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Clinical electrocardiograms
Book
reviews
THE DOCTOR HAS A HEART ATTACK. By Samuel Goodstone, M.D., Boston, 1964, Beacon Press, 118 pages. Price $3.50. Written primarily for the layman, this is a highly readable and informative account of the experiences of a physician who has had a myocardial infarction. Skillfully woven into the vivid narration are brief digressions into various aspects of cardiac diagnosis and therapy, including cardiac nursing, anticoagulants, the cardiac chair, and the use of electrocardiography and serum enzymes. This is followed by sections on the pathogenetic aspects of coronary artery disease and on the problems of readjustment and rehabilitation faced by patients convalescing from myocardial infarction. The book concludes with a set of questions and answers on topics related to coronary artery disease. A short glossary is appended at the end and will help considerably with the medical terminology employed throughout the book. This contribution is highly recommended to physicians and patients interested in coronary artery disease.
BLOOD PROGRAM IN WORLD WAR II. Edited by Colonel John B. Coates, Jr., MC, USA, and Elizabeth M. McFetridge, M.A., Washington, D.C., 1964, Surgeon General, Department of the Army (Superintendent of Documents, Government Printing Office), 922 pages. Price $8. This volume is another in the series in which the official history of the Medical Department of the United States Army in World War II is recorded. These volumes have been prepared by the Historical ITnit, United States Army Medical Service, and published under the direction of the Surgeon General of the United States Army. This volume records the development of the very extensive blood program and all of its many aspects before, during, and after World War II, with an additional section concerned with the similar problems in the Korean War. The organization and presentation are good and lucid. Some aspects of the many problems encountered are presented in considerable detail, which is essential if it is to serve the useful function as a historical guide. It is doubtful that there are very many people who are aware of, or have given consideration to, the tremendous logistical and practical problems concerned with the procuring of large quantities of whole blood and blood products and the supplying of these to areas far removed from the site of collection and processing. An analysis of some of the problems encountered in light of the policies and procedures current at that time are examined and presented in a forthright manner. Errors
286
in judgment, delays in implementation, and other critical comments are presented in a constructive manner. The magnitude of the problem of supplying such a perishable product as fresh whole blood, which must be processed with such infinite attention IO detail, is almost overpowering. A reveiw of this book is a humbling experience. The admirable manner in which these problems were solved is a tribute to all thoseconcerned and an accomplishment of which our entire nation should not only be aware but for which it should be eternally grateful, I believe that this historical record will serve the purpose quite well as outlined by the authors. Without hesitation I recommend this book to all physicians as well individuals engaged in paramedical pursuits.
SUDDEN CARDIAC DEATH. Edited by Borys Surawicz, M.D., and E. D. Pellegrino, M.D., Xew York, 1964, Grune & Stratton, Inc., 222 pages. Price $9.50. This book represents a symposium held at the University of Kentucky on Oct. 4-5, 1963. Included are discussions of anatomic factors concerned with sudden death, mechanisms, the vulnerable electric phase, ventricular fibrillation, ventricular asystole, coronary occlusion, pulmonary embolism, and prevention. The material presented varies in quality. For example, the illustrations on pages 72 and 73 are poor. Most of the material presented should be well known to most internists and certainly to cardiologists, but some physicians and undergraduate students may find the book worth reading. As in the case of most symposia, the subject can receive only superficial consideration.
CLINICAL ELECTROCARDIO~~RAMS. Edited by Stephen R. Elek, M.D., F.C.C.P., F.A.C.P., Associate Clinical Professor of Medicine, University of Southern California. Springfield, Ill., 1965, Charles C Thomas, Publisher, 236 pages. Price $11.75. This book has 58 contributors. Thus, it is not surprising that some chapters are only a page or two long, inadequately illustrated, and the entities inadequately discussed. The section entitled “Congenital Heart Disease and Vectorcardiography” consists:of one-half page of text on tetralogy of Fallot in an 8-month-old infant and presents an unbelievably unsatisfactory description of the electrocardiogram of tetralogy of Fallot. In fact, the electrocardiogram is certainly not typical of the severe type, and the superior plane projection of the vectorcardiogram for the tetrahedron is referred to as the horizontal plane. Again, on page 160, the case of
Book reviews
a patient with car pulmonale and SrS&r syndrome in the electrocardiogram is discussed in such a manner that the reader may gain the impression that an SrS& pattern is found only in patients with car pulmonale. This is certainly not true. This book is a collection of discussions of patients with various diseases, some cases documented by autopsy and some poorly illustrated (page 21). This book will be of little value to anyone.
