心脏病学 英文版PDF电子书下载

Part I:The Patient Presents With 1

1.Chest Pain 3

Differential diagnosis of chest pain 3

History to focus on the differential diagnosis of chest pain 3

Examination of patients who have chest pain 4

Investigation of patients who have chest pain 5

Preface 5

Central chest pain at rest of recent onset in an ill patient 7

Differential diagnosis of dyspnoea 11

History to focus on the differential diagnosis of dyspnoea 11

2.Dyspnoea 11

Examination of dyspnoeic patients 12

Investigation of dyspnoeic patients 13

Dyspnoea at rest of recent onset in an ill patient 15

3.Syncope 19

Differential diagnosis of syncope 19

History to focus on the differential diagnosis of syncope 19

Examination of patients who present with syncope 20

Investigation of patients who present with syncope 21

Syncope of recent onset in an ill patient 22

Differential diagnosis of palpitations 25

History to focus on the differential diagnosis of palpitations 25

4.Palpitations 25

Examination of patients who have palpitations 26

Investigation of patients who have palpitations 27

5.Ankle Swelling 31

Differential diagnosis of oedema 31

History to focus on the differential diagnosis of ankle swelling 32

Examination of patients who have oedema 32

Investigation of patients who have oedema 34

Important aspects 34

Differential diagnosis of a heart murmur 37

History to focus on the differential diagnosis of a heart murmur 37

6.Heart Murmur 37

Examination of patients who have a heart murmur 39

Investigation of patients who have a heart murmur 42

7.High Blood Pressure 43

Differential diagnosis 43

History to focus on the differential diagnosis of high blood pressure 43

Examination of patients who have high blood pressure 44

Investigation of patients who have high blood pressure 46

8.Fever Associated With A Cardiac Symptom or Sign 49

Differential diagnosis 49

History to focus on the differential diagnosis of fever 49

Examination of patients who have a fever associated with a cardiac symptom or sign 50

Investigation of patients who have a fever associated with a cardiac symptom or sign 52

Part II:History, Examination, and Common Investigations 55

9.History 57

Aim of history taking 57

Presenting complaint 57

Systems review 60

Allergies 62

Family History 62

Social history 62

How to begin the examination 65

Observation 65

10.Examination 65

Examination of the hands 66

Examination of the pulse 66

Take the blood pressure 66

Examination of the face 67

Examination of the jugular venous pressuer 67

Examination of the praecordium 68

Finishing off the examination 70

11.How to Write a Medical Clerking 71

Documentation of the history 71

At the end of the clerking 73

Sample medical clerking 73

Documentation of the examination findings 73

12.Common investigations 77

Electrocardiography 77

Echocardiography 84

Myocardial perfusion imaging 86

Magnetic resonance imaging 87

Positron emission tomography 87

Cardiac catheterization 87

Part III:Diseases and Disorders 91

Clinical features of angina pectoris 93

Risk factors for coronary artery disease 93

Pathophysiology of angina pectoris 93

Definition of angina pectoris 93

13.Angina Pectoris 93

Investigation of angina pectoris 95

Management of angina pectoris 96

Unstable angina 100

Low molecular weight heparins 101

14.Acute Myocardial Infarction 103

Definition of acute myocardial infarction 104

Clinical features of acute myocardial infarction 104

Investigation of acute myocardial infarction 106

Management of acute myocardial infarction 107

Summary of management of ischaemic chest pain 111

Heart block after myocardial infarction 112

15.Supraventricular Tachyarrythmias 113

Definition of supraventricular tachyarrhythmias 113

Sinus tachycardia 113

Premature atrial ectopics 113

Nodal and junctional ectopics 113

Atrial tachycardia 114

Atrioventricular junctional tachycardia 115

Atrioventricular nodal re-entrant tachycardia 115

Wolff-Parkinson-White syndrome 116

Atrial fibrillation 117

Afrial flutter 117

Investigation of patients who have supraventricular tachyarrhythmisas 119

Drugs used to treat tachyarrhythmias 121

16.Ventricular Tachyarrhythmias 123

Definition of ventricular tachyarrhythmias 123

Ventricular ectopic beats 123

Ventricular tachycardia 124

Ventricular fibrillation 125

Torsades de pointes 126

Drugs used to treat ventricular tachycardia and fibrillation 127

Non-pharmacological treatments of ventricular tachyarrhythmias 128

Basic life support 131

17.Cardiac Arrest and Resuscitation 131

Advanced life support 134

18.Bradyarrhythmias 137

Definition of bradyarrhythmias 137

Sinus bradycardia 137

Sinus node disease 137

Atrioventricular block 138

Bundle branch block 141

Investigation of bradyarrhythmias 142

Pacemakers 143

Pathophysiology of cardiac failure 145

Definition of cardiac failure 145

19.Cardiac Failure 145

Causes of cardiac failure 147

Clinical features of cardiac failure 148

Examination of patients who have cardiac failure 149

Investigation of cardiac failure 150

Management of cardiac failure 151

20.Cardiomyopathy 157

Definition of cardiomyopathy 157

Dilated cardiomyopathy 157

Hypertrophic obstructive cardiomyopathy 158

Restrictive cardiomyopathy 160

Acute pericarditis 161

21.Pericarditis and Pericardial Effusion 161

Dressler s syndrome 163

Chronic constrictive pericarditis 163

Pericardial effusion 163

22.Valvular Heart Disease 165

Rheumatic fever 165

Mitral stenosis 166

Mitral regurgitation 168

Aortic stenosis 171

Aortic regurgitation 173

Tricuspid regurgitation 174

Assessing the severity of a valve lesion 174

Other valve lesions 176

Prosthetic heart valves 176

23.Infective Endocardifis 177

Definition of infective endocarditis 177

Epidemiology of infective endocarditis 177

Pathophysiology of infective endocarditis 178

Clinical features of infective endocarditis 179

Investigation of a patient who has infective endocarditis 180

Management of infective endocarditis 181

Complication of infective endocarditis 182

Monitoring of patients who have infective endocarditis 182

Causes of hypertension 183

24.Hypertension 183

Definition of hypertension 183

Clinical features of hypertension 184

Investigation of a patient who has hypertension 184

Management of hypertension 186

Phaeochromocytoma 187

25.Congenital Heart Disease 189

Definition of congenital heart disease 189

Causes of congenital heart disease 189

Complication of congenital heart disease 189

Atrial septal defect 190

Ventricular septal defect 192

Patent ductus arteriosus 193

Coarctation of the aorta 193

Other causes of congenital heart disease 195

Notes on pulmonary hypertension and Eisenmenger s syndrome 195

Part IV:Self-assessment 197

Multiple-choice questions 199

Short-answer questions 203

Patient management problems 206

MCQ answers 207

SAQ answers 208

Index 211