Chest Pain With Normal Coronary Angiograms Pathogenesis Diagnosis And Management

This book is timely and challenging. Within its pages are commentaries and opinions on the scientific background and explanatory ideas for a complex of symptoms and investigations known as syndrome X. The commonest cause by far of angina pectoris is coronary artery obstruction due to atheromatous lesions both within the wall of the artery and intruding into the lumen; in such patients it is expected that there maybe ST segment depression on atrial pacing or on an exercise test indicating myocardial ischemia. Syndrome X was a term first used in an editorial written by Kemp in 1973. He was referring to patients in group X in a paper from Arbogast and Bourassa. Patients in group X had three features, namely angina as judged on a clinical history, alterations of the ST segment on the electrocardiogram during atrial pacing and smooth unobstructed coronary arteries (presumed normal) as assessed by the technique of coronary angiography. The changes on the electrocardiogram, conventionally indicative of myocardial ischemia, could not be explained on the basis of any abnormality of the coronary arteries and Kemp named the complex of fmdings syndrome X because of this seeming paradox and the lack of a single explanation. In the last thirty-one years there has been substantial scientific interest in this syndrome giving rise to a large number of publications. The name syndrome X has led to considerable confusion. Physicians are familiar with the X chromosome and with X linked congenital disorders.

Written by leading authorities in the field, Chest Pain with Normal Coronary Arteries comprehensively reviews the clinical presentation and the pathogenesis of the condition, as well as its management. This book provides a practical tool for the clinician and a bank of information and new ideas for research scientists and clinical researchers interested in understanding the causes and mechanisms of chest pain with normal coronary arteries. Whether the pain be of gastroenterologic, cardiac or endocrine in origin, the book focuses on effective diagnosis, treatment and management of different pathologies in patients. Chest Pain with Normal Coronary Arteries is an essential read for all clinicians involved in managing patients with chest pain, and those that should be aware of non-cardiac chest pain.

This book aims to provide an excellent overview of the differential diagnosis and approach to chest pain in various clinical settings. This book is divided into two sections including the introduction and the approach to chest pain. Our introductory chapter starts with the basic principles of statistics and its application in various diagnostic modalities of heart disease. Our authors present a nice approach to patients presenting with chest pain in various scenarios. We have also included a chapter describing GERD, which could present as chest pain and another chapter describing aortic dissection, which is a life-threatening disease presenting with chest pain. We hope that this book will serve as an accessible handbook on the differential diagnosis of chest pain.

In the past two decades a number of studies have shown that abnormalities in the function and structure of coronary microcirculation can be detected in several cardiovascular diseases. On the basis of the clinical setting in which it occurs, coronary microvascular dysfunction (CMD) can be classified into four types: CMD in the absence of any other cardiac disease; CMD in myocardial diseases; CMD in obstructive epicardial coronary artery disease; and iatrogenic CMD. In some instances CMD represents an epiphenomenon, whereas in others it represents an important marker of risk or may contribute to the pathogenesis of myocardial ischemia, thus becoming a possible therapeutic target. This book provides an update on coronary physiology and a systematic assessment of microvascular abnormalities in cardiovascular diseases, in the hope that it will assist clinicians in prevention, detection and management of CMD in their everyday activity.

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Chronic total occlusions (CTO) are common, and found in approximately one third of patients with significant coronary artery disease who undergo angiography. Over the past 20 years, CTO lesions have represented the most difficult anatomy for treatment — with lower success rates and higher complication rates. Chronic Total Occlusions provides interventionalists insight into the world of CTOs with introductory chapters that describe the pathology and indications of CTOs along with a review of clinical trials. Imaging modalities including CT angiography, magnetic navigation wire, and IVUS guided recanalization of CTO are also introduced, together with information on new wires technology and devices for CTOs. With numerous illustrations of these devices, technologies, and strategies to improve the CTO success rate, this clinical guide, headed up by Ron Waksman, will prove to be the ideal companion for interventional cardiologists and cardiac surgeons who are required to perform angioplasty and coronary stenting.

Two well-known and respected editors have assembled an outstanding group of electrophysiologists/physicians to write a major work representing the field of electrocardiography as we know it today. This book contains all the major subject areas within the field of electrocardiography with significant clinical and basic content to appeal to the entire electrophysiology community in addition to educating cardiologists with the latest information. The fact that Drs. Malik and Camm have edited this work assures a volume of incredible quality and readability.

For many years, there has been a great deal of work done on chronic congestive heart failure while acute heart failure has been considered a difficult to handle and hopeless syndrome. However, in recent years acute heart failure has become a growing area of study and this is the first book to cover extensively the diagnosis and management of this complex condition. The book reflects the considerable amounts of new data reported and many new concepts which have been proposed in the last 3-4 years looking at the epidemiology, diagnostic and treatment of acute heart failure.