AN OUTIJNE OF PULMONARY FUNCTION AND PULMONARY EMPHYSEMA. By Eugene Rosenman, M.D., Assistant Clinical Professor of Medicine, Loma Linda University School of Medicine, Los Angeles, Calif. Springfield, Ill., 1964, Charles C Thomas, Publisher, 137 pages. Price $6.50. This
brief volume is of value as an introduction for clinicians and students to a complicated field of investigation which has produced a literature that is often difficult. The chief faults of the book lie in its failure to adequately cover important divisions of pulmonary function, such as pulmonary diffusion and surface tension, and its sparing use of illustrative figures. Current clinical and physiologic distinctions which have been drawn between uncomplicated chronic bronchitis and pulmonary emphysema are not presented. Recent developments in the pathologic and radiologic study of these diseases are not included. Although the bibliography lists 202 references, numerous important articles are not cited.
LA ENFERMEDAD DE CHAGAS CONGENITA. By Jorge E. Howard, Profesor Extraordinario de Pediatria, Facultad de Medicina, Universidad de Chile. Santiago, 1962, 92 pages. This monograph summarizes our knowledge of one of the more unusual aspects of Chagas’ disease, that of the infection acquired in utero. Many interesting facts emerge from this book: some of the mothers of infants with congenital Chagas’ disease are unaware of their own infection; the onset of symptoms is variable, ranging from 1 to 90 days after birth; hepatosplenomegaly, - _ cutaneous lesions, and neurological manifestations lead to the diagnosis. The differential diaenosis includes congeiital syphilis, toxoplasmosis, and the hemolytic anemias of the newborn. The diagnosis is established by serology and by demonstration of the parasitemia. The therapy is unsatisfactory and the mortality is high. Clinical evidence of cardiovascular disease was found in only 1 of the 15 patients studied by the author, and in 1 of the additional 16 patients reported in the literature; however, microscopic study revealed cardiac lesions in 7 of 10 autopsied cases. The low incidence of clinical cardiovascular complications reported in this series is apparently similar to that reported in adult patients with Chagas’ disease seen in Chile.
287
A SYNOPSIS OF CARDIOLOGY. By D. Weitzman, M.D., M.R.C.P., Cardiologist, St. Bartholomew’s Hospital, London, with J. M. H. Campbell, O.B.E., M.A., M.D., F.R.C.P. Bristol, 1964, John Wright and Sons, Ltd., and Baltimore, 1964, Williams & Wilkins Co., 200 pages. Price $7. A remarkable amount of information is contained within the pages of this Synopsis. Emphasis is placed on physical diagnosis, and the descriptions of signs and symptoms of cardiovascular disease are particularly excellent. The sections on electrocardiography, vectorcardiography, cardiac catheterization, and angiography are rather brief, but the material presented has been wisely chosen. Some of the sections on therapy, i.e., the recommendations for digitalization and for the management of arrhythmias, are oversimplified and of limited usefulness. There is no information on the D.C. defibrillator, and relatively little on the problems of digitalis toxicity. Surprisingly, no mention is made of the use of the long-acting penicillin preparations, which many would surely prefer for the prophylaxis of rheumatic fever.
AN ELECTRON MICROSCOPE STUDY OF THE EARLY DEVELOPMENT OF THE RAT METANEPHRIC NEPHRON. Pentti Jokelainen, University of Helsinki, Finland. Acta Anatomica, Supplement 47, Basel, 1963, S. Karger (U.S. agent, Albert J. Phiebig, White Plains, N. Y.), 71 pages. Price $6. This monograph describes the early development of the metanephron unit of the rat as observed by modern cytological methods, including the use of reconstruction techniques based on serial sections studied by phase-contrast and electron microscopy. The course of development is traced from the primitive metanephrogenic blastemal cap to the stages characterized by the initiation of glomerulogenesis. The subject matter is clearly and concisely presented with the help of excellent diagrams. The reproduction of the electron micrographs is of high quality throughout.
LEITFADEN UND ATLAS DER ANGIOLOGISCHEN DIAGNOSTIK. By Dr. Med. Arnold Kappert, Bern and Stuttgart, 1964, Hans Huber, 184 pages. This atlas on the diagnosis of arterial disease is well illustrated with excellent photographs of lesions, diagrams of apparatus, anatomic and functional principles and angiograms. The author, of course, emphasizes the approach and procedures used in West Germany for the study of the arterial, venous, capillary, and lymphatic vessels. For example, in a study of adequacy of the peripheral circulation, emphasis is on the use of oscillography rather than plethysmography or thermography. Nevertheless, the reader has an opportunity to learn the value of oscillography in diagnosis by studying the monograph. This is a good atlas and should be useful to students and physicians.
