavicular Areas | 309 | ||
| 19.1.3.6 - Palpation of Epigastrium | 309 | ||
| 19.1.3.7 - Palpation in the Ectopic Areas | 310 | ||
| 19.1.4 - Tracheal Tug (Oliver Sign, William Silver Oliver, 1878) | 311 | ||
| 19.1.5 - Kinetic Apex Cardiogram | 311 | ||
| 19.1.5.1 - Normal Apex Cardiogram (ACG) | 311 | ||
| 19.1.5.2 - Abnormal Apex Cardiogram | 311 | ||
| References | 314 | ||
| Chapter 20 - Percussion of the Precordium | 315 | ||
| 20.1 - Methods of Percussion | 316 | ||
| 20.2 - The Scheme of Percussion | 317 | ||
| 20.2.1 - Determination of the Cardiac Borders | 317 | ||
| 20.2.2 - Percussion of the Pulmonary and Aortic Areas | 319 | ||
| 20.2.3 - Direct Percussion of the Sternum | 320 | ||
| 20.2.4 - Special Percussions | 321 | ||
| References | 323 | ||
| Chapter 21 - Cardiovascular Auscultation | 325 | ||
| 21.1 - Principles and Techniques | 326 | ||
| 21.2 - The Heart Sounds | 333 | ||
| 21.3 - The Heart Murmurs | 370 | ||
| References | 395 | ||
| Chapter 22 - Cardiovascular System Examination in Common Heart Diseases | 401 | ||
| 22.1 - Acquired Heart Diseases | 402 | ||
| 22.1.1 - Mitral Stenosis | 402 | ||
| 22.1.2 - Mitral Regurgitation | 406 | ||
| 22.1.3 - Aortic Stenosis | 407 | ||
| 22.1.4 - Aortic Regurgitation | 411 | ||
| 22.1.5 - Tricuspid Stenosis | 417 | ||
| 22.1.6 - Tricuspid Regurgitation | 420 | ||
| 22.2 - Acyanotic Congenital Heart Diseases | 421 | ||
| 22.2.1 - Pulmonary Stenosis | 421 | ||
| 22.2.2 - Coarctation of Aorta (Coarctation = Narrowing, Contracted in Latin) | 426 | ||
| 22.2.3 - Atrial Septal Defect | 427 | ||
| 22.2.4 - Ventricular Septal Defect | 428 | ||
| 22.2.5 - Patent Ductus Arteriosus | 433 | ||
| 22.2.6 - Ebstein Anomaly | 435 | ||
| 22.3 - Cyanotic Congenital Heart Diseases | 437 | ||
| 22.3.1 - CCHD With Decreased Pulmonary Blood Flow | 437 | ||
| 22.3.2 - CCHD With Increased Pulmonary Blood Flow | 437 | ||
| 22.3.3 - Tetralogy of Fallot | 439 | ||
| 22.3.4 - Tricuspid Atresia | 441 | ||
| 22.3.5 - Complete Transposition of Great Arteries | 442 | ||
| 22.3.6 - Double Outlet Right Ventricle | 445 | ||
| 22.3.7 - Anomalous Pulmonary Venous Connection | 446 | ||
| 22.4 - Cardiomyopathy | 450 | ||
| 22.4.1 - Dilated Cardiomyopathy | 451 | ||
| 22.4.2 - Hypertrophic Cardiomyopathy | 453 | ||
| 22.4.3 - Restrictive Cardiomyopathy | 454 | ||
| 22.5 - Pericardial and Myocardial Diseases | 455 | ||
| 22.5.1 - Acute Pericarditis | 455 | ||
| 22.5.2 - Acute Myocarditis | 457 | ||
| 22.5.3 - Cardiac Tamponade | 459 | ||
| 22.5.4 - Constrictive Pericarditis | 461 | ||
| References | 464 | ||
| Part VI - Clinical Electrocardiogrphy | 467 | ||
| Chapter 23 - Introduction, Basic Anatomical Concepts, Electrophysiological Principles, Methods of Recording, and Electrocardiographic Grid | 469 | ||
