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Tarascon medicina de cardiologia
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  Tarascon Pocket Cardiologica Timothy Wm. Smith, DPhil, MD, FACC, FHRS Associate Professor of MedicineDirector, Cardiac Electrophysiology LaboratoryWashington University School of MedicineSaint Louis, Missouri Duane S. Pinto, MD, MPH, FACC, FSCAI Assistant Professor of Medicine, Harvard Medical SchoolAssociate Director, Interventional Cardiology SectionDirector, Cardiology Fellowship Training ProgramBeth Israel Deaconess Medical CenterBoston, Massachusetts  World Headquarters   Jones & Bartlett Learning5 Wall StreetBurlington, MA 01803978-443-5000info@jblearning.comwww.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com.Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones & Bartlett Learning via the above contact information or send an email to specialsales@jblearning.com. Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner.The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of the products and procedures described. Treatments and side effects described in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice, and government regulations often change the accepted standard in this field. When consider-ation is being given to use of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations on dose, precautions, and contraindications, and determining the appropri-ate usage for the product. This is especially important in the case of drugs that are new or seldom used. Production Credits Executive Publisher: Christopher DavisSenior Acquisitions Editor: Nancy Anastasi DuffyAssociate Editor: Laura BurnsProduction Assistant: Sarah BurkeMarketing Manager: Rebecca RockelManufacturing and Inventory Control Supervisor: Amy BacusComposition: CenveoCover Design: Kate Ternullo/Kristin ParkerCover Image: © Courtesy of National Library of MedicinePrinting and Binding: CenveoCover Printing: Cenveo ISBN: 978-1-4496-1516-1 6048Printed in the United States of America15 14 13 12 11 10 9 8 7 6 5 4 3 2 1  Tarascon Pocket Cardiologica Contents  Contributors ix SECTION I DIAGNOSTICS AND EVALUATION 2 1 Introduction: Signs and Symptoms of Cardiovascular Disease 3 Introduction 3Goals of Evaluation and Treatment 3Symptoms 4Signs and Syndromes 5Organization of this Book 6  2 The Physical Examination of the Heart 7 Introduction 7Arterial Pulse Examination 7 Jugular Venous Pulsation (JVP) 7Heart Sounds 8Heart Murmurs 9  3 Electrocardiography 11 Introduction 11What Is the ECG? What Are Those Waves? 11Recording the ECG 12The ECG Output 15Reading the Electrocardiogram: bRRAICE Yourself 18  4 Ambulatory ECG Monitoring 30 Introduction 30Holter Monitoring 30Event/Loop Monitoring 30Continuous Extended Monitoring 31Implantable Loop Recorder 31  5 ECG Exercise Stress Testing 32 Introduction 32Indications for ECG Stress Testing 32Contraindications 32Preparation 33Exercise 33ECG Interpretation 34Evaluation of Functional Status and Prognosis 34Pharmacologic Stress Testing 35Imaging 36  6 Cardiac Imaging 37 Introduction 37Transthoracic Echocardiography (TTE) 37Transesophageal echocardiography (TEE) 40Cardiac Radionuclide Imaging 42Cardiac Computerized Tomography (CT) 45Cardiac Magnetic Resonance Imaging (CMR)   46  7 Cardiac Catheterization and Angiography 48 Introduction 48Indications 48Contraindications 49Techniques 49Angiography 50Complications 52  8 The Electrophysiology Study 53 Introduction 53Recorded Electrograms (Figure 8-1) 55Bradycardias 55Tachycardias 56  9 Perioperative Cardiac Evaluation 59 Goals of Evaluation 59Functional Capacity 60Surgical Risk for Noncardiac Procedures 60
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