reviews
THE DOCTOR HAS A HEART ATTACK. By Samuel Goodstone, M.D., Boston, 1964, Beacon Press, 118 pages. Price $3.50. Written primarily for the layman, this is a highly readable and informative account of the experiences of a physician who has had a myocardial infarction. Skillfully woven into the vivid narration are brief digressions into various aspects of cardiac diagnosis and therapy, including cardiac nursing, anticoagulants, the cardiac chair, and the use of electrocardiography and serum enzymes. This is followed by sections on the pathogenetic aspects of coronary artery disease and on the problems of readjustment and rehabilitation faced by patients convalescing from myocardial infarction. The book concludes with a set of questions and answers on topics related to coronary artery disease. A short glossary is appended at the end and will help considerably with the medical terminology employed throughout the book. This contribution is highly recommended to physicians and patients interested in coronary artery disease.
BLOOD PROGRAM IN WORLD WAR II. Edited by Colonel John B. Coates, Jr., MC, USA, and Elizabeth M. McFetridge, M.A., Washington, D.C., 1964, Surgeon General, Department of the Army (Superintendent of Documents, Government Printing Office), 922 pages. Price $8. This volume is another in the series in which the official history of the Medical Department of the United States Army in World War II is recorded. These volumes have been prepared by the Historical ITnit, United States Army Medical Service, and published under the direction of the Surgeon General of the United States Army. This volume records the development of the very extensive blood program and all of its many aspects before, during, and after World War II, with an additional section concerned with the similar problems in the Korean War. The organization and presentation are good and lucid. Some aspects of the many problems encountered are presented in considerable detail, which is essential if it is to serve the useful function as a historical guide. It is doubtful that there are very many people who are aware of, or have given consideration to, the tremendous logistical and practical problems concerned with the procuring of large quantities of whole blood and blood products and the supplying of these to areas far removed from the site of collection and processing. An analysis of some of the problems encountered in light of the policies and procedures current at that time are examined and presented in a forthright manner. Errors
286
in judgment, delays in implementation, and other critical comments are presented in a constructive manner. The magnitude of the problem of supplying such a perishable product as fresh whole blood, which must be processed with such infinite attention IO detail, is almost overpowering. A reveiw of this book is a humbling experience. The admirable manner in which these problems were solved is a tribute to all thoseconcerned and an accomplishment of which our entire nation should not only be aware but for which it should be eternally grateful, I believe that this historical record will serve the purpose quite well as outlined by the authors. Without hesitation I recommend this book to all physicians as well individuals engaged in paramedical pursuits.
SUDDEN CARDIAC DEATH. Edited by Borys Surawicz, M.D., and E. D. Pellegrino, M.D., Xew York, 1964, Grune & Stratton, Inc., 222 pages. Price $9.50. This book represents a symposium held at the University of Kentucky on Oct. 4-5, 1963. Included are discussions of anatomic factors concerned with sudden death, mechanisms, the vulnerable electric phase, ventricular fibrillation, ventricular asystole, coronary occlusion, pulmonary embolism, and prevention. The material presented varies in quality. For example, the illustrations on pages 72 and 73 are poor. Most of the material presented should be well known to most internists and certainly to cardiologists, but some physicians and undergraduate students may find the book worth reading. As in the case of most symposia, the subject can receive only superficial consideration.
CLINICAL ELECTROCARDIO~~RAMS. Edited by Stephen R. Elek, M.D., F.C.C.P., F.A.C.P., Associate Clinical Professor of Medicine, University of Southern California. Springfield, Ill., 1965, Charles C Thomas, Publisher, 236 pages. Price $11.75. This book has 58 contributors. Thus, it is not surprising that some chapters are only a page or two long, inadequately illustrated, and the entities inadequately discussed. The section entitled “Congenital Heart Disease and Vectorcardiography” consists:of one-half page of text on tetralogy of Fallot in an 8-month-old infant and presents an unbelievably unsatisfactory description of the electrocardiogram of tetralogy of Fallot. In fact, the electrocardiogram is certainly not typical of the severe type, and the superior plane projection of the vectorcardiogram for the tetrahedron is referred to as the horizontal plane. Again, on page 160, the case of
Book reviews
a patient with car pulmonale and SrS&r syndrome in the electrocardiogram is discussed in such a manner that the reader may gain the impression that an SrS& pattern is found only in patients with car pulmonale. This is certainly not true. This book is a collection of discussions of patients with various diseases, some cases documented by autopsy and some poorly illustrated (page 21). This book will be of little value to anyone.
