Table Of Content

Ragavendra R. Baliga Kim A. Eagle Editors Practical Cardiology Evaluation and Treatment of Common Cardiovascular Disorders Third Edition 123 Practical Cardiology Ragavendra R. Baliga • Kim A. Eagle Editors Practical Cardiology Evaluation and Treatment of Common Cardiovascular Disorders Third Edition Editors Ragavendra R. Baliga Kim A. Eagle Division of Cardiovascular Medicine University of Michigan Health System The Ohio State University Wexner Cardiovascular Center Medical Center Ann Arbor, MI Columbus, OH USA USA ISBN 978-3-030-28326-1 ISBN 978-3-030-28328-5 (eBook) https://doi.org/10.1007/978-3-030-28328-5 © Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Contents 1 Chest Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Sharon Roble 2 Dyspnea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Fernando J. Martinez, Mei Lan K. Han, and Keith D. Aaronson 3 Palpitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Ruchika D. Husa 4 Edema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Mashhood A. Kakroo, Peter V. Vaitkevicius, and Ragavendra R. Baliga 5 Syncope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Ragavendra R. Baliga, Michael Lehmann, and Ruchika D. Husa 6 Primary Prevention of Coronary Artery Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Kavita Sharma, Melvyn Rubenfire, and Eric R. Bates 7 Secondary Prevention of Coronary Artery Disease . . . . . . . . . . . . . . . . . . . . . . . . . 75 Kavita Sharma, Claire Duvernoy, and Melvyn Rubenfire 8 Stable Angina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Sharon Roble 9 Unstable Angina/Non-ST Elevation Myocardial Infarction . . . . . . . . . . . . . . . . . . 99 Jason Evanchan 10 Acute ST Elevation Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111 Satya Shreenivas and Scott Lilly 11 Primary Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125 Kenneth A. Jamerson 12 Approach to Secondary Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 J. Brian Byrd, John D. Bisognano, and Robert D. Brook 13 Heart Failure due to Left Ventricular Systolic Dysfunction . . . . . . . . . . . . . . . . . .149 Brent C. Lampert, David B. S. Dyke, and Todd M. Koelling 14 Paroxysmal Supraventricular Tachycardia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177 Hakan Oral and Fred Morady 15 Atrial Fibrillation and Atrial Flutter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185 Toshimasa Okabe, Aman Chugh, Frank Pelosi Jr, and Fred Morady 16 Ventricular Tachycardia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .197 Frank Bogun and Fred Morady 17 Bradycardia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .213 Eric D. Good and Krit Jongnarangsin v vi Contents 18 Infective Endocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .225 Ragavendra R. Baliga and Sunil K. Das 19 Mitral Regurgitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .245 Jim X. Liu and Viren Patel 20 Aortic Regurgitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .255 Viren Patel and Jim X. Liu 21 Mitral Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .263 Vincent E. Brinkman 22 Aortic Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .271 Anna M. Booher, Michael J. Shea, and G. Michael Deeb 23 Tricuspid/Pulmonary Valve Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .281 Vincent E. Brinkman 24 Acute Pericarditis/Pericardial Effusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .289 Elina Yamada, Mani A. Vannan, and Mauro Moscucci 25 Pericardial Constriction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .297 Elina Yamada, Julie A. Kovach, and Richard L. Prager 26 Abdominal Aortic Aneurysms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .303 Venkataramu Krishnamurthy, David M. Williams, James C. Stanley, Gilbert R. Upchurch Jr, and John E. Rectenwald 27 Acute Aortic Dissection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .323 Anna M. Booher, David M. Williams, Kim Allen Eagle, and G. Michael Deeb 28 Lower Extremity Ischemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .331 Katherine A. Gallagher, John E. Rectenwald, James B. Froehlich, and Peter K. Henke 29 Pulmonary Embolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .349 John G. Weg, Melvyn Rubenfire, and Gbemiga Sofowora 30 Pulmonary Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .365 Veronica Franco 31 Simple Congenital Cardiac Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .379 Timothy B. Cotts and Albert P. Rocchini 32 Complex Congenital Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .395 Timothy B. Cotts 33 Perioperative Evaluation and Management of Patients Undergoing Noncardiac Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .411 Ajay Vallakati, Ragavendra R. Baliga, and Kim Allen Eagle 34 Complementary and Alternative Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .429 Cynthia Thaik, Mauro Moscucci, Sara L. Warber, and Keith D. Aaronson 35 Cardio-Oncology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .447 