Patient Studies in Valvular, Congenital, and Rarer Forms of Cardiovascular Disease. An Integrative Approach

  • ID: 3148689
  • Book
  • 448 Pages
  • John Wiley and Sons Ltd
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A number of cardiology training programs emphasize coronary artery disease whilst neglecting other aspects of cardiology such as valvular, congenital heart or vascular disease. This book attempts to redress this imbalance by reiterating the importance of history and physical findings in detecting valvular, congenital or vascular disease and to correlate the clinical findings to invasive and non–invasive studies. This approach will be useful to cardiologists in training particularly those sitting the Cardiology Board examinations, where recognition of auscultatory findings is now a requirement, and those with an interest in problem solving.

Each of the 90+ patient studies follows a templated design and consists of: history, physical examination, phonocardiography (whenever possible), ECG, Chest X–ray, echocardiography, hemodynamics, and, sometimes, angiography. These sections may or may not be randomized and readers are challenged to write an interpretation on each section as well as answering self–test questions posed in the legends. Patient studies have been arranged in approximately chronological order from 1966–2013 with emphasis on establishing a likely diagnosis based on the available tools then in existence.

Test your problem solving skills, improve your knowledge, and prepare for Boards, with this collection of unusual and challenging patient studies focused on the physical diagnosis of cardiovascular disease. This book:

  • Contains over 90 case histories with self–test questions designed to test the reader s knowledge and also reinforce clinical best practices
  • Focuses on diseases of valvular, vascular or congenital origin, and on comparatively rare disorders/diseases, rather than coronary artery disease, to help readers improve their skills at interpreting and making decisions based on physical examination and basic, non–invasive imaging modalities
  • Pairs each with original materials – e.g. x–rays, echocardiograms, lab reports, charts so that readers can work through their diagnosis using the same information as the physician who treated the patient originally
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About the Author vii

Preface  ix

Acknowledgments  xi

Abbreviations xiii

Worked Example  xv

Companion Website  xix

Patient Study 1 46–year–old chronic alcoholic man with heart failure and sudden death (1968)  1

Patient Study 2 24–year–old man with dyspnea, edema, and a heart murmur (1973)  7

Patient Study 3 27–year–old man with hemoptysis and dyspnea (1973)  19

Patient Study 4 22–year–old female with exertional chest pain and palpitations (1974)  23

Patient Study 5 40–year–old man and the perils of walking in the street (1997)  30

Patient Study 6 54–year–old man with dyspnea and a lifelong murmur (1974)  37

Patient Study 7 26–year–old man with an asymptomatic heart murmur (1979)  44

Patient Study 8 20–year–old man with chest pain and a life–long heart murmur (1979)  50

Patient Study 9 23–year–old female with heart failure and a heart murmur (1975)  59

Patient Study 10 17–year–old man with fever, myalgias, and a heart murmur (1977)  71

Patient Study 11 24–year–old man with left leg pain (1977)  80

Patient Study 12 48–year–old female with dyspnea (1976)  87

Patient Study 13 19–year–old man with easy fatiguability, cyanosis, and clubbing (1977)  93

Patient Study 14 29–year–old man with an asymptomatic murmur and an abnormal chest X ray (1977)  100

Patient Study 15 32–year–old man with a history of dyspnea and syncope over last 38 years (1967)  107

Patient Study 16 55–year–old female with chest pain and hematemesis (1993)  120

Patient Study 17 27–year–old man with decreased exercise tolerance and a heart murmur (1982)  126

Patient Study 18 29–year–old man with pleuritic chest pain, dyspnea, and cardiomegaly (1985)  135

Patient Study 19 25–year–old man with new onset of hemoptysis (1986)  142

Patient Study 20 80–year–old man with hemoptysis and dyspnea (1998)  149

Patient Study 21 21–year–old man with hemoptysis, cyanosis, and a heart murmur (1989)  157

Patient Study 22 23–year–old female with chest pain and visual symptoms (1992)  167

Patient Study 23 Approximately 40–year–old man with new onset of a murmur and heart failure (1975)  173

Patient Study 24 54–year–old female with altered mental status (1993)  182

Patient Study 25 74–year–old female admitted with abdominal pain followed by shock (1994)  187

