哈里森心血管病学

章节摘录

版权页：   插图：   Patients with exertional dyspnea should be asked to walk under observation in order to reproduce the symptoms.The patient should be examined for new findings that were not present at rest and for oxygen saturation.A "picture" of the patient while symptomatic may be worth thousands of dollars in laboratory tests. Following the history and physical examination,a chest radiograph should be obtained.The lung volumes should be assessed (hyperinflation indicates obstructive lung disease,low lung volumes suggest interstitial edema or fibrosis,diaphragmatic dysfunction,or impaired chest wall motion).The pulmonary parenchyma should be examined for evidence of interstitial disease and emphysema.Prominent pulmonary vasculature in the upper zones indicates pulmonary venous hypertension,while enlarged central pulmonary arteries suggest pulmonary artery hypertension.An enlarged cardiac silhouette suggests a dilated cardiomyopathy or valvular disease.Bilateral pleural effusions are typical of congestive heart failure and some forms of collagen vascular disease.Unilateral effusions raise the specter of carcinoma and pulmonary embolism but may also occur in heart failure.Computed tomography (CT) of the chest is generally reserved for further evaluation of the lungparenchyma (interstitial lung disease) and possible pulmonary embolism. Laboratory studies should include an electrocardiogram to look for evidence of ventricular hypertrophy and prior myocardial infarction.Echocardiography is indicated in patients in whom systolic dysfunction,pulmonary hypertension,or valvular heart disease is suspected. DISTINGUISHING CARDIOVASCULAR FROM RESPIRATORYSYSTEM DYSPNEA If a patient has evidence of both pulmonary and cardiac disease,a cardiopulmonary exercise test should be carried out to determine which system is responsible for the exercise limitation.If,at peak exercise,the patient achieves predicted maximal ventilation,demonstrates an increase in dead space or hypoxemia (oxygen saturation below 90%),or develops bronchospasm,the respiratory system is probably the cause of the problem.Alternatively,if the heart rate is >85% of the predicted maximum,if anaerobic threshold occurs early,if the blood pressure becomes excessively high or drops during exercise,if the O2 pulse (O2 consumption/heart rate,an indicator of stroke volume) falls,or if there are ischemic changes on the electrocardiogram,an abnormality of the cardiovascular system is likely the explanation for the breathing discomfort.

内容概要

作者：（美国）洛斯卡奥（Joseph Loscalzo）

书籍目录

ContributorsPreface    SECTION I INTRODUCTION TO CARDIOVASCULAR DISORDERS1 Basic Biology of the Cardiovascular System2 Epidemiology of Cardiovascular Disease3  Approach to the Patient with Possible    SECTION II DIAGNOSIS OF CARDIOVASCULAR DISORDERS4 Chest Discomfort5 Dyspnea and Pulmonary Edema6 Hypoxia and Cyanosis7 Edema8 Palpitations9 Physical Examination of the Cardiovascular System10 Approach to the Patient with a Heart Murmur11 Electrocardiography12 Noninvasive Cardiac Imaging: Echocardiography,Nuclear Cardiology, and MP,I/CT Imaging13 Diagnostic Cardiac Catheterization and Angiography    SECTION III HEART RHYTHM DISTURBANCES14 Principles ofElectrophysiology15 The Bradyarrhythmias16 The Tachyarrhythmias    SECTION IV DISORDERS OF THE HEART17 Heart Failure and Cor Pulmonale18 Cardiac Transplantation and Prolonged Assisted Circulation19 Congenital Heart Disease in the Adult20 Valvular Heart Disease21 Cardiomyopathy and Myocarditis22 Pericardial Disease23 Tumors and Trauma of the Heart24 Cardiac Manifestations of Systemic Disease25 Infective Endocarditis26 Acute Rheumatic Fever27 Chagas' Disease28 Cardiogenic Shock and Pulmonary Edema29 Cardiovascular Collapse, Cardiac Arrest, and Sudden Cardiac Death    SECTION V DISORDERS OF THE VASCULATURE30 The Pathogenesis, Prevention, and31 Disorders of Lipoprotein Metabolism32 The Metabolic Syndrome33 Ischemic Heart Disease34 Unstable Angina and Non-ST-Elevation Myocardial Infarction35 ST-Segment Elevation Myocardial Infarction36 Percutaneous Coronary Intervention87 HypertensiveVascular Disease38 Diseases of the Aorta39 Vascular Diseases of the Extremities40 Pulmonary Hypertension    SECTION VI CARDIOVASCULAR ATLASES41 Atlas of Electrocardiography42 Atlas of Noninvasive Cardiac Imaging43 Atlas of Cardiac Arrhythmias 44 Atlas of Percutaneous RevascularizationAppendixReview and Self-AssessmentIndex

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《哈里森心血管病学(英文)》是一部内科学经典名著，享有“内科学著作之父”的美誉。

作者简介

《哈里森心血管病学(英文)》为《哈里森内科学》系列之《哈里森心血管病学》分册，《哈里森心血管病学(英文)》强调基础与临床的整合，汇集了本领域内最新的进展，不但内容具有权威性和先进性，而且语言规范、地道。无论是临床医生、教师还是医学生，有这样一本原版经典专著放在案头，经常翻阅，不但可以获取医学知识，对提高专业外语水平也大有裨益。

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