Recent advances in cardiology

RECENT ,\I>\TANCES IN CARI~IOLOGY. By Terence East, M.X., I).M., F.R.C.P., and Curtis Bain, M.D., D.nI., F.R.C.P. Fifth Edition, Boston, 1959, Little, Brown & Company. Pp. 421, indexed. Price $10.00. This is quite a good little book. _1lthough at first glance I was inclined to he critical of the age of some of the references, the authors’ preface anticipates this shortcoming. r\s they put it, “The time of literary gestation tends to increase so that many months must elapse between conception on paper and parturition in print. ” There are \-cry few references to work published after 1957. lf’e have, then, a somewhat hypermature offspring and xve must be content with the fact that most of the advances are “relatively” recent. \\‘hat the authors have done with their material is admirable. The discussions are remarkabl) pithy. with hardly a wasted paragraph. All of the important topics in modern cardiology (up to the date of the book’s editing) ha\-e been dealt with in a critical and sensible way. There are adequate references to each subject. The volume is organized into ten major chapters, each dealing with a major aspect of cardiology. These include congenital cardiac defects, infections of the heart, aorta, and pericardial sac, m,yocardial disease, hypertension pulmonar\- heart disease, the heart and circulation in various clunc,rl states, diseases of the coronar\- circulation, bradycardia and disorders of conduction, tachycardia, and heart failure and its treatment. The book is nicely printed and well illustrated. Surgery is not dealt with as a separate topic, hut is discussed where appropriate. In a few places 1 wondered about the basis for certain comments, for example, on page 236 the authors indicate that the serum transaminase is increased in hepatitis but not to the same extent as in myocardial infarction. On page 268 the authors cite some disappointing experiences with the use of noradrenalin in patients with shock following myocardial infarction. However, other studies purporting to show that this drug may be of benefit are not quoted. On page 380 the authors discuss chlorothiazide and it is clear that at the time of writing little experience with the drug was available. The fact that it tends to lower blood pressure is mentioned, but its usefulness in the management of hypertension is not discussed in the section devoted to that disease. On page 311 the authors advise that digitalis be stopped following the conversion of atrial flutter to fibrillation, in order for a normal sinus rhythm to be permitted to return spontaneously. hIan> have questioned the advisability of stopping digitalis in this way. By and large, however, I was pleased to find that the point of view expressed by the authors is consonant with the best in modern cardiology in almost e\-cry respect. This book certainly can be recommended to practitioners, internists, and students, and would serve as an excellent review for an!.one interested in surveying the field. -Abraham Genecin

DIE

PHLEBOGRAPHIE DER VNTEREN EXTREMITXT (THE VENOGRAPHY THE LOUVER EXTREMITIES). By Robert May, M.D., and Raimund Nissl, Stuttgart, 1959, Georg Thieme Verlag. Pp. 197, indexed. Price $17.85.

OF M.D.

‘The purpose of this monograph is to further the diagnostic evaluation of patients with diseases involving the veins of the lower extremities and the pelvis. Since thrombosis and its sequelae haxe become a major, clinical and social problem in man! countries, the urgency of finding new therapeutic means is obvious. This attempt must be based on sound diagnostic methods, among which venography will be of increasing importance, not only as initial examination, but also to check the results during the period of treatment. Introductor\, chapters review the anatomy, physiology, and pathoph) siology and acquaint the reader with the technique of retrograde venographs, including \-arious contrast media and their potential harmfulness. Two hundred fifty illustrations of excellent quality (roentgenographs, line drawings, photographs) demonstrate the appearance of acute and chronic thrombosis, the post-thrombotic syndrome, congenital anomalies, alterations in leg ulcers, tumors, and venous aneurysms. In many cases the roentgenographic findings are compared with the surgical or anatomic specimen: in others, long-term follow-up results are demonstrated.