| 23.1 - Introduction | 469 | ||
| 23.2 - History of Development of ECG | 470 | ||
| 23.3 - Utility of ECG in the Present Era | 471 | ||
| 23.4 - Conduction System of the Heart | 471 | ||
| 23.5 - Electrophysiology of the Cardiac Muscle | 471 | ||
| 23.6 - Methods of ECG Recording | 474 | ||
| 23.7 - Electrocardiographic Grid | 479 | ||
| References | 480 | ||
| Chapter 24 - Normal Electrocardiogram and Its Variants | 483 | ||
| 24.1 - Normal ECG | 483 | ||
| 24.1.1 - Normal Waves | 485 | ||
| 24.1.2 - Normal Intervals | 486 | ||
| 24.1.3 - Segments | 488 | ||
| 24.1.4 - Electrical Axis in ECG | 488 | ||
| 24.1.5 - Effects of Heart Position on ECG | 491 | ||
| 24.2 - ECG Variants | 492 | ||
| References | 495 | ||
| Chapter 25 - Abnormal P, T, and U Waves | 497 | ||
| 25.1 - Abnormal P Waves | 497 | ||
| 25.1.1 - Abnormal P Waves due to Abnormal Sites of Atrial Activation | 497 | ||
| 25.1.2 - Atrial Abnormality or Enlargement | 500 | ||
| 25.1.3 - Dextrocardia | 501 | ||
| 25.2 - Abnormal T Waves | 504 | ||
| 25.2.1 - Etiology and Differential Diagnosis of Abnormal T Waves | 504 | ||
| 25.3 - Abnormal U Waves | 508 | ||
| 25.3.1 - Etiology and Differential Diagnosis of Abnormal U Waves | 508 | ||
| References | 510 | ||
| Chapter 26 - Ventricular Hypertrophy | 513 | ||
| 26.1 - Left Ventricular Hypertrophy (LVH) | 513 | ||
| 26.2 - Right Ventricular Hypertrophy | 519 | ||
| 26.3 - Biventricular Hypertrophy | 523 | ||
| References | 524 | ||
| Chapter 27 - Intraventricular Conduction Defects | 527 | ||
| 27.1 - Right Bundle Branch Block (RBBB) | 527 | ||
| 27.1.1 - Mechanism and ECG Changes | 527 | ||
| 27.1.2 - Diagnostic ECG Criteria | 528 | ||
| 27.1.3 - RBBB Variants | 528 | ||
| 27.1.4 - Common Causes of Complete and Incomplete RBBB | 533 | ||
| 27.2 - Left Bundle Branch Block (LBBB) | 533 | ||
| 27.2.1 - Mechanism and ECG Changes | 533 | ||
| 27.2.2 - Diagnostic ECG Criteria | 533 | ||
| 27.2.3 - Incomplete Left Bundle Branch Block | 535 | ||
| 27.2.4 - Common Causes of Complete and Incomplete LBBB | 535 | ||
| 27.3 - Fascicular Blocks | 536 | ||
| 27.3.1 - Left Anterior (Hemiblock) Fascicular Block | 536 | ||
| 27.3.1.1 - Mechanism and ECG Changes | 536 | ||
| 27.3.1.2 - Diagnostic ECG Criteria | 537 | ||
| 27.3.1.3 - Etiology and Differential Diagnosis of Left Axis Deviation | 538 | ||
| 27.3.2 - Left Posterior (Hemiblock) Fascicular Block | 538 | ||
| 27.3.2.1 - Mechanism and ECG Changes | 538 | ||
| 27.3.2.2 - Diagnostic ECG Criteria | 539 | ||
| 27.3.2.3 - Etiology and Differential Diagnosis of Right Axis Deviation | 540 | ||
| 27.3.3 - Multifascicular Blocks | 540 | ||
| 27.3.3.1 - Bifascicular Blocks | 541 | ||
| 27.3.3.2 - Trifascicular Blocks | 541 | ||
