Index
A
Aneurysms
aortic dissection, 194 -195
Angina pectoris, stable, 106 , 107 -108
nonsurgical treatment, 108 -109, 111 -112
prognosis, 108
surgery for, 109 -111
Angina pectoris, unstable, 106 , 112
diagnosis, 112 -113
prognosis, 113 -114
treatment, 113
Angiocardiography, 43
digital subtraction, 43 -45
to evaluate coronary-artery disease, 104 , 105
Angioplasty. See Coronary angioplasty
Aorta
coarctation of, 163 , 171 -172, 192
Aortic insufficiency. See Regurgitation, aortic
Aortic stenosis, 130 , 137 -139, 146 , 174
coarctation of aorta, 163 , 171 -172
complications, 139
diagnosis, 139
sudden death from, 90
surgery for, 139 -140
syncope and, 92
treatment, 139
See also Aortic valve; Stenosis
bicuspid valve, 174
See also Aortic stenosis; Semilunar valves
atrial, 73
escape rhythms, 72
mechanism of, 72 -76
myocardial infarction and, 117
preexcitation, 87 -88
significance of, 79 -80
sinus arrhythmias, 72
treatment, 56 -58
—evaluation of, 83 -84
—See also Atrial fibrillation
Bradycardia
Heart block
Tachycardia
Ventricular fibrillation
Atherosclerosis, 96
of arteries, 54
See also Coronary-artery disease
Atherosclerotic plaque, 97
cholesterol and, 99
coronary reserve and, 101
rupture of, 97 -98
Atresia
pulmonary, 172
tricuspid, 172 -173
Atrial fibrillation, 73 , 75 -76, 80 -81, 95
Atrial septal defect, 163 -165, 164
Atrioventricular dissociation, 78 -79
Atrioventricular valves, 7 , 7
B
Balloon angioplasty. See Coronary angioplasty
Balloon pumping, intraaortic. See Intraaortic balloon pumping
Balloon valvuloplasty, 54 -55, 140
Basal metabolism, 23
Beta-adrenergic blocking agents, 108 -109
Birth defects. See Congenital malformations
Blood
circulation. See Circulatory system
mixing, in congenital heart disease, 161 -163, 172
Blood flow volume. See Cardiac output
cardiac output and, 18
kidneys' role in, 176 -177
normal (in adults), 18
pulmonary circulation and, 21
regulation of, 18 -20, 19 , 175 -176
systemic circulation and, 20 -21
See also Hypertension
lymphatic system, 12
structure, 11 -12
veins, 9
treatment for, 87
See also Arrhythmias
Bundle-branch block, 78
C
Calcium channel blocking agents, 109
function, 22
Cardiac arrest, 76 , 80 , 83 , 90 -91
Cardiac catheterization, 40 -43, 42
Cardiac conduction, 13 -15, 14
atrioventricular dissociation, 78 -79
reentry, 74 -75
Cardiac conduction system
sinoatrial node (S-A node), 13 , 14 -15
Cardiac cycle, 16 -17
Cardiac output, 18 -20
Cardiomyopathy, 151 -152
complications, 153
restrictive, 154 -155
Cardiopulmonary resuscitation (CPR), 124
CAT scan. See Computed axial tomography
Chest pain, 27
from angina pectoris, 107 , 112
from aortic dissection, 195
cardiovascular causes, 94 -95
from myocardial infarction, 115 , 195
from myocardial ischemia, 101
noncardiac causes, 95
Cholesterol, 98 -99
Circulatory system, 1 -3, 2 , 19 , 19
blood mixing in, 161 -163, 172
cardiovascular shunts, 162 -163
fetal circulation, 160 -161, 161
pulmonary circulation, 1 -2, 2 , 10 -11, 11 , 21 , 185
systemic circulation, 1 , 2 , 2 , 8
Computed axial tomography (CAT scan), 40
Congenital heart disease, 26 -27, 43
Congenital malformations, 7 , 63 -64, 159 -160
atrial septal defect, 163 -165, 164
coarction of aorta, 163 , 171 -172
complete heart block, 86
Ebstein's anomaly, 173 -174
patent ductus arteriosus, 168 -169
preexcitation arrhythmias and, 87 -88
pulmonary atresia, 172
pulmonary hypertension and, 188 , 191
pulmonary stenosis, 169 -170, 174
single ventricle, 174
