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PEARLS AND PITFALLS IN ELECTROCARDIOGRAPHY
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~IIII. the bookshelf
INTRODUcrION TO RESPIRATORY MEDICINE, 2nd ed. Edited by MEIR H. KRYGER. New York: Churchill Livingstone, 1990,402 pp, $25.95 This book is an overview of the pathophysiology of respiration. It contains 18 chapters, all well illustrated by graphs and tables and written by teacherphysicians knowledgeable in their fields. The various chapters cover a wide range of topics, from airBow obstruction to symptoms and signs. Overall, this book is succinct and well written. Its strength is in respiratory physiology. Its weakness is in respiratory pathology. Particularly informative are the chapters entitled "Adult Respiratory Distress Syndrome," by Thomas L. Petty, and "Respiratory Failure:' by Meir H. Kryger. Bibliographic references are limited, averaging ten per chapter. In my opinion, this softbound textbook is up to date and practical for teaching medical students, residents. and fellows. It is not a reference textbook.
s. Donald Greenber~,
M.D., F.C.C.P.
Houston
PEARLS AND PITFALLS IN ELECfROCARDIOGRAPHY. By HENRY J. L. MARRIOTT. Philadelphia: Lea & Febiger. 1990, 157 pp, $17.50 By Professor Marriott's description, he has assembled 70 "tricks of the trade" designed to improve ECG reading skill. The individual segments are generally 200 to 300 words in length and illustrated by several appropriate strips and an occasional diagram. The result is avowedly "not a textbook"; the individual segments are rather loosely grouped and could probably be reviewed in any order without reference to one another. Substantial ECG knowledge and some background in complex electrophysiologic mechanisms are presupposed for many segments; most examples will challenge senior medical residents seriously interested in cardiology. The usual format for each segment (aphorism or principle followed by brief explanation and example) occasionally leads to surprisingly thorough elucidation of fairly complex ECG or electrophysiologic mechanisms. There is little that is truly new here; virtually all the material has been published previously in one form or another in various texts, often by the author himself; references to the seminal work of Pick, Langendorf, and Rosenbaum from the 1945 to 1970 era are nearly as (.'ommon as those to Sherlock Holmes. The experienced electrocardiographer will, as with many of Professor Marriott's previous presentations, find some of the examples too pat and the diagnoses too firm without supporting electrophysiologic or other documentation. For example, the ambiguities ofapplying complex, sometimes conBicting morphologiC criteria to raise diagnostic accuracy in wide complex tachycardia (SO percent are ventricular in origin) to "an accurate diagnosis \\ith considerable confidence in 85 percent" of cases are not addressed (and I still cannot re<.'Ollect them all when I need them). Overall, this monograph will provide reasonably sophisticated electrocardiographers <.'Onsiderahle entertainment when only brief or frequently interrupted periods of quality reading time are available and additional polish is desired.
Vernon H. Humbert. Jr.. M.D., F.C.C.P. Evansville. Indiana
CT AND MRI OF THE THORAX. Edited by E. A. Z..:RHOlJNI. New York: Churchill Livingstone, 1990,222 pp, $62.00 This book is a must for everyone who deals with imaging the chest. Radiologists, pulmonologists, thoracic surgeons, and their trainees all need to read this book. This superb text is a glimpse into the workings of the excellent thoracic imaging service at Johns Hopkins University. It contains up-to-theminute discussions on the role ofcomputed tomography (Cf) versus magnetic resonance (MR) imaging and when to use each modality. It is interesting to compare this text, which is the lIth in a series on contemporary issues in cr, with an earlier one on just CT of the chest. The role of (.1 in the evaluation of thoracic diseases has evolved as scanners have improved, as has our knowledge of the Cf appearance of various lung diseases. MR imaging has added another new dimension to the evaluation of thoracic diseases. This book begins with a discussion of the role of pulmonary cr in the evaluation of immunocompromised and aClltely ill patients. This new role for CT is helpful in the evaluation of <"omplex pleuropulmonary diseases, and CT may be diagnostic in some pulmonary diseases such as invasive aspergillosis. The next three chapters discuss the relative roles of cr and MR imaging in the evaluation of the mediastinum. This is an important discussion, since each
A-22
has its strong and weak points. It is evident that MR imaging is becoming more accepted as the modality of choice for such entities as dissection and intracardiac tumors. The last four chapters include discussions of the relative roles of the two imaging modalities in the evaluation of focal lung disease, the pleura, the diaphragm, and the airways. It appears that still is the study of choice for imaging these areas. The book finishes with five very nice case studies touching on the areas discussed in the text with examples of the CT and MR findings. I have already recommended this book to all and will do so again.
cr
Robert D. Tarver, M. D. Indianapolis
CLINICAL MANIFESTATIONS OF RESPIRATORY DISEASE, 2nd ed. By TERRY DES JARDINS. Chicago: Year Book Medical Publishers, 1990, 385 pp, $29.95 This se<.'Ond edition provides the respiratory care student and practitioner with a well-designed and informative respiratory disease text. Within the 23 disease groupings, the author uses illustrations and discusses the etiology, clinical manifestations, and general management of the most common and important respiratory diseases. Each section also <.'Ontains self-assessment questions. What is unique and therefore attractive about this text is that it is \\Titten for those who need it most - respiratory care students, who require a straightforward approach to respiratory pathology, and respiratory educators, who need a course textbook that is easily incorporated into a course outline. Both of these targeted groups are served well by this book, since the author provides the requisite information and avoids the temptation to include material that is better left to other pulmonary pathophysiology texts. This book is re<.'Ommended as the textbook for an introductory course in respiratory diseases not only for respiratory care students but also for other allied health practitioners.
