Taylor’s Cardiovascular Diseases

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Taylor’s Cardiovascular

Diseases

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Taylor’s Cardiovascular Diseases

A Handbook

Robert B. Taylor, M.D. Editor

Professor Emeritus

Department of Family Medicine Oregon Health & Science University

School of Medicine Portland, Oregon

Associate Editors

Alan K. David, M.D. Scott A. Fields, M.D.

Professor and Chairman Professor and Vice Chairman Department of Family and Department of Family Medicine

Community Medicine Oregon Health & Science University Medical College of Wisconsin School of Medicine

Milwaukee, Wisconsin Portland, Oregon

D. Melessa Phillips, M.D. Joseph E. Scherger, M.D., M.P.H.

Professor and Chairman Clinical Professor Department of Family Medicine Department of Family and University of Mississippi School Preventive Medicine

of Medicine University of California, San Diego Jackson, Mississippi School of Medicine

San Diego, California

With 10 Illustrations

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Robert B. Taylor, M.D.

Professor Emeritus

Department of Family Medicine Oregon Health & Science University

School of Medicine Portland, OR 97201-3098, USA

Associate Editors

Alan K. David, M.D. Scott A. Fields, M.D.

Professor and Chairman Professor and Vice Chairman Department of Family and Department of Family Medicine

Community Medicine Oregon Health & Science University Medical College of Wisconsin School of Medicine

Milwaukee, WI 53226-0509, USA Portland, OR 97201-3098, USA

D. Melessa Phillips, M.D. Joseph E. Scherger, M.D., M.P.H.

Professor and Chairman Clinical Professor

Department of Family Medicine Department of Family and University of Mississippi School Preventive Medicine

of Medicine University of California, San Diego

Jackson, MS 39216-4500, USA School of Medicine San Diego, CA 92103-0801

Library of Congress Cataloging-in-Publication Data

Taylor’s cardiovascular diseases: a handbook/Robert B. Taylor, editor; associate editors, Alan K. David . . . [et al.].

p.; cm.

“This book is comprised of chapters from the sixth edition of the large reference book, Family medicine: principles and practice”—Pref.

Includes bibliographical references and index.

ISBN 0-387-22351-7 (alk. paper)

1. Cardiovascular system—Diseases—Handbooks, manuals, etc. I. Title: Cardiovascular diseases. II. Taylor, Robert B. III. Family medicine.

[DNLM: 1. Cardiovascular Diseases. WG 120 T247 2005]

RC669.15.T396 2005

616.1—dc22 2004058950

ISBN 0-387-22351-7 Printed on acid-free paper.

All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, Inc., 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden.

The use in this publication of trade names, trademarks, service marks and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights.

While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.

Printed in the United States of America. (MP/MVY) 9 8 7 6 5 4 3 2 1 SPIN 10994986

springeronline.com

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Preface

In the end, most of our patients—and also most of us clinicians—

will die a cardiovascular death. During life, many will experience discomfort and disability caused by diseases of the heart and blood vessels. This book is intended to be a primer on these causes of mor- bidity and mortality.

This book is comprised of chapters from the sixth edition of the large reference book, Family Medicine: Principles and Practice. Pub- lishing chapters on selected topics provides volumes that are easy to carry in the pocket, are available at lower cost than large compre- hensive volumes, and that allow clinicians to select books on areas that meet their specific needs.

This book on cardiovascular diseases includes the chapter on Hypertension, which afflicts approximately 60 million Americans and contributes to many instances of heart disease, stroke, and kid- ney disease. Chapters related directly to the heart are those on Isch- emic Heart Disease, Cardiac Arrhythmias, Valvular Heart Disease, and Heart Failure. I included the chapter on Dyslipidemia, because elevated serum lipid levels contribute to many instances of cardiovascular disease. Venous Thromboembolism and Cerebrovascular Disease are the chief diseases of blood vessel. The chapter on Car- diovascular Emergencies includes what the primary care clinician needs to know when the unexpected strikes. When the primary care clinician provides Medical Care of the Surgical Patient, cardiovascular disease is often the main area of concern. Finally, Chapter 11 on Selected Disorders allows discussion of a variety of problems in- cluding pericarditis, myocarditis, endocarditis, the cardiomyopathies, pulmonary hypertension, and peripheral vascular disease.

