Coronary care, 2nd edition

Coronary care, 2nd edition

International Journal of cardiology ELSEVIER International Journal of Cardiology 53 (1996) 193 Book review corollary care, 2nd Edltlon G.S. Fran...

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cardiology ELSEVIER

International Journal of Cardiology 53 (1996) 193

Book review

corollary care, 2nd Edltlon G.S. Francis, J.S. Alpert (Editors) Churchill Livingstone, Edinburgh, UK, 1995; 805 pp.; st&95.00, ISBN O-316-29161-7 Over 70 authors have contributed to this multiauthor textbook covering all aspectsof myocardial infarction and coronary care now in its secondedition. Each chapter is well set out and referenced. The book is much more comprehensive than its title would suggest. It deals in detail with the pathophysiology of myocardial infarction and the biochemical changes resulting from it. There follow sections on management, complications, special procedures, therapeutic interventions, follow-up, rehabilitation and risk stratification. Finally there is a section on CCU administration and ethical issues. Inevitably in a book with many authors there is a degreeof repetition. Thombolysis is discussedin three chapters with streptokinase and r-tPA getting a chapter each, but only one clearly sets out the contra-indications. There is a very detailed section on mechanical support for the failing circulation. The intra-aortic balloon pump is well discussedbut there is no mention of which patients should be balloon pumped.

One of the most important current issues in myocardial infarction is that of primary angioplasty and its possible benefits over conventional thrombolysis. Unfortunately this topic is dealt with in a chapter of only two pages.The section on the treatment of ventricular arrhythmias in acute myocardial infarction did not contain a single ECG, and hardly any mention of possible proarrhythmic effects of anti-arrhythmic drugs. Qunidine, a drug virtually abandoned in the UK becauseof its pro-arrhythmic effects,gets far more coverage than Amiodarone, a valuable drug in ventricular arrhythmias in the coronary care setting which is not discussedat all. It would have been helpful for the trainee cardiologist or cardiac nurse specialist using this book to have a chapter on ECG changes in myocardial infarction. Although cardiac enzymes are discussedat length, diagnosis from the ECG is not covered at all. The editors acknowledge this in the preface but it is still a vital part of coronary care - the book’s title. Although the book is packed with detail, much of the practical information needed by the cororary care physician is difficult to find. This book must alas be regarded as a luxury rather than a necessity in a cardiac department’s library.

016%5273i96M5.00 0 1996Elsevier Science Ireland Ltd. All rights reserved SSDI 0167-5273(95)02530-A