Elina Yamada Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .453 Contributors Keith D. Aaronson, MD, MS Division of Cardiovascular Medicine, University of Michigan Medical School, Cardiac Transplant Service, Ann Arbor, MI, USA Ragavendra R. Baliga, MD, MBA, FACP, FRCP, FACC Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA Eric R. Bates, MD Division of Cardiovascular Diseases, Department of Internal Medicine, University of Michigan Cardiovascular Center, Ann Arbor, MI, USA John D. Bisognano, MD, PhD Division of Cardiology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA Frank Bogun, MD Division of Cardiovascular Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Anna M. Booher, MD Traverse Heart and Vascular, Traverse City, MI, USA Vincent E. Brinkman, MD The Ohio State University Wexner Medical Center, Columbus, OH, USA Heart and Vascular Center at Memorial Health, Marysville, OH, USA Robert D. Brook, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA J. Brian Byrd, MD Michigan Medicine Cardiology Clinic/Cardiovascular Center, University of Michigan Medical School, Ann Arbor, MI, USA Aman Chugh, MD Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA Timothy B. Cotts, MD Division of Pediatric Cardiology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA Sunil K. Das, MD University of Michigan Health System, Ann Arbor, MI, USA G. Michael Deeb, MD Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Claire Duvernoy, MD VA Ann Arbor Healthcare System, University of Michigan, Ann Arbor, MI, USA David B. S. Dyke, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Kim Allen Eagle, MD Department of Internal Medicine/Cardiovascular Disease, Michigan Medicine, Albion Walter Hewlett Professor of Internal Medicine, Samuel and Jean Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA Jason Evanchan, DO Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center/Heart and Vascular Center, Columbus, OH, USA vii viii Contributors Veronica Franco, MD Division of Cardiovascular Diseases, Co-Director Pulmonary Vascular Disease Program, Section of Advanced Heart Failure and Transplantation, The Ohio State University Wexner Medical Center, Columbus, OH, USA James B. Froehlich, MD, MPH University of Michigan Medical School, Ann Arbor, MI, USA Katherine A. Gallagher, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Eric D. Good, DO Genesys Regional Medical Center, Ann Arbor, MI, USA Mei Lan K. Han, MD Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA Peter K. Henke, MD Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA Cardiovascular Center, Ann Arbor, MI, USA Ruchika D. Husa, MD, MS Heart and Vascular Institute, Denver, CO, USA Kenneth A. Jamerson, MD Michigan Medicine Hypertension Clinic/Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA Krit Jongnarangsin, MD Cardiovascular Center, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Mashhood A. Kakroo, MD Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA Todd M. Koelling, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Julie A. Kovach, MD Department of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH, USA Venkataramu Krishnamurthy, MBBS Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Brent C. Lampert, DO, FACC Division of Cardiovascular Medicine, The Ohio State UniversityWexner Medical Center, Columbus, OH, USA Michael Lehmann, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Scott Lilly, MD, PhD Division of Cardiology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA Jim X. Liu, MD Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA Fernando J. Martinez, MD, MS Division of Pulmonary and Critical Care Medicine, Weill Department of Medicine, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA Fred Morady, MD Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA Mauro Moscucci, MD Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD, USA Toshimasa Okabe, MD Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA Hakan Oral, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Contributors ix Viren Patel, MD Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA Frank Pelosi Jr, MD Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA Richard L. Prager, MD Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, USA John E. Rectenwald, MD Division of Vascular Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA Sharon Roble, MD OhioHealth Heart and Vascular Physicians, Mansfield, OH, USA Albert P. Rocchini, MD Division of Pediatric Cardiology, Department of Pediatrics, C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA Melvyn Rubenfire, MD University of Michigan Hospitals-Michigan Medicine, Ann Arbor, MI, USA Kavita Sharma, MD OhioHealth Heart and Vascular Physicians, Delaware, OH, USA Michael J. Shea, MD Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Satya Shreenivas, MD The Christ Hospital Heart and Vascular Center, Cincinnati, OH, USA Gbemiga Sofowora, MBCHB