Cardiac Intensive Care E-Book
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1678 pages

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The new edition of Cardiac Intensive Care—the only textbook dedicated to cardiac intensive care medicine—chronicles the progress made in the diagnosis, assessment, and treatment of patients with critical cardiac illness. Editors Allen Jeremias, MD, MSc and David L. Brown, MD present the landmark discoveries, greater understanding of syndromes, and technological advancements that have helped make clinical cardiology a progressive and interventional field. You’ll get coverage of the plethora of noncoronary diseases in the CICU, as well as a complete compendium of up-to-date pharmacologic agents. The new full-color design and layout and nine new chapters give you the latest theoretical, technical, diagnostic, and therapeutic advances in an accessible and visually appealing format.
  • Features the authoritative perspectives of a stellar group of contributors—many of whom are the pioneers in the fields they cover—for the best available guidance.
  • Provides the basic science framework for the clinical material through a section on the scientific foundation of cardiac intensive care to give you the complete picture.
  • Presents a pharmacological introduction to the classes of drugs so you know which are most commonly used in the CICU.
  • Covers which noncoronary diseases frequently result in admittance to the CICU to prepare you for those diagnoses that are not of a cardiac nature.
  • Features nine new chapters—Quality Assurance and Improvement in the Cardiac Intensive Care Unit; Physical Examination in the CICU; Mechanical Treatments for Acute ST-Elevation MI; Non-ST Elevation Myocardial Infarction: Diagnosis, Prognosis, Risk Stratification, and Management; Glycoprotein IIb/IIIa Inhibitors; Vascular Access Procedures; Ventilator Management for the Cardiac Patient; Management of Post-Operative Complications in the Cardiac Surgery Patient; Guidelines Relevant to Care in the Cardiac Intensive Care Unit—to keep the book and you up to date.
  • Presents the text in a new, full-color design and layout for a more visually-appealing and accessible format that makes finding the information you need quick and easy.


Derecho de autor
Chronic obstructive pulmonary disease
Reperfusion therapy
Cardiac dysrhythmia
Functional disorder
ST elevation
Myocardial infarction
Circulatory collapse
Transesophageal echocardiography
Cardiac monitoring
Medical procedure
Intensive care unit
Sudden cardiac death
Percutaneous coronary intervention
Left bundle branch block
Unstable angina
Ventricular assist device
Valvular heart disease
Atrioventricular block
Acute coronary syndrome
Cardiogenic shock
Adenoid cystic carcinoma
Coarctation of the aorta
Mitral regurgitation
Congenital heart defect
Thrombolytic drug
Ventricular tachycardia
Pulmonary hypertension
Heart block
Airway management
Laryngeal mask airway
Aortic insufficiency
Antiarrhythmic agent
Random sample
Blood flow
Low molecular weight heparin
Chest pain
Peripheral vascular disease
Acute respiratory distress syndrome
Critical care
Pulmonary edema
Drug overdose
Renal failure
Aortic dissection
Cardiac tamponade
Health care
Medical ventilator
Heart failure
Nitric oxide
Pulmonary embolism
Internal medicine
Malignant hypertension
General practitioner
Ventricular fibrillation
Tracheal intubation
Cellular respiration
Heart disease
Cardiopulmonary resuscitation
Angina pectoris
Ischaemic heart disease
Cardiac arrest
Circulatory system
Blood pressure
Health science
Diabetes mellitus
Hypertension artérielle
Divine Insanity
Neotragus moschatus
Intensive Care
Hypotension artérielle


Publié par
Date de parution 15 mai 2010
Nombre de lectures 0
EAN13 9781437711011
Langue English
Poids de l'ouvrage 5 Mo

Informations légales : prix de location à la page 0,0554€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.


Cardiac Intensive Care
Second Edition

Allen Jeremias, MD, MSc
Assistant Professor, Department of Medicine
Director, Vascular Medicine and Peripheral Intervention, Division of Cardiovascular Medicine, SUNY-Stony Brook School of Medicine, Health Sciences Center, Stony Brook, New York

David L. Brown, MD
Professor, Department of Medicine
Co-Director, Stony Brook Heart Center
Chief, Division of Cardiovascular Medicine, SUNY-Stony Brook School of Medicine, Health Sciences Center, Stony Brook, New York
Front Matter

Cardiac Intensive Care
Second Edition
Allen Jeremias, MD, MSc
Assistant Professor, Department of Medicine, Director, Vascular Medicine and Peripheral Intervention, Division of Cardiovascular Medicine, SUNY-Stony Brook School of Medicine, Health Sciences Center, Stony Brook, New York
David L. Brown, MD
Professor, Department of Medicine, Co-Director, Stony Brook Heart Center, Chief, Division of Cardiovascular Medicine, SUNY-Stony Brook School of Medicine, Health Sciences Center, Stony Brook, New York

1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
Copyright © 2010, by Saunders, an imprint of Elsevier Inc.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier's Health Sciences Rights Department in Philadelphia, PA, USA. phone: (+1) 215 239 3804, fax: (+1) 215 239 3805, e-mail: . You may also complete your request on-line via the Elsevier homepage ( ), by selecting "Customer Support" and then "Obtaining Permissions".

Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on his or her own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Editors assume any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book.
The Publisher
Library of Congress Cataloging-in-Publication Data
Cardiac intensive care / [edited by] Allen Jeremias, David L. Brown. — 2nd ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4160-3773-6
1. Cardiac intensive care. I. Jeremias, Allen. II. Brown, David L.
(David Lloyd).
[DNLM: 1. Heart Diseases—therapy. 2. Intensive
Care—methods. WG 166 C263 2010]
RC684.C36C37 2010
Executive Publisher: Natasha Andjelkovic
Developmental Editor: Bradley McIlwain
Project Manager: Jagannathan Varadarajan
Design Direction: Steven Stave
Publishing Services Manager: Hemamalini Rajendrababu
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Dedicated to my parents, Dr. Andreas and Susanne Jeremias, who always supported me in every endeavor and made me who I am today; and to my grandfather, Dr. Nicolaus Jeremias, whose unwavering dedication to patient care has set the standard that I aspire to.

Allen Jeremias
This edition is dedicated to my mentor, Kanu Chatterjee, MBBS, on the occasion of his retirement from the Division of Cardiovascular Medicine at University of California, San Francisco, where he inspired and taught generations of trainees the art, science, and humanity of medicine.

David L. Brown
The care of acutely ill cardiac patients has evolved over the past 40 years through a series of landmark developments and milestones. Coronary intensive care began in the 1960s with the introduction of electrocardiogram (ECG) monitoring for patients with acute myocardial infarction (MI). ECG monitoring coupled with the introduction of antiarrhythmic interventions (cardioversion, defibrillation, and lidocaine) led to a dramatic decrease in the mortality of patients with acute MI, largely through a reduction of in-hospital ventricular dysrhythmias. This was the first major milestone in the care of patients with acute MI. At this time, hemodynamic dysfunction and pump failure emerged as the leading causes of death in acute MI.
In the early 1970s, the introduction of bedside pulmonary artery catheterization, by Willie Ganz and Jeremy Swan at the Cedars-Sinai Medical Center, made possible accurate assessment of hemodynamic dysfunction in critically ill cardiac patients. This landmark development spawned a new era of coronary care that led to better assessment and management of pump dysfunction, stimulating the introduction of afterload-reducing therapy for heart failure. Around the same time, the concept of infarct size as a major determinant of ventricular dysfunction and prognosis began in the experimental laboratory, triggering a search for interventions to limit infarct size in experimental animals. The results of various therapies in this regard were inconsistent in the laboratory and in the clinical arena.
The next major milestone came in the late 1970s and early 1980s, when the role of coronary thrombosis as the proximate cause of acute MI became firmly established through the landmark study of Marcus DeWood, then a trainee in cardiology. With this observation and the elegant early experimental work of many investigators, the importance of timely reperfusion as a powerful method for infarct size limitation was recognized. The focus on reperfusion, initially with intracoronary and subsequently with intravenous thrombolysis and more recently with primary angioplasty, as a means of reducing infarct size and decreasing mortality revolutionized contemporary care of patients with developing MI.
This advance represented another major milestone in coronary care. All this stepwise progress over the years has led to a substantive and steadily declining mortality for patients with acute MI. The past several years have witnessed an explosion in our knowledge of vascular biology, atherogenesis, plaque disruption and thrombosis, and the concept of acute coronary syndromes. These concepts have led to dramatic improvements in our ability to diagnose and manage patients with unstable angina with potent antithrombotic strategies ranging from aspirin and heparin to platelet receptor antagonists and direct thrombin inhibitors to angioplasty and stent implantation.
Throughout this progress, coronary care units evolved from specialized areas catering to patients with acute ischemic syndromes to a place where we now take care of the ever-increasing population of patients with other critical cardiovascular illnesses, such as acute and severe chronic heart failure, chronic pulmonary hypertension, life-threatening cardiac dysrhythmias, aortic dissection, and other diagnoses. A modern coronary care unit is, in reality, a cardiac intensive care unit.
This second edition of Cardiac Intensive Care, presented in a new full-color design, edited by Allen Jeremias, MD, MSc, and David L. Brown, MD, provides a state-of-the-art compendium summarizing all of the progress that has been made in the diagnosis, assessment, and treatment of patients with critical cardiac illnesses over the past several years. The 52 chapters and 3 appendices are written by experienced authors who have made important contributions in their respective fields. Nine new chapters have been added in this new edition dealing with topics including quality assurance and improvement, physical examination, mechanical treatments for acute ST segment elevation MI, non–ST segment elevation MI, and management of post–cardiac surgery patients. The convenience of full-text online access at is an added bonus.
The editors have captured the essence of what is the state-of-the-art in a rapidly evolving and dynamic field. The contents of this text provide a nice blend of pathophysiology and the more pragmatic issues of actual intensive cardiac care. In addition to dealing in detail with the issues of acute cardiac problems, this text provides a broader perspective by including many useful chapters that deal with critical care issues of a more general nature, such as airway and ventilator management, resuscitation, dialysis, and ultrafiltration. The editors and the authors are to be commended for having produced an up-to-date and useful treatise on cardiovascular critical care.

P.K. Shah, MD, Shapell and Webb Chair and Director, Division of Cardiology and Oppenheimer Atherosclerosis Research Center, Cedars-Sinai Heart Institute, Los Angeles, California
Since the publication of the first edition of Cardiac Intensive Care, there have been considerable changes in the level of care and the complexity of therapies provided in the cardiac intensive care unit (CICU). To reflect these changes appropriately, the second edition of Cardiac In

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