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Coronary artery disease (CAD) causes severe disability and more death than any other disease in affluent societies, including cancer. The medical conditions associated with it are angina, ischaemia, unstable angina, myocardial infarction, arrhythmias, heart failure and sudden death. Choosing the appropriate investigation to confirm a diagnosis helps to assess risk and determine the correct treatment path. GPs also need to know the effective life-style and risk-factor modifications in addition to advocating the best medical therapy.
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ABC OF INTERVENTIONAL CARDIOLOGY Edited by Ever D Grech ABC OF INTERVENTIONAL CARDIOLOGY For Lisa, Alexander, and Frances ABC OF INTERVENTIONAL CARDIOLOGY Edited by EVER D GRECH Consultant Cardiologist, South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, UK © BMJ Publishing Group 2004 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording and/or otherwise, without the prior written permission of the publishers. First published in 2004 by BMJ Publishing Group Ltd, BMA House, Tavistock Square, London WC1H 9JR www.bmjbooks.com British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 0 7279 1546 0 Cover shows coloured arteriogram of arteries of the heart. With permission from Science Photo Library. Typeset by BMJ Electronic Production and Newgen Imaging Systems Printed and bound in Spain by GraphyCems, Navarra Contents Contributors vi Preface vii Acknowledgements viii 1 Pathophysiology and investigation of coronary artery disease Ever D Grech 1 2 Percutaneous coronary intervention. I: History and Development Ever D Grech 5 3 Percutaneous coronary intervention. II: The procedure Ever D Grech 8 4 Chronic stable angina: treatment options Laurence O’Toole, Ever D Grech 12 5 Acute coronary syndrome: unstable angina and non-ST segment elevation myocardial infarction Ever D Grech, David R Ramsdale 16 6 Acute coronary syndrome: ST segment elevation myocardial infarction Ever D Grech, David R Ramsdale 19 7 Percutaneous coronary intervention: cardiogenic shock John Ducas, Ever D Grech 22 8 Interventional pharmacotherapy Roger Philipp, Ever D Grech 25 9 Non-coronary percutaneous intervention Ever D Grech 29 10 New developments in percutaneous coronary intervention Julian Gunn, Ever D Grech, David Crossman, David Cumberland 33 11 Percutaneous interventional electrophysiology Gerry C Kaye 37 12 Implantable devices for treating tachyarrhythmias Timothy Houghton, Gerry C Kaye 41 13 Interventional paediatric cardiology Kevin P Walsh 45 Index 49 v Contributors David Crossman Professor of Clinical Cardiology, Cardiovascular Research Group, Clinical Sciences Centre, Northern General Hospital, Sheffield David Cumberland Consultant Cardiovascular Interventionist, Ampang Puteri Specialist Hospital, Kuala Lumpur, Malaysia John Ducas Consultant Cardiologist, Health Sciences Centre and St Boniface Hospital, Winnipeg, Manitoba and Associate Professor, University of Manitoba, Winnipeg, Canada Ever D Grech Consultant Cardiologist, South Yorkshire Cardiothoracic Centre, Northern General Hospital, Sheffield, UK Julian Gunn Senior Lecturer and Honorary Consultant Cardiologist, Cardiovasc