tetralogy of Fallot, 170 -171
total anomalous venous return, 173
transposition of the great arteries, 172 , 173
tricuspid atresia, 172 -173
truncus arteriosus, 174
valve abnormalities, 174
valvular stenosis, 163
ventricular septal defect, 166 , 166 -168, 172
Coronary angioplasty, 54 -55, 55 , 109 , 121
Coronary arteriography, 43
Coronary-artery disease, 96 -97
acute syndromes, 106
asymptomatic, 106 -107
atherosclerosis and, 96
chronic pump failure and, 124 -125
chronic syndromes, 106
complications, 142 -143
consequences of, 97
incidence of, 98
predictors, 99
risk factors, 99 -100
sudden death from, 90 , 106 , 123 -124
treatment, 100
See also Myocardial ischemia
Coronary atherosclerosis. See Coronary-artery disease
Coronary reserve, 101 -102
Cor pulmonale, 190
acute, 189
CPR. See Cardiopulmonary resuscitation
Cyanosis, 161 -162, 163 , 170 -171
D
Death, sudden, 89 -90
coronary-artery disease and, 90 , 106 , 123 -124
from myocardial infarction, 116
Defibrillation, electric, 57 , 91
Diagnostic imaging, 40
Diagnostic indicators, 26 -28, 29 -30
Diagnostic tests, 26 -46
interpreting results, 45 -46
invasive tests, 40 -46
noninvasive tests, 30 -40
physical examination, 28 -30
See also names of specific diagnostic tests or techniques
Diastolic overload. See Volume overload
Diet
coronary-artery disease and, 98 , 100
after myocardial infarction, 123
Diuretics, 51 , 53 , 69 , 70 , 136See also Fluid retention
Down's syndrome, 159
Dressler syndrome, 157
Drugs, 49
administration of, 50 -51
antianginal drugs, 52
antiarrhythmic drugs, 52
anticoagulants, 52 , 136 , 189
anti-heart failure, 52
antihypertensive drugs, 52 , 183
antithrombotic, 52 , 115 , 121 , 189
beta-adrenergic blocking agents, 51 , 108 -109, 154
calcium channel blocking agents, 52 , 109 , 154
diuretics, 51 , 53 , 69 , 70 , 136
to enhance cardiac contraction, 51 , 69
interactions, 50
lipid-lowering, 52
nitroglycerin, 52 , 107 , 109 , 115
pacing studies of, 83 -84
procaineamid, 52
propranolol, 51
quinidine, 52
to reduce serum cholesterol, 100
to reduce workload, 69 -70
risk-benefit relationship, 53
side effects, 49
thrombolytic, 52 , 115 , 121 , 189
in acute myocarditis, 151
in mitral stenosis, 134 -135
E
Echocardiography, 34 -38, 151 , 157
doppler, 37
transesophageal, 37
Electric countershock. See Cardioversion; Defibrillation, electric
Electrocardiography, 30 -33, 31 , 73
Electrophysiological study, for diagnosis, 45
Emboli, in systemic circulation, 118
Embolism, pulmonary, 188 -189
cor pulmonale, acute, 189
pulmonary infarct, 189
Emergencies, cardiac, 89
Endocarditis, infective, 143 , 145 , 146 -149, 154 , 167
Exercise
circulation and, 24 -25
oxygen consumption and, 22 -24
See also Workload
F
Familial hyperlipidemia, 99
Fibrillation. See Arrhythmias; Atrial fibrillation; Defibrillation, electric; Ventricular fibrillation
ascites, 65
heart failure and, 65 , 66 -67, 67
pleural effusion, 65
See also Diuretics
Flutter, 75
atrial, treatment, 81
G
Greater circulation. See Systemic circulation
H
Heart
atrioventricular valves, 7 ,7
semilunar valves, 5 , 6 , 8 , 16 -17
Heartbeat, 71
echo beats, 75
ectopic beats, 72 -73, 73 , 74 , 82
escape beats, 72
Heart block, 76 -78, 77 , 85 -86
complete, 86 -87
myocardial infarction and, 118
acute, 67 -68
from acute myocarditis, 151
chronic, 68
dyspnea and, 65 -66
fluid retention and, 66 -67, 67
mitral regurgitation and, 143
myocardial infarction and, 117
treatment, 68 -70
Heart murmurs, 29 , 163 , 167 , 169