| 27.3.3.3 - Etiology and Differential Diagnosis of Fascicular Blocks | 542 | ||
| References | 544 | ||
| Chapter 28 - Pericardial Diseases and Myocarditis | 547 | ||
| 28.1 - Pericardial Diseases | 547 | ||
| 28.1.1 - Pericarditis | 547 | ||
| 28.1.2 - Pericardial Effusion (PEf) | 549 | ||
| 28.1.3 - Cardiac Tamponade (CT) | 549 | ||
| 28.1.4 - Constrictive Pericarditis (CP) | 550 | ||
| 28.2 - Myocarditis | 551 | ||
| References | 553 | ||
| Chapter 29 - Drug Effects and Electrolytes Abnormalities | 555 | ||
| 29.1 - Digitalis | 555 | ||
| 29.2 - Quinidine | 558 | ||
| 29.3 - Electrolyte Abnormalities and ECG Changes | 559 | ||
| References | 563 | ||
| Chapter 30 - Myocardial Infarction and Ischemia | 565 | ||
| 30.1 - Myocardial Infarction | 565 | ||
| 30.2 - Myocardial Ischemia | 569 | ||
| 30.3 - Right Ventricular Infarction | 570 | ||
| 30.4 - Atrial Infarction | 572 | ||
| 30.5 - MI in Bundle Branch Blocks and During RV Pacing | 574 | ||
| 30.6 - Prediction of the Site of Coronary Artery Occlusion in CAD | 577 | ||
| 30.7 - Prognostic Value of ECG for MI | 582 | ||
| 30.8 - Quantitative Estimation of Infarct Size From ECG | 583 | ||
| References | 584 | ||
| Chapter 31 - Sinus Nodal Disturbances and Arrhythmias | 587 | ||
| 31.1 - Sinus Tachycardia | 588 | ||
| 31.2 - Sinus Bradycardia | 589 | ||
| 31.3 - Sinus Arrhythmia | 589 | ||
| 31.4 - Sinus Arrest or Sinus Pause | 590 | ||
| 31.5 - Sinoatrial Exit Block (SAEB) | 591 | ||
| 31.6 - Wandering Pacemaker | 593 | ||
| 31.7 - Sick Sinus Syndrome (SSS/Bradycardia–Tachycardia Syndrome) | 593 | ||
| 31.8 - Sinus Node Reentry Tachycardia | 594 | ||
| 31.9 - Types and Differential Diagnosis of Sinus Nodal Arrhythmias | 595 | ||
| References | 595 | ||
| Chapter 32 - Atrial Arrhythmias | 597 | ||
| 32.1 - Premature Atrial Contractions (PACs) | 597 | ||
| 32.2 - Focal Atrial Tachycardia (FAT) | 598 | ||
| 32.3 - Multifocal Atrial Tachycardia (MAT) | 599 | ||
| 32.4 - Atrial Flutter (AFl) | 600 | ||
| 32.5 - Atrial Fibrillation (AF) | 602 | ||
| 32.6 - Types and Differential Diagnosis of Atrial Arrhythmias | 606 | ||
| References | 606 | ||
| Chapter 33 - AV Junctional Arrhythmias | 609 | ||
| 33.1 - AV Junctional Escape Beats and AV Junctional Rhythm | 609 | ||
| 33.2 - AV Junctional Premature Beats (AVJPBs) | 611 | ||
| 33.3 - AV Junctional Tachycardia | 612 | ||
| 33.3.1 - Focal Junctional Tachycardia (FJT, Paroxysmal Junctional Tachycardia) | 612 | ||
| 33.3.2 - Nonparoxysmal Junctional Tachycardia (NPJT) | 613 | ||
| 33.4 - AV Nodal Reciprocating (Reentrant) Tachycardia (AVNRT) | 613 | ||
| 33.5 - Differential Diagnosis of AV Junctional Arrhythmias | 616 | ||
| Reference | 617 | ||
| Chapter 34 - Preexcitation Syndrome | 619 | ||