AN OUTIJNE OF PULMONARY FUNCTION AND PULMONARY EMPHYSEMA. By Eugene Rosenman, M.D., Assistant Clinical Professor of Medicine, Loma Linda University School of Medicine, Los Angeles, Calif. Springfield, Ill., 1964, Charles C Thomas, Publisher, 137 pages. Price $6.50. This
brief volume is of value as an introduction for clinicians and students to a complicated field of investigation which has produced a literature that is often difficult. The chief faults of the book lie in its failure to adequately cover important divisions of pulmonary function, such as pulmonary diffusion and surface tension, and its sparing use of illustrative figures. Current clinical and physiologic distinctions which have been drawn between uncomplicated chronic bronchitis and pulmonary emphysema are not presented. Recent developments in the pathologic and radiologic study of these diseases are not included. Although the bibliography lists 202 references, numerous important articles are not cited.
LA ENFERMEDAD DE CHAGAS CONGENITA. By Jorge E. Howard, Profesor Extraordinario de Pediatria, Facultad de Medicina, Universidad de Chile. Santiago, 1962, 92 pages. This monograph summarizes our knowledge of one of the more unusual aspects of Chagas’ disease, that of the infection acquired in utero. Many interesting facts emerge from this book: some of the mothers of infants with congenital Chagas’ disease are unaware of their own infection; the onset of symptoms is variable, ranging from 1 to 90 days after birth; hepatosplenomegaly, - _ cutaneous lesions, and neurological manifestations lead to the diagnosis. The differential diaenosis includes congeiital syphilis, toxoplasmosis, and the hemolytic anemias of the newborn. The diagnosis is established by serology and by demonstration of the parasitemia. The therapy is unsatisfactory and the mortality is high. Clinical evidence of cardiovascular disease was found in only 1 of the 15 patients studied by the author, and in 1 of the additional 16 patients reported in the literature; however, microscopic study revealed cardiac lesions in 7 of 10 autopsied cases. The low incidence of clinical cardiovascular complications reported in this series is apparently similar to that reported in adult patients with Chagas’ disease seen in Chile.
287
A SYNOPSIS OF CARDIOLOGY. By D. Weitzman, M.D., M.R.C.P., Cardiologist, St. Bartholomew’s Hospital, London, with J. M. H. Campbell, O.B.E., M.A., M.D., F.R.C.P. Bristol, 1964, John Wright and Sons, Ltd., and Baltimore, 1964, Williams & Wilkins Co., 200 pages. Price $7. A remarkable amount of information is contained within the pages of this Synopsis. Emphasis is placed on physical diagnosis, and the descriptions of signs and symptoms of cardiovascular disease are particularly excellent. The sections on electrocardiography, vectorcardiography, cardiac catheterization, and angiography are rather brief, but the material presented has been wisely chosen. Some of the sections on therapy, i.e., the recommendations for digitalization and for the management of arrhythmias, are oversimplified and of limited usefulness. There is no information on the D.C. defibrillator, and relatively little on the problems of digitalis toxicity. Surprisingly, no mention is made of the use of the long-acting penicillin preparations, which many would surely prefer for the prophylaxis of rheumatic fever.
AN ELECTRON MICROSCOPE STUDY OF THE EARLY DEVELOPMENT OF THE RAT METANEPHRIC NEPHRON. Pentti Jokelainen, University of Helsinki, Finland. Acta Anatomica, Supplement 47, Basel, 1963, S. Karger (U.S. agent, Albert J. Phiebig, White Plains, N. Y.), 71 pages. Price $6. This monograph describes the early development of the metanephron unit of the rat as observed by modern cytological methods, including the use of reconstruction techniques based on serial sections studied by phase-contrast and electron microscopy. The course of development is traced from the primitive metanephrogenic blastemal cap to the stages characterized by the initiation of glomerulogenesis. The subject matter is clearly and concisely presented with the help of excellent diagrams. The reproduction of the electron micrographs is of high quality throughout.
LEITFADEN UND ATLAS DER ANGIOLOGISCHEN DIAGNOSTIK. By Dr. Med. Arnold Kappert, Bern and Stuttgart, 1964, Hans Huber, 184 pages. This atlas on the diagnosis of arterial disease is well illustrated with excellent photographs of lesions, diagrams of apparatus, anatomic and functional principles and angiograms. The author, of course, emphasizes the approach and procedures used in West Germany for the study of the arterial, venous, capillary, and lymphatic vessels. For example, in a study of adequacy of the peripheral circulation, emphasis is on the use of oscillography rather than plethysmography or thermography. Nevertheless, the reader has an opportunity to learn the value of oscillography in diagnosis by studying the monograph. This is a good atlas and should be useful to students and physicians.