Heart transplants. See Transplantation, cardiac
Hemodynamic monitoring, 42 -43
Hemorrhage
from aortic dissection, 195
pulmonary, mitral stenosis and, 135
subintimal, 98
Holter monitor test, 32 -33, 83 , 102 , 103 -104
Hypertension, 99 , 100 -101, 175 , 178
aortic dissection and, 194
causes, 177 -178
coarctation of the aorta and, 171 -172
diagnosis, 178 -179
drug therapy for, 179 -180, 183 -184
effects of, 180
hypertensive encephalopathy, 181
prognosis, 180 -181
severity categories, 179
treatment, 182 -184
See also Blood pressure
Hypertension, pulmonary, 165 , 185 -188, 191
arteriolar spasm, 188
hyperkinetic, 186 -187
mitral stenosis and, 135 -136
passive, 186
primary, 190 -191
Hypertensive encephalopathy, 181
Hypertrophy, 63
in cardiomyopathy, 90 , 153 -154
Hypotension, myocardial infarction and, 117
I
Infection, respiratory, mitral stenosis and, 135
Intraaortic balloon pumping, 56 , 57
Ischemia
myocardial. See Myocardial ischemia
silent, 106 -107
Ischemic heart disease. See Coronary-artery disease
Isotopic perfusion imaging, 38 -39, 39
for myocardial ischemia, 102 , 104 , 106
K
Kidneys
blood pressure role, 176 -177
heart failure effect on, 65
L
Lesser circulation. See Pulmonary circulation
Lipoproteins, coronary-artery disease and, 98
Lymphatic system, 12
M
Magnetic resonance imaging, 40
marfan's syndrome, 193
Medications. See Drugs
Mitral insufficiency. See Regurgitation, mitral
Mitral stenosis, 129 , 129 -130, 134 , 146
atrial fibrillation and, 81
complications, 135 -136
diagnosis, 135
dyspnea in, 134 -135
progression of, 134
pulmonary hypertension and, 191
respiratory infection and, 135
rheumatic fever and, 133 -134
treatment, 135
See also Mitral valve; Stenosis
congenital clefts, 143
prolapse, 141 -142
regurgitation, 118 , 130 -131, 140 -143, 154
See also Mitral stenosis
Myocardial contraction. See Heart contraction
Myocardial infarction, 95 , 114
cardiogenic shock and, 94
electrocardiographic indicators, 103
infarct size increase, 117
patient management for, 120 -123
prognosis, 114 -115, 116 -117, 122 -123
subendocardial infarction, 115
symptoms, 115 -116
transmural infarction, 115 , 120
treatment, 120 -123
Myocardial ischemia, 94 -95, 101 -102, 105 , 150
See also Coronary-artery disease
Myocardial isotopic perfusion imaging.
See Isotopic perfusion imaging
Myocarditis, acute, 150 -151
N
Nitroglycerin, 52 , 107 , 109 , 115
Nuclear cardiology, 38
Nuclear ventriculography, 38 , 39 -40
left ventriculography, 43 , 44
O
Oxygen consumption, 22 -24
P
malfunction of, 86
Pacemakers, electronic, 55 -56, 87 , 91
pacing overdrive technique, 58
Patent ductus arteriosus, 168 -169
Patient management, 48 -49
after myocardial infarction, 120 -123
Percutaneous transluminal coronary angioplasty (PTCA). See Coronary angioplasty
Pericardial effusion, 155 , 157
Pericardial tamponade, 94 , 156
Pericarditis, 118
chronic constrictive, 157 -158
purulent, 158
tuberculous, 157
viral, 151
Pericarditispostradiation, 157 , 158
Physical examinations, 26 , 28 -30
Pressure overload, 63
Preventive cardiology, 48
Procaineamid, 52
Propranolol, 51
PTCA (percutaneous transluminal coronary angioplasty). See Coronary angioplasty
Pulmonary circulation, 1 -2, 2 , 10 -11, 11 , 21 , 185
Pulmonary congestion, 64
Pulmonary hypertension. See Hypertension, pulmonary
Pulmonary valve, 5 - 6. See also Semilunar valves
Pump failure, chronic, 106 , 124 -125
Pumping, intraaortic balloon, 56 , 57
Q
Quinidine, 52