| 34.1 - Accessory Pathways | 619 | ||
| 34.2 - Preexcitation Syndrome (PES) | 621 | ||
| References | 630 | ||
| Chapter 35 - Ventricular Arrhythmias | 631 | ||
| 35.1 - Premature Ventricular Contractions | 631 | ||
| 35.2 - Ventricular Tachycardia | 635 | ||
| 35.3 - Idioventricular Rhythm | 642 | ||
| 35.4 - Ventricular Fibrillation and Ventricular Flutter | 643 | ||
| References | 644 | ||
| Chapter 36 - Narrow and Wide QRS Tachycardia | 645 | ||
| 36.1 - Narrow QRS Tachycardia | 645 | ||
| 36.1.1 - Regular Narrow QRS Tachycardia | 645 | ||
| 36.1.2 - Irregular Narrow QRS Tachycardia (INQRST) | 648 | ||
| 36.2 - Wide QRS Tachycardia | 651 | ||
| 36.2.1 - Regular Wide QRS Tachycardia | 651 | ||
| 36.2.2 - Irregular Wide QRS Tachycardia | 652 | ||
| References | 656 | ||
| Chapter 37 - Heart Blocks—AV Blocks | 657 | ||
| 37.1 - First Degree AV Block | 657 | ||
| 37.2 - Second Degree AV Block | 659 | ||
| 37.3 - Complete or Third Degree AV Block | 661 | ||
| 37.3.1 - Acquired Complete AV Block | 661 | ||
| 37.3.2 - Congenital Complete AV Block | 662 | ||
| 37.4 - Types and Differential Diagnosis of AV Blocks | 663 | ||
| References | 664 | ||
| Part VII - Radiological Evaluation of Heart and Great Vessels | 665 | ||
| Chapter 38 - Introduction to the Radiological Evaluation of Heart and Great Vessels | 667 | ||
| 38.1 - Cardiac Imaging—Introduction | 667 | ||
| 38.1.1 - Usefulness of Chest X-Ray in Present Era | 667 | ||
| 38.1.2 - Useful Technical Facts | 667 | ||
| References | 668 | ||
| Chapter 39 - Radiological Evaluation of Heart—Cardiac Position, Cardiac Size, Cardiac Contour, and Cardiac Borders | 669 | ||
| 39.1 - Evaluation of Chest Roentgenogram | 669 | ||
| 39.1.1 - Cardiac Position | 670 | ||
| 39.1.2 - Cardiac Size | 671 | ||
| 39.1.3 - Cardiac Contour | 676 | ||
| 39.1.3.1 - Etiology and Differential Diagnosis of Cardiac Contour | 676 | ||
| 39.1.4 - Cardiac Borders | 676 | ||
| 39.1.4.1 - Differential Diagnosis of Cardiac Enlargement | 685 | ||
| References | 685 | ||
| Chapter 40 - Radiological Evaluation of Pulmonary Vasculature | 687 | ||
| 40.1 - Normal Pulmonary Vasculature | 687 | ||
| 40.2 - Evaluation of Abnormal Pulmonary Vasculature | 689 | ||
| References | 693 | ||
| Chapter 41 - Radiological Evaluation Cardiac Calcification | 695 | ||
| References | 699 | ||
| Chapter 42 - Radiological Evaluation of Extracardiac Structures | 701 | ||
| 42.1 - Visceral Status | 701 | ||
| 42.2 - Notching of the Ribs | 702 | ||
| 42.3 - Lungs and Pleura | 704 | ||
| Reference | 704 | ||
| Chapter 43 - Introduction to CT Coronary Angiography and Cardiac Magnetic Resonance Imaging | 705 | ||
| 43.1 - CT Angiogram | 705 | ||
| 43.2 - Cardiac MRI | 708 | ||
| References | 711 | ||
| Index | 713 |