On Call Cardiology
M. Gabriel Khan
486 pp. Philadelphia: Saunders; 2001. $28.00. ISBN 0-7216-9222-2
Another title for this book could be “The Survivor’s Guide to CCU Call.” Directed at medical students and residents, this book is intended for use as a quick guide to common, cardiology-related problems that may arise while on call.
The premise is that young physicians in training are faced with difficult and intimidating clinical scenarios at night with limited back-up resources. This book is a quick “how to” on clinical cardiology in the acute inpatient arena.
This is the second edition of this book. New features include expansion of new diagnostic and therapeutic strategies, study sections to allow the reader to review key concepts, a new chapter on evaluating and treating patients with murmurs, and a Global Drug Table comparing the names of cardiac drugs among different countries.
The general outline of the book is easy to read and follows a simplistic style (often cookbook-like). The book is divided into 3 sections. The first section covers introductory material on the following: (1) approach to the diagnosis and management of on-call problems, (2) documentation, (3) extrathoracic physical examination, (4) cardiac physical examination, and (5) guide to ecg diagnosis.
The second section is called “Patient-Related Problems: The Common Calls.” This places the reader in a first-person scenario in the setting of common cardiac situations. Acute myocardial infarction, unstable angina, pericarditis, cardiac tamponade, hypotension/shock, dyspnea, edema, cough, pulmonary embolism, congestive heart failure, palpitations, arrhythmias, fever, hypertension, syncope, cardiac arrest, deep vein thrombosis, and murmurs are covered. The book walks you through every aspect of critical thinking, including what questions to ask the nurse on the phone, what you should be thinking about on the elevator, and what to do at the bedside.
The third section is an appendix that includes advanced cardiac life support protocols, infusion pump charts, and drug tables outlining indications, interactions, dosages, and adverse effects.
This book is well organized, and the content covers the salient points of caring for hospitalized cardiac patients. The ECG section is excellent. This section is complete with vector pathophysiology and a nice assortment of abnormal ECGs that the reader will need to recognize while on call.
I thought that the common calls section was well thought-out and complete. This is not a board review textbook; thus, the pathophysiology is minimal. However, this section does a nice job of walking the house officer through many cardiac challenges. There are a few landmark trial references that are nice for the reader to use for further study.
A section on central lines would have been appropriate for this book. Indications, anatomy, technique, and pitfalls of central line placement deserve some mention in a textbook of this context. Some attention to basic pacemaker interrogation would also have been of value.
In summary, this book is well written and serves as a nice guide for medical students and residents in managing acute cardiac problems in the hospital. The content is a bit shallow for a fellow’s daily use; however, it may come in handy when getting swamped in the cardiac care unit (CCU).