Patient Study 26 Approximately 82–year–old female admitted with recurrent lower GI bleeding and a known abdominal aortic aneurysm (2001)  191

Patient Study 27 41–year–old female with chest pain and a heart murmur (1994)  197

Patient Study 28 48–year–old man with leg numbness and weakness (1994)  201

Patient Study 29 67–year–old female with chest pain and a new heart murmur (1995)  208

Patient Study 30 62–year–old man with chest pain and hypertension (1996)  214

Patient Study 31 17–year–old female with fatigue and a heart murmur (1997)  219

Patient Study 32 31–year–old female with fatigue and syncope (1997)  224

Patient Study 33 33–year–old female with dyspnea, edema, and a murmur (1995)  231

Patient Study 34 21–year–old man with dyspnea and chest pain (1995)  238

Patient Study 35 54–year–old man with chest pain, hypertension, and abdominal pain (2005) 245

Patient Study 36 19–year–old female with aching legs on exertion (1995)  249

Patient Study 37 58–year–old man with dyspnea, chest pain, and Sjorgen s syndrome (1996)  256

Patient Study 38 37–year–old ex cocaine user with dyspnea and a heart murmur (1998)  261

Patient Study 39 24–year–old female with a heart murmur (1997)  266

Patient Study 40 34–year–old Asian female with heart failure(2001)  272

Patient Study 41 73–year–old man with chest pain and hypertension (2000)  278

Patient Study 42 42–year–old female with dyspnea and a heart murmur (2001)  283

Patient Study 43 37–year–old female with dyspnea and cyanosis (1999)  289

Patient Study 44 27–year–old female with dyspnea, a murmur, and kyphoscoliosis (1996)  296

Patient Study 45 41–year–old man with presumed cardiomyopathy (2002)  302

Patient Study 46 78–year–old female with chest pain and a heart murmur (2002)  310

Patient Study 47 31–year–old man with long–standing clubbing (1997)  317

Patient Study 48 79–year–old man with dyspnea and edema 3 years after an operation (1995)  328

Patient Study 49 37–year–old female with recurrent syncope and heart failure (1984)  336

Patient Study 50 33–year–old man with new onset of hemiplegia (1985)  342

Patient Study 51 44–year–old female with chest pain and dyspnea (2008)  345

Patient Study 52 80–year–old diabetic female with an abnormal echocardiogram and no CVS symptoms (2008)  352

Patient Study 53 42–year–old female with palpitations and an abnormal echocardiogram (2006)  355

Patient Study 54 53–year–old alcoholic man and the perils of winter (2009)  360

Patient Studies 55 56 90–year–old female with dyspnea and hemoptysis (2000)  366

Patient Study 57 1–month–old Infant with unsuspected cardiac pathology on echocardiography (2002)  372

Patient Study 58 69–year–old man with lower extremity pain (2008)  374

Patient Study 59 71–year–old man with dizziness and weakness (2010)  379

Patient Study 60 20–year–old man with pleuritis and fever (1995)  383

Patient Study 61 20–year–old man with swollen face and chest pain (2008)  389

Patient Study 62 17–year–old female with an acute myocardial infarction (2013)  395

Patient Study 63 66–year–old diabetic female with ICD dysfunction (2008)  401

Patient Study 64 39–year–old man with chest pain and syncope (2011)  406

Patient Study 65 58–year–old female with dyspnea, hypertension, and hematuria (2008)  413

Crossword Puzzle Pediatric cardiology and general medical crossword puzzle  419

Subject Index 421

Patient Studies Index 423

Disease Classification Index 425

Answers to Crossword Puzzle 427

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This book will challenge the problem–solver, improve the reader′s knowledge of cardiology, and help prepare the trainee for the cardiology board examination. Its specific strong points include an attractive cover, paper of high–grade stock, excellent colored illustrations, well–constructed diagrams and tables, an assortment of worthwhile images, and a wealth of detailed and practical information on a wide variety of valvular, congenital, and rare forms of cardiovascular disease. Especially useful are the discussion, key points, and references that conclude most of the patient studies.   (Texas Heart Institute Journal, 1 August 2015)

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