R
Radiation therapy, pericarditis and, 157 , 158
angiocardiography, 43
Regurgitation, 126 -127
Regurgitation, aortic, 131 , 143 -145, 193
causes, 143 -144
complications, 145
diagnosis, 144
prognosis, 144 -145
Regurgitation, mitral, 118 , 130 -131, 140 , 143 , 191
causes, 140 -141
in hypertrophic cardiomyopathy, 154
infective endocarditis and, 143
ischemic, 142 -143
rheumatic, 141
Regurgitation, pulmonary, 145
Rheumatic fever, 127 -128
aortic regurgitation and, 144
mitral stenosis and, 133 -134
Rupture
of chordae tendineae, 142
of ventricular septum, 118
S
Semilunar valves, 5 , 6 , 16 -17
See also Aortic valve
Pulmonary valve
Shock, 93 -94
myocardial infarction and, 94 , 117
noncardiac causes, 94
syncope and, 93 -94
Shortness of breath. See Dyspnea
Sick-sinus syndrome, 86
Silent ischemia, 106 -107
congenital defects and, 160
congenital valvular, 163 , 174
in coronary arteries, 97
See also Aortic stenosis
Mitral stenosis
Stokes-Adams attack. See Syncope
Strokes, embolic, 135
Surgery
aortic commisurotomy, 139
aortic-valve replacement, 139 -140
artificial hearts, 61
blood clot removal, 189
cardiac transplantation, 61 , 70 , 125 , 153
cardiopulmonary bypass, 59 , 60
closure of atrial septal defect, 165
for congenital malformations, 169 , 171 , 172
coronary bypass, 59 -60, 109 -111, 110 , 111
for hypertrophic myocardiopathy, 154
for mitral stenosis, 131 , 136 -137
resection of the aorta, 194 , 195
for valvular diseases, 131 , 133
Symptoms, of heart disease, 26 -28. See also names of specific symptoms
abnormal reflexes and, 92
aortic stenosis and, 92
presyncopal attacks, 92
prognosis, 93
shock and, 93 -94
Systemic circulation, 1 , 2 , 2 , 8
blood pressure and, 20 -21
Systolic overload. See Pressure overload
T
ectopic, 73
paroxysmal atrial, 80 , 83 , 95
supraventricular, 80 , 83 , 95
See also Arrhythmias
Tetralogy of Fallot, 170 -171
Thallium perfusion imaging, 38 -39, 39 .
See also Isotopic perfusion imaging
Therapy. See Treatment
Thrombosis, 188 -189
coronary, 98
mitral stenosis and, 135
preventive treatment, 100
Transplantation, cardiac, 61 , 70 , 125 , 153
Treadmill stress test, 32 , 102 -103
Treatment, 47
balloon valvuloplasty, 54 -55
cardioversion, 58
coronary angioplasty, 54 -55, 55
electric defibrillation, 57
exercise, 49
of heart failure, 68 -70
interventional therapy, 53 -54
intraaortic balloon pumping, 56 , 57
pacing overdrive, 58
patient life-style, 48 -49, 122
risk-benefit relationship, 47 -48, 84
surgical therapies, 59 -61
Ebstein's anomaly, 173 -174
regurgitation, 145 -146
stenosis, 145
Triglycerides, as predictors of coronary-artery disease, 99
Tumors, cardiac, 143
V
Valves, 126
aortic valve, 130
diseases, 126 -144
insufficiency. See Regurgitation
mitral valve, 129
prosthetic, inffective endocarditis and, 149
regurgitation, 126 -127
See also Aortic valve
Mitral valve
Stenosis
Valvular diseases, surgery for, 131 , 133
Veins, 9
Ventricular fibrillation, 57 , 74 , 80 , 83
electric countershock and, 91
treatment, 85 ,
See also Arrhythmias
Ventricular septal defect, 166 , 166 -168
Ventricular standstill, 86
sudden death from, 90
Verapamil, 52
Volume overload, 63 -64
W
Wolff-Parkinson-White syndrome, 87 -88
Workload, 62 -63
external, 24 -25
hypertrophy and, 63
myocardial oxygen demand and, 101
pressure overload, 63
pulmonary circulation disturbances and, 185
valvular disease effect on, 131
volume overload, 63
See also Exercise
X
X rays. See Radiation therapy
Radiography