Robert G. McGee, M.S., R.R.'f. Henderson, Kentucky
CARDIAC APPLICATION OF DIGITAL ANGIOGRAPHY. Edited by ALAN G. WASSERMAN and ALLAN M. Ross. Mount Kis<.'O, NY: FuturaPublishing, 1989, 311 pp, $53.00 This book examines current applications of digital imaging technology for evaluation of cardiac anatomy and function. An introductory chapter on principles ofdigital imaging and processing serves to outline the fundamentals of this technique, and the physics of this technology is presented in an entirely readable form. The majority of the book concerns how digital imaging technology can be applied to evaluation of left ventricular function as well as the diagnosis of coronary artery disease. There is an excellent chapter on the different techniques for objective assessment of coronary anatomy, including electronic caliper measurement, computerized edge tracing, biplane three-dimensional reconstruction, automated edge detection, and densitometry, as well as predictions about future directions of this technique. Also of interest is the information presented on assessment of coronary Bow reserve, since analysis of flow reserve provides both anatomic and physiologic information and will likely become an extremely important tool in the evaluation of coronary artery disease. Other chapters in this book concern the utilization of digital subtraction angiography for assessment of stenosis before and after angioplasty, a chapter on the use of this technique in pediatrics, and an excellent chapter on the noncardiac applications of digital subtraction angiography, including elegant photographs of the aorta and great vessels. This text is clinically oriented and is designed for the invasive cardiologist as well as for radiologists involved in cardiac imaging. In general, the chapters are <.'Omprehensive and well \\Titten, and the physics is presented in a highly readable form. The chapters are reasonably well referen<.-ed with current literature. In general, the editors have presented a comprehensive overview of the application of digital angiography and digital subtraction techniques for the evaluation of cardiac function and coronary anatomy. This book should serve as a solid basis for understanding the application of these techniques.
lbtricia L. Cole. M. D. StLouis
~IIII. the bookshelf
INTRODUcrION TO RESPIRATORY MEDICINE, 2nd ed. Edited by MEIR H. KRYGER. New York: Churchill Livingstone, 1990,402 pp, $25.95 This book is an overview of the pathophysiology of respiration. It contains 18 chapters, all well illustrated by graphs and tables and written by teacherphysicians knowledgeable in their fields. The various chapters cover a wide range of topics, from airBow obstruction to symptoms and signs. Overall, this book is succinct and well written. Its strength is in respiratory physiology. Its weakness is in respiratory pathology. Particularly informative are the chapters entitled "Adult Respiratory Distress Syndrome," by Thomas L. Petty, and "Respiratory Failure:' by Meir H. Kryger. Bibliographic references are limited, averaging ten per chapter. In my opinion, this softbound textbook is up to date and practical for teaching medical students, residents. and fellows. It is not a reference textbook.
s. Donald Greenber~,
M.D., F.C.C.P.
Houston
PEARLS AND PITFALLS IN ELECfROCARDIOGRAPHY. By HENRY J. L. MARRIOTT. Philadelphia: Lea & Febiger. 1990, 157 pp, $17.50 By Professor Marriott's description, he has assembled 70 "tricks of the trade" designed to improve ECG reading skill. The individual segments are generally 200 to 300 words in length and illustrated by several appropriate strips and an occasional diagram. The result is avowedly "not a textbook"; the individual segments are rather loosely grouped and could probably be reviewed in any order without reference to one another. Substantial ECG knowledge and some background in complex electrophysiologic mechanisms are presupposed for many segments; most examples will challenge senior medical residents seriously interested in cardiology. The usual format for each segment (aphorism or principle followed by brief explanation and example) occasionally leads to surprisingly thorough elucidation of fairly complex ECG or electrophysiologic mechanisms. There is little that is truly new here; virtually all the material has been published previously in one form or another in various texts, often by the author himself; references to the seminal work of Pick, Langendorf, and Rosenbaum from the 1945 to 1970 era are nearly as (.'ommon as those to Sherlock Holmes. The experienced electrocardiographer will, as with many of Professor Marriott's previous presentations, find some of the examples too pat and the diagnoses too firm without supporting electrophysiologic or other documentation. For example, the ambiguities ofapplying complex, sometimes conBicting morphologiC criteria to raise diagnostic accuracy in wide complex tachycardia (SO percent are ventricular in origin) to "an accurate diagnosis \\ith considerable confidence in 85 percent" of cases are not addressed (and I still cannot re<.'Ollect them all when I need them). Overall, this monograph will provide reasonably sophisticated electrocardiographers <.'Onsiderahle entertainment when only brief or frequently interrupted periods of quality reading time are available and additional polish is desired.