I hope that you find this book useful in daily practice.

Robert B. Taylor, M.D.

Portland, Oregon, USA

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Clinical Practice Notice

Everyone involved with the preparation of this book has worked very hard to assure that information presented here is accurate and that it represents accepted clinical practices. These efforts include confirming that drug recommendations and dosages discussed in this text are in accordance with current practice at the time of publication. Nevertheless, therapeutic recommendations and dosage sched- ules change with reports of ongoing research, changes in govern- ment recommendations, reports of adverse drug reactions, and other new information.

A few recommendations and drug uses described herein have Food and Drug Administration (FDA) clearance for limited use in restricted settings. It is the responsibility of the clinician to determine the FDA status of any drug selection, drug dosage, or device recommended to patients.

The reader should check the package insert for each drug to determine any change in indications or dosage as well as for any pre- cautions or warnings. This admonition is especially true when the drug considered is new or infrequently used by the clinician.

The use of the information in this book in a specific clinical set- ting or situation is the professional responsibility of the clinician. The authors, editors, or publisher are not responsible for errors, omissions, adverse effects, or any consequences arising from the use of information in this book, and make no warranty, expressed or implied, with respect to the completeness, timeliness, or accuracy of the book’s contents.

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Contributors

David E. Anisman, M.D., Assistant Professor of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda; As- sistant Program Director, Family Practice Residency, Malcolm Grow Medical Center, Andrews Air Force Base, MD

Michael H. Bross, M.D., Medical Director, North Central County Health Center, Institute for Research and Education in Family Med- icine, St. Louis, MO

Stephen A. Brunton, M.D., Director of Faculty Development, Stam- ford Hospital/Columbia University Family Practice Residency Pro- gram, Stamford, CT

David C. Campbell, M.D., M.Ed., Clinical Professor of Commu- nity and Family Medicine, St. Louis University School of Medi- cine; The Institute for Research and Education in Family Medi- cine, St. Louis, MO

Mel P. Daly, M.D., Family Physician, Greater Baltimore Medical Center, Baltimore, MD

A. Kesh Hebbar, M.D., Assistant Professor of Family Medicine, Med- ical University of South Carolina, Charleston, SC

Denise D. Hermann, M.D., Associate Clinical Professor of Medicine, Division of Cardiology, Department of Medicine, University of Cal- ifornia–San Diego Medical Center, San Diego, CA

William J. Hueston, M.D., Professor and Chairman, Department of Family Medicine, Medical University of South Carolina, Charleston, SC

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Michael S. Klinkman, M.D., M.S., Associate Professor of Family Med- icine, University of Michigan School of Medicine, Ann Arbor, MI Patrick E. McBride, M.D., M.P.H., Professor of Medicine, Univer- sity of Wisconsin Medical School, Madison, WI

William A. Norcross, M.D., Professor of Clinical Family Medicine, University of California–San Diego School of Medicine, La Jolla, CA Jim Nuovo, M.D., Associate Professor of Family and Community Medicine, University of California–Davis School of Medicine, Sacra- mento, CA

Glenn S. Rodriguez, M.D., Regional Medical Director of Quality Im- provement and Health Services Integration, Providence Health Sys- tem, Portland; Adjunct Associate Professor of Family Medicine, Ore- gon Health & Science University School of Medicine, Portland, OR Thomas M. Schwartz, M.D., Clinical Assistant Professor of Family Medicine, Oregon Health and Science University School of Medi- cine; Faculty, Providence Milwaukie Family Practice Residency Pro- gram, Portland, OR

James H. Stein, M.D., Associate Professor of Medicine, University of Wisconsin Medical School, Madison, WI

Gail Underbakke, R.D., M.S., Nutrition Coordinator, Preventive Car- diology Program, University of Wisconsin Hospital and Clinics, Madison, WI

Eric Walsh, M.D., Associate Professor of Family Medicine, Oregon Health & Science University School of Medicine, Portland; Direc- tor, Oregon Health & Science University Family Practice Residency Program, Portland, OR

xii Contributors

Taylor’s Cardiovascular Diseases

Taylor’s Cardiovascular

Diseases

Taylor’s Cardiovascular Diseases

Preface

Clinical Practice Notice

Contents

Contributors