Harrison's Principles of Internal Medicine has been a respected information source for more than 60 years. Over time, the traditional textbook has evolved to meet the needs of internists, family physicians, nurses, and other health care providers. The growing list of Harrison's products now includes Harrison's for the iPad, Harrison's Manual of Medicine, and Harrison's Online. This book, Harrison's Cardiovascular Medicine, now in its second edition, is a compilation of chapters related to cardiovascular disorders.
Our readers consistently note the sophistication of the material in the specialty sections of Harrison's. Our goal was to bring this information to our audience in a more compact and usable form. Because the topic is more focused, it is possible to enhance the presentation of the material by enlarging the text and the tables. We have also included a Review and Self-Assessment section that includes questions and answers to provoke reflection and to provide additional teaching points.
Cardiovascular disease is the leading cause of death in the United States, and is rapidly becoming a major cause of death in the developing world. Advances in the therapy and prevention of cardiovascular diseases have clearly improved the lives of patients with these common, potentially devastating disorders; yet, the disease prevalence and the risk factor burden for disease (especially obesity in the United States and smoking worldwide) continue to increase globally. Cardiovascular medicine is, therefore, of crucial importance to the field of internal medicine.
Cardiovascular medicine is a large and growing subspecialty, and comprises a number of specific subfields, including coronary heart disease, congenital heart disease, valvular heart disease, cardiovascular imaging, electrophysiology, and interventional cardiology. Many of these areas involve novel technologies that facilitate diagnosis and therapy. The highly specialized nature of these disciplines within cardiology and the increasing specialization of cardiologists argue for the importance of a broad view of cardiovascular medicine by the internist in helping to guide the patient through illness and the decisions that arise in the course of its treatment.
The scientific underpinnings of cardiovascular medicine have also been evolving rapidly. The molecular pathogenesis and genetic basis for many diseases are now known and, with this knowledge, diagnostics and therapeutics are becoming increasingly individualized. Cardiovascular diseases are largely complex phenotypes, and this structural and physiological complexity recapitulates the complex molecular and genetic systems that underlie it. As knowledge about these complex systems expands, the opportunity for identifying unique therapeutic targets increases, holding great promise for definitive interventions in the future. Regenerative medicine is another area of cardiovascular medicine that is rapidly achieving translation. Recognition that the adult human heart can repair itself, albeit sparingly with typical injury, and that cardiac precursor (stem) cells reside within the myocardium to do this can be expanded, and can be used to repair if not regenerate a normal heart is an exciting advance in the field. These concepts represent a completely novel paradigm that will revolutionize the future of the subspecialty.
In view of the importance of cardiovascular medicine to the field of internal medicine, and the rapidity with which the scientific basis for the discipline is advancing, Harrison's Cardiovascular Medicine was developed. The purpose of this sectional is to provide the readers with a succinct overview of the field of cardiovascular medicine. To achieve this goal, Harrison's Cardiovascular Medicine comprises the key cardiovascular chapters contained in the eighteenth edition of Harrison's Principles of Internal Medicine, contributed by leading experts in the field. This sectional is designed not only for physicians-in-training on cardiology rotations, but also for practicing clinicians, other health care professionals, and medical students who seek to enrich and update their knowledge of this rapidly changing field. The editors trust that this book will increase both the readers' knowledge of the field, and their appreciation for its importance.
The first section of the book, “Introduction to Cardiovascular Disorders,” provides a systems overview, beginning with the basic biology of the cardiovascular system, followed by epidemiology of cardiovascular disease, and approach to the patient. The integration of pathophysiology with clinical management is a hallmark of Harrison's, and can be found throughout each of the subsequent disease-oriented chapters. The book is divided into six main sections that reflect the scope of cardiovascular medicine: (I) Introduction to the Cardiovascular System; (II) Diagnosis of Cardiovascular Disorders; (III) Heart Rhythm Disturbances; (IV) Disorders of the Heart; (V) Disorders of the Vasculature; and (VI) Cardiovascular Atlases.
Our access to information through web-based journals and databases is remarkably efficient. Although these sources of information are invaluable, the daunting body of data creates an even greater need for synthesis by experts in the field. Thus, the preparation of these chapters is a special craft that requires the ability to distill core information from the ever-expanding knowledge base. The editors are, therefore, indebted to our authors, a group of internationally recognized authorities who are masters at providing a comprehensive overview while being able to distill a topic into a concise and interesting chapter. We are indebted to our colleagues at McGraw-Hill. Jim Shanahan is a champion for Harrison's and these books were impeccably produced by Kim Davis. We hope you find this book useful in your effort to achieve continuous learning on behalf of your patients.