Division of Cardiovascular Diseases, The Ohio State University Wexner Medical Center, Columbus, OH, USA Stoneridge Medical Services, Dublin, OH, USA James C. Stanley, MD Cardiovascular Center, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Cynthia Thaik, MD Holistic Healing Heart Center, Burbank, CA, USA Gilbert R. Upchurch Jr, MD Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA Peter V. Vaitkevicius, MD Oakwood Medical Center, Internal Medicine/Cardiovascular Disease, Dearborn, MI, USA Ajay Vallakati, MD Division of Cardiovascular Diseases, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA Mani A. Vannan, MBBS, FACC Piedmont Heart Institute, Atlanta, GA, USA Sara L. Warber, MD Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA John G. Weg, MD Department of Internal Medicine, University of Michigan Health Center, Ann Arbor, MI, USA David M. Williams, MD Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Elina Yamada, MD Michigan Medicine Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA Chest Pain 1 Sharon Roble Definition and Scope of Problem cardiogenic shock to relatively “low-risk” unstable angina. The common pathophysiologic process involves myocardial Chest pain can be broadly defined as any discomfort in the oxygen supply-demand mismatch. This can be due to rupture anterior thorax occurring above the epigastrium and below of an atherosclerotic plaque in an epicardial coronary artery the mandible. However, pain of cardiac origin may be felt with resultant platelet aggregation, activation of the coagula- primarily in the arms or jaw regions. Of the 110 million tion cascade, and thrombus formation or progressive narrow- patients who presented to U.S. hospital emergency depart- ing and obstruction to coronary blood flow. Thus, treatment ments in 2004 over six million were for the evaluation of and management strategies are similar. chest pain syndromes [1]. History Principal Causes The history is the most important component of the evalua- The principal causes of chest pain can be grouped as life- tion of chest pain. The history can be documented expedi- threatening and non–life-threatening (Table 1.1). The principal tiously for most patients and will guide further diagnostic life-threatening causes of chest pain include: acute coronary testing. In addition to detailed questioning about the nature syndromes, aortic dissection, pulmonary embolism, and esoph- of the chest pain, the physician should elicit a history of prior ageal perforation. The principal non–life-threatening causes myocardial infarction, coronary revascularization [coronary are stable angina, pericarditis, gastrointestinal reflux disease artery bypass graft (CABG) or percutaneous transluminal (GERD), esophageal spasm, musculoskeletal disorders, valvu- coronary angioplasty (PTCA)], and congestive heart failure lar heart disease, and hypertrophic cardiomyopathy. When the (CHF) symptoms. All patients should be queried about the patient with chest pain arrives in a medical facility, it is the major cardiovascular risk factors [diabetes, smoking, hyper- responsibility of the medical personel to assess the risk and to cholesterolemia, family history of premature coronary artery embark on an apprpriate treatment program. disease (CAD), and hypertension] and for a history or symp- Acute coronary syndromes comprise a broad range of clin- toms of peripheral vascular disease. Illicit drugs such as ical manifestations from acute myocardial infarction with cocaine may cause chest pain and myocardial infarction more commonly in the younger population. All patients should be asked about the associated symptoms of dyspnea, Table 1.1 Principal causes of chest pain diaphoresis, and nausea, as well as the response to nitroglyc- Life-threatening Non–life-threatening erin although esophageal pathology may also respond to Acute coronary syndromes Stable angina nitroglycerin (i.e., esophageal spasm). Pericarditis The interviewer should elicit the location, onset, duration, Aortic dissection GERD/esophageal spasm Pulmonary embolism Musculoskeletal character, intensity, and radiation of the chest pain. When Esophageal rupture Valvular heart disease questioning the patient, the interviewer should use the term Hypertrophic cardiomyopathy chest “discomfort” rather than chest “pain,” because many GERD gastroesophageal reflux disease patients deny having “pain.” In fact, many patients emphati- cally point out to the interviewer that the discomfort is not a S. Roble (*) “pain.” For the purposes of discussion, this chapter retains OhioHealth Heart and Vascular Physicians, Mansfield, OH, USA the traditional term chest “pain.” e-mail: [email protected] © Springer Nature Switzerland AG 2020 1 R. R. Baliga, K. A. Eagle (eds.), Practical Cardiology, https://doi.org/10.1007/978-3-030-28328-5_1

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Author:	Ragavendra R. Baliga, Kim A. Eagle
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