Rutherford - Unstable Angina (Fundamental and Clinical Cardiology)
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Unstable Angina (Fundamental and Clinical Cardiology)
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Explores the pathology and pathophysiology of the coronary artery lesions associated with unstable angina pectoris, and broadly outlines various methods of evaluating and risk-stratifying patients, and the medical therapies available, such as nitrates, beta blockers, calcium antagonists, antiplatele
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Cardiovascular Division Department of Medicine Harvard Medical School and Brigham and Women's Hospital Boston, Massachusetts
1. Drug Treatment of Hyperlipidemia, edited by Basil M. Rifkind
2. Cardiotonic Drugs: A Clinical Review: Second Edition, Revised and Expanded, edited by Carl V. Leier
3. Complications of Coronary Angioplasty, edited by Alexander J. R. Black, H. Vernon Anderson, and Stephen G. Ellis
4. Unstable Angina, edited by John D. Rutherford
Additional Volumes in Preparation
Beta-Blockers in the Management of Cardiac Arrhythmia, edited by Prakash C. Deedwania
Exercise and the Heart in Health and Cardiac Disease, edited by Roy Shephard and Henry S. Miller, Jr.
Cardiopulmonary Physiology in Critical Care, edited by Steven M. Scharf
Adjunctive Therapy for Acute Myocardial Infarction, edited by Eric Bates
Page i
Unstable Angina
Edited by John D. Rutherford
Brigham and Women's Hospital Harvard Medical School Boston, Massachusetts
Page ii
ISBN 0-8247-8618-1
This book is printed on acid-free paper.
Copyright 1992 by MARCEL DEKKER. INC. All Rights Reserved
Neither this book nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage and retrieval system, without permission in writing from the publisher.
MARCEL DEKKER. INC. 270 Madison Avenue, New York, New York 10016
John D. Rutherford, M.B., Ch.B., has edited a comprehensive book on unstable angina for this new series of books on Fundamental and Clinical Cardiology. Dr. Rutherford had assembled the talents of world-renowned authorities to discuss the most contemporary aspects of important cardiovascular topics. His book is divided into initial chapters on pathophysiology, middle chapters on practical management aspects of unstable angina, and concluding chapters on areas of continuing controversy. As a practicing cardiologist, I have long sought a book such as this one to aid me in making day-to-day patient management decisions as well as broaden my understanding of underlying pathophysiologic principles. This beautifully produced book will enhance patient care and belongs on the bookshelves of medical libraries and in the offices of cardiologists, internists, family practitioners, cardiac surgeons, and other practitioners who must deal with the challenging issues that arise in patients with unstable angina.
Marcel Dekker, Inc., has done a service by helping to integrate rapidly advancing information for the clinician and clinical researcher. I extend my heartiest congratulations to Dr. Rutherford for the editing of this book and to Marcel Dekker for placing it on the "publication fast track" so that its contents will be timely and topical.
SAMUEL Z. GOLDHABER, M.D.
Page v
Foreword
Atherosclerotic coronary artery disease is by far the most common cause of death and a frequent cause of hospitalization and disability in the industrialized world. This form of heart disease encompasses a wide clinical-pathologic spectrum, each end of which has been well defined. At one end of the spectrum are patients with acute myocardial infarction, who now most often are treated with thrombolytic therapy and require mechanical revascularization only occasionally. At the other end are patients with chronic stable angina who usually have atherosclerotic plaques that greatly narrow their epicardial coronary vessels. While these patients often respond to medical measures, when unresponsive they require mechanical revascularization.
Between these two ends of the clinical-pathologic spectrum lie a third group of patients, probably larger than either of the other two: those with unstable angina. This is a common disorder, responsible for some three-quarters of a million hospital admissions in the United States each year. Thus, unstable angina is among the most frequent diagnoses in hospitalized patients in this country at present. It is a serious condition; almost 100,000 patients each year develop acute myocardial infarction within 1 month after the onset of unstable angina. After recovery from the unstable episode, many of the remainder are left with severe chronic stable angina. A group of patients with unstable angina that appears to have a particularly poor prognosis are those who develop this condition shortly after experiencing acute myocardial infarction.
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