Vernon H. Humbert. Jr.. M.D., F.C.C.P. Evansville. Indiana
CT AND MRI OF THE THORAX. Edited by E. A. Z..:RHOlJNI. New York: Churchill Livingstone, 1990,222 pp, $62.00 This book is a must for everyone who deals with imaging the chest. Radiologists, pulmonologists, thoracic surgeons, and their trainees all need to read this book. This superb text is a glimpse into the workings of the excellent thoracic imaging service at Johns Hopkins University. It contains up-to-theminute discussions on the role ofcomputed tomography (Cf) versus magnetic resonance (MR) imaging and when to use each modality. It is interesting to compare this text, which is the lIth in a series on contemporary issues in cr, with an earlier one on just CT of the chest. The role of (.1 in the evaluation of thoracic diseases has evolved as scanners have improved, as has our knowledge of the Cf appearance of various lung diseases. MR imaging has added another new dimension to the evaluation of thoracic diseases. This book begins with a discussion of the role of pulmonary cr in the evaluation of immunocompromised and aClltely ill patients. This new role for CT is helpful in the evaluation of <"omplex pleuropulmonary diseases, and CT may be diagnostic in some pulmonary diseases such as invasive aspergillosis. The next three chapters discuss the relative roles of cr and MR imaging in the evaluation of the mediastinum. This is an important discussion, since each
A-22
has its strong and weak points. It is evident that MR imaging is becoming more accepted as the modality of choice for such entities as dissection and intracardiac tumors. The last four chapters include discussions of the relative roles of the two imaging modalities in the evaluation of focal lung disease, the pleura, the diaphragm, and the airways. It appears that still is the study of choice for imaging these areas. The book finishes with five very nice case studies touching on the areas discussed in the text with examples of the CT and MR findings. I have already recommended this book to all and will do so again.
cr
Robert D. Tarver, M. D. Indianapolis
CLINICAL MANIFESTATIONS OF RESPIRATORY DISEASE, 2nd ed. By TERRY DES JARDINS. Chicago: Year Book Medical Publishers, 1990, 385 pp, $29.95 This se<.'Ond edition provides the respiratory care student and practitioner with a well-designed and informative respiratory disease text. Within the 23 disease groupings, the author uses illustrations and discusses the etiology, clinical manifestations, and general management of the most common and important respiratory diseases. Each section also <.'Ontains self-assessment questions. What is unique and therefore attractive about this text is that it is \\Titten for those who need it most - respiratory care students, who require a straightforward approach to respiratory pathology, and respiratory educators, who need a course textbook that is easily incorporated into a course outline. Both of these targeted groups are served well by this book, since the author provides the requisite information and avoids the temptation to include material that is better left to other pulmonary pathophysiology texts. This book is re<.'Ommended as the textbook for an introductory course in respiratory diseases not only for respiratory care students but also for other allied health practitioners.
Robert G. McGee, M.S., R.R.'f. Henderson, Kentucky
CARDIAC APPLICATION OF DIGITAL ANGIOGRAPHY. Edited by ALAN G. WASSERMAN and ALLAN M. Ross. Mount Kis<.'O, NY: FuturaPublishing, 1989, 311 pp, $53.00 This book examines current applications of digital imaging technology for evaluation of cardiac anatomy and function. An introductory chapter on principles ofdigital imaging and processing serves to outline the fundamentals of this technique, and the physics of this technology is presented in an entirely readable form. The majority of the book concerns how digital imaging technology can be applied to evaluation of left ventricular function as well as the diagnosis of coronary artery disease. There is an excellent chapter on the different techniques for objective assessment of coronary anatomy, including electronic caliper measurement, computerized edge tracing, biplane three-dimensional reconstruction, automated edge detection, and densitometry, as well as predictions about future directions of this technique. Also of interest is the information presented on assessment of coronary Bow reserve, since analysis of flow reserve provides both anatomic and physiologic information and will likely become an extremely important tool in the evaluation of coronary artery disease. Other chapters in this book concern the utilization of digital subtraction angiography for assessment of stenosis before and after angioplasty, a chapter on the use of this technique in pediatrics, and an excellent chapter on the noncardiac applications of digital subtraction angiography, including elegant photographs of the aorta and great vessels. This text is clinically oriented and is designed for the invasive cardiologist as well as for radiologists involved in cardiac imaging. In general, the chapters are <.'Omprehensive and well \\Titten, and the physics is presented in a highly readable form. The chapters are reasonably well referen<.-ed with current literature. In general, the editors have presented a comprehensive overview of the application of digital angiography and digital subtraction techniques for the evaluation of cardiac function and coronary anatomy. This book should serve as a solid basis for understanding the application of these techniques.
lbtricia L. Cole. M. D. StLouis