Table of Contents

Section I. Introduction. Evolution of the coronary care unit: past, present, and future.
Ethical issues of care.
Physical examination.
Section II. Scientific foundation of cardiac intensive care. The role of the cardiovascular system in coupling the external environment to cellular respiration.
Regulation of cardiac output.
Coronary physiology and pathophysiology.
Pathophysiology of acute coronary syndromes: plaque rupture and atherothrombosis.
Regulation of hemostasis and thrombosis.
Section III. Coronary artery disease. Acute myocardial infarction.
Diagnosis of acute myocardial infarction.
Use of the electrocardiogram in acute myocardial infarction.
Reperfusion therapies for acute ST- elevation myocardial infarction.
Adjunctive pharmacologic therapies in acute myocardial infarction.
Complications of acute myocardial infarction.
Post-myocardial infarction cardiogenic shock.
Right ventricular infarction.
Mechanical complications of acute myocardial infarction.
Supraventricular and ventricular arrhythmias in acute myocardial infarction.
Conduction disturbances in acute myocardial infarction.
Complications of percutaneous interventional procedures.
Section IV. Noncoronary diseases: diagnosis and management. Acute heart failure and pulmonary edema.
Acute fulminant myocarditis.
Stress (Takotsubo) cardiomyopathy.
Distributive shock.
Cardiorenal syndrome.
Sudden cardiac death.
Diagnosis and treatment of ventricular tachycardia.
Diagnosis and treatment of unstable supraventricular tachycardia.
Acute presentations of valvular heart disease.
Hypertensive emergencies.
Acute aortic syndromes: diagnosis and management.
Acute pericardial disease.
Acute respiratory failure.
Massive acute pulmonary embolism.
Pulmonary hypertension.
Hemodynamically unstable presentations of congenital heart disease in adults.
Overdose of cardiotoxic drugs.
Section V. Pharmacologic agents in the cardiac intensive care unit. Anticoagulation: antithrombin therapy.
Anti-platelet therapy.
Inotropic and vasoactive agents.
Intensive diuresis and ultrafiltration.
Antiarrhythmic electrophysiology and pharmacotherapy.
Analgesics, tranquilizers, and sedatives.
Pharmacologic interactions.
Section VI. Advanced diagnostic and therapeutic techniques: indications and technical considerations. Central venous access procedures.
Temporary pacing.
Invasive hemodynamic monitoring.
Temporary mechanical circulatory support devices.
Ventricular assist device therapy in advanced heart failure.
Heart transplantation for advanced heart failure.
Emergency airway management.
Mechanical ventilation.
Cardiopulmonary cerebral resuscitation after cardiac arrest.
Palliative care. "With the aim of improving survival from in-hospital cardiac arrest after myocardial infarction, in 1961, Desmond Julian, the legendary British cardiologist, proposed a "special intensive-care unit...staffed by suitably experienced people throughout 24 hours, since it is unreasonable to expect good results when the care of patients is entrusted to [the] inexperienced." With central tenets of regionalized specialty care, collaborative teamwork with specialized nursing, and continuous physiologic monitoring, the initial coronary care units were reported to achieve impressive reductions in mortality after myocardial infarction. Since then, the characteristics of the patients we care for, the medical problems that we encounter, and the technologies that we deploy in the cardiac intensive care unit (CICU) have all changed radically. The fast-paced progression of cardiac critical care toward increasing complexity requires that those who oversee or practice in the CICU embrace a forward-looking culture of continuous redesign and quality improvement; to do so effectively also requires the practitioner to maintain a broad fund of knowledge that keeps to the cutting edge while building on the fundamentals of cardiovascular medicine and critical care. Now in its third edition, Cardiac Intensive Care, edited by David L. Brown, MD, is uniquely positioned with a focus on cardiac critical care, distilling more than a half century of advances in state-of-the-art contemporary cardiac intensive care. This textbook delivers a comprehensive and deep treatment of the pathophysiologic principles, foundational basic and clinical science, and pragmatic clinical practice essential to the diagnosis, assessment, and treatment of patients with cardiac critical illness. From the basics of recognition and management of mechanical complications of myocardial infarction and cardiogenic shock to the essential topics of medical ethics and end-of-life care in the CICU, authoritative experts present the landmark studies, latest advances, and practical pearls in the field. The liberal incorporation of figures and videos enhances the accessibility of the material to the reader. While advances in practice have markedly improved survival and quality of life in many domains of cardiovascular medicine, the nature of the conditions and severity of illness encountered in the CICU continue to confer unacceptably high rates of morbidity and mortality. These facts challenge the field to respond with new research and insightful attention to evolving organizational models and individual processes of care. This textbook is a welcomed companion for practitioners seeking to provide state-of-the-art care in the high-stakes environment of cardiac intensive care. "--Résumé de l'éditeur.