We, the editors of rhe third edition of The Washington Manual™ Cardiology Subspe-cialty Consult, wish to [hank you for choosing our book as worthy of your time to learn about cardiovascular diseases. There are many excellent resources available to learners, but we hope chat as you navigate through these pages, you discover the passion that our authors have harnessed to create this up-to-date and clinically impactful portable text.
We specifically wish co thank the editor of the first edition, Dr. Perer Crawford, who planted the seeds of high-level intellect and compassionate tutelage from which this edition grows. We are most indebted to rhe marvelous effort of those who contributed to the current edition: house staff, fellows, and attending physicians alike. While we expected excellence from our authors, we were overwhelmed by the high quality of information and clear passion for teaching found in each chapter.
Every chapter of the third edition has been written by a pair of authots: one cardiovascular fellow and one cardiovascular or pulmonary clinician-educator. This pairing embodies the overriding theme of this edition; front-line, middle-of-the-nigh[ synthesis and application of up-to-date guidelines, seasoned with expert clinical experience. As with previous editions, we deliberately stress the most useful information as it relates to the patient's diagnosis and treatment with mnemonics, bullet-point lists, bold-faced clinical pearls, and easy-to-read figures. To keep rhe text thin enough to be portable, guidelines from the American Heart Association and American College of Cardiology are emphasized with journal and online references ar the end of each chaptet. We strongly encourage reading these current pracrice recommendations as well as peer-reviewed journals, review articles, and primary textbooks to supplement the material in this handbook.
We are particularly proud of the deprh of the specialties in this edition. For example, in an effort ro restore the lost arc of the cardiovascular physical exam, we asked one of our most gifted master clinicians to author a dedicated chapter on this topic. Additionally, the clinical impact of heart failure with preserved ejection fraction, or diastolic heart failure, has inspired a new chapter for this edition. The continued importance of individualization of medicine inspired dedicated chapters on cardiovascular diseases in elderly populations and in women specifically. These new chapters are coupled wirh a simplified reorganization of the book, grouping chapters together in rhe most logical ways.
Now more than ever, it is a thrilling time to be interested in cardiovascular disease. Discovery is happening at a rapid pace, and translating these new discoveries to the patient's bedside happens quickly. More so than decades pasr, there is a strong interest in providing cost-effective evidence-based cardiology. This process requires a continuous synthesis and evaluation of the most recent clinical trials into daily pracrice while maintaining diagnostic skills that are at the center of cardiovascular disease management. It is our hope that both the information and rhe enthusiasm contained in the chapters that follow provide you with the means to meet these challenges and with it become a better teacher, a better learner, and a better physician. —PSC & AMK

American College of Cardiology/American Heart Association Clinical Practice Guidelines vi

Con tributing Authors vii

Chairman's Note xii

Foreword xiii

Preface xiv

1.Approach to the Cardiovascular Consult 1

Andrew M. Kates

2.Cardiovascular Physical Examination 3

Justin M. Vader and Alan N. Weiss

3.Basic Electrocardiography 16

Phillip S. Cuculich and John Verbsky

4.Evaluation of Acute Chest Pain 24

Christopher L. Holley

5.Evaluation of Acute Heart Failure 31

Kory J, Lavine and Joel D. Schilling

6.Approach to Syncope 40

Christopher L. Holley, Daniel H. Cooper, and Scott M. Nordlicht

7.Cardiovascular Emergencies 49

Sara C. Martinez and Phillip S, Cuculich

8.Procedures in Cardiovascular Critical Care 63

C. Huie Lin and Alan Zajarias

9.The Cardiac Patient Undergoing Noncardiac Surgery 79

Corey G. Foster and Lynne M. Seacord

10.Stable Angina 86

Sara C. Martinez and David B. Schwartz

11.Acute Coronary Syndromes 99

Jeremiah P. Depta and Richard G. Bach

12.Acute ST-Segment Elevation Myocardial Infarction 117

Michael Yeung, Sudeshna Banerjee, and Howard I. Kurz

13.Primary and Secondary Prevention of Cardiovascular Disease 133

Kristen Scott-Tillery, Mohammad All Kizilbash, and Andrew M. Kates

14.Evaluation and Management of Systolic Heart Failure 149

Shane J. LaRue and Susan M. Joseph

15.Evaluation and Management of Heart Failure with Preserved Ejection Fraction (Diastolic Heart Failure) 167

Ashwin Ravichandran and Gregory A. Ewald

16.Hypertrophic Cardiomyopathy 177

Shimoli Shah and Keith Mankowitz

17.Diseases of the Pericardium 183

Jeremiah P. Depta and Craig K. Reiss

18.Pulmonary Hypertension: Pulmonary Arterial Hypertension and Right Heart Failure 202

Mohammed Hadi and Murali M. Chakinala

19.Aortic Valve Disease 216

Suzanne V, Arnold and Brian R. Lindman

20.Mitral Valve Disease 230

William J. Nienaber and Jose A. Madrazo

21.Tricuspid Valve Disease 247

William J. Nienaber and Jose A. Madrazo

22.Infective Endocarditis and Cardiac Devices 251

Risa M. Cohen and Pablo F. Soto

23.Advanced Electrocardiography: ECG 201 273

Shivak Sharma and Timothy W. Smith

24.Bradyarrhythmias and Permanent Pacemakers 288

Derrick R. Fansler and Jane Chen

25.Sudden Cardiac Death 301

Marye J. Gleva and Jefferson Lee

26.Atrial Fibrillation 314

Thomas K. Kurian and Mitchell N. Faddis

27.QT Syndromes 327

Andrew J. Krainik and Preben Bjerregaard

28.Peripheral Arterial Disease 338

C. Huie Lin and Jasvindar Singh

29.Diseases of the Aorta 352

Jay Shah and Alan C. Braverman

30.Standard Imaging and Diagnostic Testing Modalities:Nuclear Cardiology 369

Chirayu Gor and Sudhir K. Jain

31.Echocardiography 381

Majesh Makan and Mohammed Saghir

32.Cardiac Computed Tomography and Magnetic Resonance Imaging 389

Mohammed Saghir and Ravi RasalingaM

33.Positron Emission Tomography 398

JiafU OU and Robert J. GropLer

34.Coronary Angiography, Intravascular Ultrasound, and Intracardiac Echocardiography 404

ALok BacHUwar and John m. Lasala

35.Adult Congenital Heart Disease 416

Elisa A. Bradley and Ari M. Cedars

36.Cardiovascular Disease in Older Patients 449

Michael W. Rich

37.Diabetes and Cardiovascular Disease 460

Ilia G. Halatchev and Ronald J. Krone

38.Cardiovascular Disease in Special Populations 467

Angela L Brown and Jeffrey M.C. Lau

Index 486

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