Coronary Heart Disease in
Clinical Practice
Coronary Heart Disease in
Clinical Practice
Satish Mittal
With 14 Figures, 2 in Full Color
3
Satish Mittal, MBBS
General Medical Practitioner (formerly, General Practice Principal, East Molesey, East Surrey Health Authority, Surrey, UK; and Clinical Governance Lead cum Chairman Clinical Governance Committee, East Elmbridge Primary Care Group, Esher, Surrey, UK)
Cover illustration: Courtesy of Vahini V. Naidoo, MD, Consultant in Nuclear Cardiology, Hon. Senior Lecturer, Imperial College, Royal Brompton Hos- pital, London.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library Library of Congress Control Number: 2005923549
ISBN-10: 1-85233-936-5 e-ISBN 1-84628-135-0 ISBN-13: 978-1-85233-936-4
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this pub- lication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licences issued by the Copyright Licens- ing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers.
Springer Science+Business Media springeronline.com
© Springer-Verlag London Limited 2005
The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use.
Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature.
Typeset by SNP Best-set Typesetter Ltd., Hong Kong Printed in the United States of America
28-543210 Printed on acid-free paper
In memory of my father, Harish Chandra,
and my mother, Ramanandi
Foreword
Dr. Satish Mittal has produced a single authored book entitled, Coronary Heart Disease in Clinical Practice. In it, he has reviewed several clinical topics that are important in evaluation and treat- ment of patients with coronary heart disease. Topics reviewed include risk factors, diabetes, hypertension, coronary interven- tions, heart failure, and arrhythmias. The acute coronary syn- dromes are discussed and a “Healthy Life Style” is reviewed. In each chapter, key clinical studies are summarized and recommen- dations for treatment are developed. Questions pertaining to spe- cific clinical problems and their answers are also provided in the text of each discussion. The single focus of the book, the reviews of clinical studies, and the useful clinical approach that is provided for the care of each of these problems should be helpful to all who care for patients with this very important problem.
James T. Willerson, MD President, The University of Texas Health Science Center at Houston President-Elect and Medical Director, Texas Heart Institute
About This Book
Coronary heart disease is increasingly common and is the single largest preventable and treatable cause of mortality worldwide.
Coronary Heart Disease in Clinical Practice is a concise and thorough reference book directed at medical practitioners, clini- cians, practice nurses, medical students, and those in associated fields. The information is presented in an accessible question- and-answer format. It highlights important aspects of numerous current guidelines, making this a valuable, timesaving reference tool that incorporates the latest research in the field.
The broad coverage of this book includes chapters on coronary heart disease, its risk factors (lipids, hypertension, diabetes, and lifestyle), and coronary events (angina, acute myocardial infarc- tion, heart failure, and arrhythmias). The text contains carefully selected, complex discussions on medical hot topics. Each topic is explained at length with the aid of illustrations and tables. In a book of this size I have endeavoured to include most of the impor- tant relevant issues pertaining to coronary heart disease in clinical practice. In doing so I have adhered to the widely accepted guide- lines on various important issues in clinical medicine. I have mentioned the pharmaceutical preparations by generic names only and have not included combination preparations for which the reader should refer to the particular pharmaceutical preparations.
I am thankful to my son Ajay for contributing the tables and illustrations.
Contents
Foreword by James T. Willerson . . . . vii
About this Book . . . . ix
1 Healthy Living . . . . 1
2 Lipids . . . . 25
3 Diabetes Mellitus . . . . 48
4 Hypertension . . . . 68
5 Cardiac Investigations . . . . 92
6 Coronary Artery Disease . . . . 107
7 Chronic Stable Angina . . . . 151
8 Acute Coronary Syndrome . . . . 167
9 Heart Failure . . . . 199
10 Arrhythmias . . . . 208
Index . . . . 213
