Chapter 17: Cardiovascular Drugs

 Introduction This chapter reviews the physiologic basis and clinical use of cardiovascular drugs. Although a multitude of drugs are available to treat cardiac disorders, these agents can be grouped by their pharmacologic actions into a small number of categories. Additionally, many drugs are useful in more than one form of heart disease. Inotropic Drugs and […]

Chapter 16: Congenital Heart Disease

Introduction Congenital heart diseases are the most common form of birth defects and are the leading cause of death from birth abnormalities in the first year of life. These conditions affect approximately 8 of 1,000 live births, and an estimated 1 million people in the United States have congenital heart lesions. Some abnormalities are severe […]

Chapter 15: Diseases of the Peripheral Vasculature

Introduction Peripheral vascular disease is an umbrella term that includes a number of diverse pathologic entities that affect arteries, veins, and lymphatics. Although this terminology makes a distinction between the “central” coronary and “peripheral” systemic vessels, the vasculature as a whole comprises a dynamic, integrated, and multifunctional organ system that does not naturally comply with […]

Chapter 14: Diseases of the Pericardium

Introduction Diseases of the pericardium form a spectrum that ranges from benign, self-limited pericarditis to life-threatening cardiac tamponade. The clinical manifestations of these disorders and the approaches to their management can be predicted from an understanding of pericardial anatomy and pathophysiology, as presented in this chapter. Anatomy and Function The pericardium is a two-layered sac […]

Chapter 13: Hypertension

Introduction Approximately 60 million Americans, and 1 billion people throughout the world, have hypertension—a blood pressure high enough to be a danger to their well-being. This number will undoubtedly rise; data from the Framingham Heart Study indicate that 90% of people over age 55 will develop hypertension during their lifetimes. Thus, this condition represents a […]

Chapter 12: Clinical Aspects of Cardiac Arrhythmias

Introduction Chapter 11 presented the mechanisms by which abnormal heart rhythms develop. This chapter describes how to recognize and treat such disorders. Table 12.1 categorizes the common arrhythmias considered in this chapter. Table 12.1.Common Arrhythmias Location Bradyarrhythmias Tachyarrhythmias SA node    Sinus bradycardia  Sick sinus syndrome Sinus tachycardia Atria    Atrial premature beats  Atrial flutter […]

Chapter 11: Mechanisms of Cardiac Arrhythmias

Introduction Normal cardiac function relies on the flow of electric impulses through the heart in an exquisitely coordinated fashion. Abnormalities of the electric rhythm are known as arrhythmias (also termed dysrhythmias) and are among the most common clinical problems encountered. The presentations of arrhythmias range from common benign palpitations to very severe symptoms of low […]

Chapter 10: The Cardiomyopathies

Introduction The cardiomyopathies are a group of heart disorders in which the major structural abnormality is limited to the myocardium. These conditions often result in symptoms of heart failure, and although the underlying cause of myocardial dysfunction can sometimes be identified, the etiology frequently remains unknown. Excluded from the classification of this group of diseases […]

Chapter 9: Heart Failure

Introduction The heart normally accepts blood at low filling pressures during diastole and then propels it forward at higher pressures in systole. Heart failure is present when the heart is unable to pump blood forward at a sufficient rate to meet the metabolic demands of the body (forward failure), or is able to do so […]

Chapter 8: Valvular Heart Disease

Introduction This chapter describes the pathophysiologic abnormalities in patients with common valvular heart diseases. Each of the conditions is discussed separately because unifying principles do not govern the behavior of all stenotic or regurgitant valves. Effective patient management requires accurate identification of the valvular lesion, a determination of its severity, and a clear understanding of […]