Chest Pain 1st Edition by J. Willis Hurst (Author), Douglas C. Morris (Author)

SHRINK-WRAPPED NEW: Chest Pain 1st Edition HARDCOVER 2001 Chest Pain 1st Edition by J. Willis Hurst (Author), Douglas C. Morris (Author) OUR REFERENCE: 131A4-116B5-115B6-130A7-HC-0879934824-2-LB DESCRIPTION J. Willis Hurst, MD, a pioneer in the development of cardiology, and his colleague, Douglas C. Morris, M.D., both of Emory University, have edited this book and chose its unusual title for very specific reasons. Patients sometimes have an odd view as to anatomic landmarks that identify the location of the chest, and may assign terms other than pain to their discomfort. Hence the quotation marks around "chest pain." The arrow (-->) after "chest pain" indicates that the physician initially may not know the cause of the symptom, so a differential diagnosis must be established. This book was written to reintroduce in the modern clinical setting the knowledge and skills needed to analyze symptoms, physical findings, and ECG and x-ray abnormalities in order to accurately diagnose more than 50 different conditions that may bring about a complaint of "chest pain." Experts in the fields of cardiology, pulmonology, dermatology, orthopedics, thoracic surgery, and psychiatry contribute a unique perspective on this common but compelling medical problem. Each chapter concentrates on one causative syndrome or malady, from its initial presentation to its etiology, to differential diagnosis and treatment, while an abundance of well-designed figures serve to illustrate the location of the "chest pain." Any cardiologist, primary care, or emergency care physician who may encounter a patient complaining of "chest pain" will benefit from this book''s clear, concise and thorough approach to the problem. Editorial Reviews From The New England Journal of Medicine Chest pain is a common presenting symptom in clinical practice, but is there a need for a new book devoted entirely to this subject? The answer is yes, with some qualifications. Chest Pain, a relatively short book, describes the multiple cardiac and noncardiac causes of chest pain. The book has 14 parts, each devoted to diseases or conditions that are related to a specific organ system or anatomical location and that can cause chest pain. The final part describes chest pain of ``controversial origin.'' Not surprisingly, given the editors' specialty and the importance of the cardiac causes of chest pain, the part of the book devoted to heart disease is the largest and most detailed. Overall, the book is easy to use and provides a practical, clinically relevant, up-to-date review. In general, the concise and well-written chapters within each part of the book provide useful and interesting overviews without excessive detail. Because each chapter has an identical structure, the style of the chapters is similar even though the text has multiple authors. Each chapter is an effective blend of relevant data and the authors' own clinical experience. The sections in each chapter on epidemiology (``General Considerations'' and ``Clinical Setting'') and pathophysiology (``Etiology and Basic Mechanisms Responsible for the Pain'') are especially interesting and well presented. I particularly appreciate the emphasis on the importance of obtaining and interpreting primary data (the history and results of physical examination) -- skills that are in danger of being lost, given our increasing reliance on diagnostic technology. The book is not an evidence-based treatise, nor is it a comprehensive specialty textbook. Rather, it is a quick, practical reference on chest pain. Reflecting this approach, the reference lists are short. Many of the works cited are textbooks on cardiology or general medicine, and many are classic rather than current. I was an attending physician in our general-medicine inpatient service while reading this book and was pleasantly surprised at how often I was able to use it during teaching rounds. What are my reservations? Although the identical structure of each chapter, which insists on a statement after each of 18 subheadings, helps to standardize the style of this multiauthored book, such a structure also promotes redundancy and results in many chapters in which the subheadings are almost as long as the text following them. Many of the subheadings could have been combined without loss of clarity. In addition, some of the structural organization is confusing. In each chapter, the subsection entitled ``Routine Laboratory Tests'' appears under the larger category of ``Associated Signs,'' which should be limited to physical findings. There are two separate subsections addressing laboratory tests (``Routine Laboratory Tests'' and ``Other Diagnostic Tests''), when one overall section would suffice. Descriptions of medical treatments are sometimes inappropriately included in the section called ``Relief of the Chest Pain'' -- which should be limited in scope to the patient's characterization of the pain -- only to be duplicated in the separate section on treatment, where they belong. The book does not specify what constitutes a ``routine'' test. I believe it is debatable whether any test should be considered ``routine,'' since all tests perform best when ordered with a specific question in mind. This book is primarily about differentiating anginal pain from other causes of chest pain, and the longest chapter, appropriately, is about this subject. It would have been helpful if this goal had been stated at the outset of the book and if the chapters had been ordered to reflect it; for instance, the chapter on angina pectoris might have been put first, and each subsequent chapter might have included a specific statement as to how the pain differs from or is similar to ischemic pain, perhaps with a summary table pointing out key distinguishing points in the history, findings on physical examination, and laboratory data. Like many topic-based books, this one assumes that the reader has already identified the appropriate clinical entities in the differential diagnosis. Patients present with a symptom or sign, however, rather than with a disease label. A valuable additional chapter would have been a description of the differential diagnosis of chest pain, perhaps with an algorithm outlining the pertinent initial history, physical examination, and laboratory analysis and then the best method of proceeding, given the results. Such a symptom-based approach would be clinically useful and practically applicable. On the whole, this book succeeds as a clinically useful, well-organized, accessible, and concise summary of the important medical entity of chest pain. It is a book for primary care providers, hospitalists, emergency physicians, and other physicians who see patients with chest pain, including cardiologists; it may also be appropriate for sophisticated patients. Richard J. Haber, M.D. Review "This book...is worth owning. It is not going out of date next year!" William C. Roberts American Journal of Cardiology Product details Publisher ‏ : ‎ Wiley-Blackwell; 1st edition (April 15, 2001) Language ‏ : ‎ English Hardcover ‏ : ‎ 387 pages ISBN-10 ‏ : ‎ 0879934824 ISBN-13 ‏ : ‎ 978-0879934828