SiteThe accelerating advances in cardiology since the publication of the fifth edition of Heart Disease have required the most extensive changes yet made in any revision. This edition, the first in the new millennium, contains 30 chapters that are new (the most for any revision to date), and the remaining 42 have been extensively revised and updated. The editors warmly welcome 56 authors who are new to this edition.
Cardiovascular disease is now, more than ever, a global problem with enormous economic consequences. The various forms of heart disease in different economies and cultures are presented in the new opening chapter by Gaziano, and principles of cost-effective practice are described in a new chapter by Hlatky and Mark. Part II, The Examination of the Patient, begins with the clinical examination and moves progressively from simple to more sophisticated non-invasive and invasive techniques. All of these approaches are described in detail with many new illustrations. The new chapter “Relative Merits of Cardiovascular Diagnostic Techniques,” by Beller, provides a rational approach to the selection among several methods available to image the heart.
Heart failure is becoming an increasingly prevalent problem. Bristow has prepared two new chapters on the treatment of this condition, with emphasis on new treatment options based on pathophysiological considerations. There also has been enormous progress in cardiac electrophysiology and arrhythmology. Zipes has enlisted a cadre of talented authors to help update this section, always one of the strongest in Heart Disease.
The section on atherosclerosis is entirely new, reflecting greatly expanded information in this field and Libby's expertise in the area. The risk factors for the development of atherosclerosis and methods for its prevention are presented in new chapters. In view of the increasing importance of diabetes as a risk factor for vascular disease, a new chapter on diabetes mellitus and cardiovascular disease has been added. The cardiologist is called upon increasingly to deal with patients with extra cardiac vascular disease. In new chapters on this subject, Creager and Libby describe the diagnosis and management of these conditions, and Dake and Samuels describe the extra cardiac vascular interventions.
The acute coronary syndromes are, by far, the most common diagnoses for cardiovascular patients admitted to the hospital. In a new chapter on unstable angina, Cannon and Braunwald describe the many new diagnostic techniques and therapeutic measures available to care for these patients, and Antman and Braunwald provide a detailed contemporary description of the clinical manifestations and management of acute myocardial infarction. Interventional cardiology has progressed rapidly since the mid-1990s, and Popma and Kuntz have prepared an excellent new chapter on this important sub-specialty of cardiology.
The sixth edition also focuses on the different manifestations in various populations, with new chapters on acquired heart disease in infancy, congenital heart disease in adults, and heart disease in athletes, in diabetics, in the elderly, and in patients with HIV infection and neoplastic disease, and an updated chapter on coronary artery disease in women.
The impact of molecular biology and genetics on cardiovascular disease is growing rapidly. A new chapter, “Principles of Cardiovascular Molecular Biology and Genetics,” by Leiden joins the updated chapter “Genetics and Cardiovascular Disease” by Pyeritzin providing clear explanations of this important area. Many cardiovascular diseases result, in part, from coagulation disorders. Schafer and colleagues have prepared an excellent new chapter on hemostasis, thrombosis, and fibrinolysis to equip the cardiologist with the information required to deal effectively with these disorders. Other important new chapters include “Echocardiography,” by Armstrong and Feigenbaum, and “Hypotension and Syncope,” by Calkins and Zipes.
Practice guidelines are increasingly influencing the diagnosis and therapy of heart disease. Lee provides useful summaries of the most important guidelines developed by authoritative groups and skilfully places them into the perspective of modern patient care.
Considerable revisions were made both in galley proofs and page proofs to include information about the most recent advances in the field. Particular emphasis has been placed on ensuring a comprehensive and up-to-date bibliography of more than 18,000 pertinent references, including hundreds of publications that appeared in 2000. Many of the 1700 figures and 546 tables are new to this edition.
In order to allow the reader to keep pace with the enormous expansion of cardiovascular knowledge, Heart Disease is supplemented by a number of companion volumes. These include Cardiac Imaging, Cardiovascular Therapeutics, Molecular Basis of Heart Disease, and Clinical Trials in Cardiovascular Disease. These books have been well received, and new editions are in preparation. Companion volumes in other important segments of cardiology are planned. In addition, a Review and Assessment book will again accompany this edition of Heart Disease. It consists of 600 questions based on material discussed in the text book and provides the answers as well as detailed explanations. The publisher, , comprising W.B. Saunders, Mosby, and Churchill Livingstone, is developing a comprehensive website in cardiology: MDConsult-Cardiology. The sixth edition of Heart Disease will serve as the “anchor” of this website, which will be updated continuously. This multipronged educational effort—Heart Disease, the growing number of companion volumes, and the Review and Assessment book, all appearing in print and electronic (CD-ROM) form, as well as the new website—is designed to assist the reader with the awesome task of learning and remaining current in this dynamic field.
We hope that this textbook will prove useful to those who wish to broaden their knowledge of cardiovascular
medicine. To the extent that it achieves this goal and thereby aids in the care of patients afflicted with heart
disease, credit must be given to the many talented and dedicated persons involved in its preparation. Our deepest
appreciation goes to our fellow contributors for their professional expertise, knowledge, and devoted scholarship,
which are at the very “heart” of this book. At the W.B. Saunders Company, our editor, Richard Zorab, and the
production team, Lynne Gery, Frank Polizzano, and Anne Ostroff, were enormously helpful. Our editorial associates,
Kathryn Saxon, Janet Hutcheson, and Karen Williams, rendered invaluable and devoted assistance.
Eugene
Braunwald
Douglas P. Zipes
Peter Libby
2001
Cardiovascular disease is the greatest scourge affecting the industrialized nations. As mwith previous scourges—bubonic plague, yellow fever, and smallpox—cardiovascular disease not only strikes down a significant fraction of the population without warning but also causes prolonged suffering and disability in an even larger number. In the United States alone, despite recent encouraging declines, cardiovascular disease is still responsible for almost 1 million fatalities each year and more than half of all deaths; almost 5 million persons afflicted with cardiovascular disease are hospitalized each year. The cost of these diseases in terms of human suffering and of material resources is almost incalculable. Fortunately, research focusing on the causes, diagnosis, treatment, and prevention of heart disease is moving ahead rapidly.
In order to provide a comprehensive, authoritative text in a field that has become as broad and deep as cardiovascular medicine, I chose to enlist the aid of a number of able colleagues. However, I hoped that my personal involvement in the writing of about half of the book would make it possible to minimize the fragmentation, gaps, inconsistencies, organizational difficulties, and impersonal tone that sometimes plague multiauthored texts.
Since the early part of the 20th century, clinical cardiology has had a particularly strong foundation in
the basic sciences of physiology and pharmacology. More recently, the disciplines of molecular biology, genetics,
developmental biology, biophysics, biochemistry, experimental pathology, and bioengineering have alsom begun to provide
critically important information about cardiac function and malfunction. Although Heart Disease: A Textbook of
Cardiovascular Medicine is primarily a clinical treatise and not a textbook of fundamental cardiovascular science, an
effort has been made to explain, in some detail, the scientific bases of cardiovascular diseases.
— Eugene
Braunwald, 1980
