Practical Cardiovascular Medicine. Elias B. Hanna

Indications for therapy II. Notes on LDL, HDL, and triglycerides III. Drugs: LDL-lowering drugs IV. Drugs: TG/HDL-treating drugs and lifestyle modification V. Metabolic syndrome VI. Diabetes and cardioprotective diabetic drugs VII. Elevated hs-CRP (high-sensitivity C-reactive protein test) ≥2 mg/l VIII. Chronic kidney disease (CKD) IX. Causes of dyslipidemia to consider X. Side effects of specific drugs: muscle and liver intolerance with statins, fibrates, and niacin XI. Aspirin is ineffective in primary prevention QUESTIONS AND ANSWERS References 25 Pulmonary Hypertension I. Definition II. Categories of PH III. Two tips in the evaluation of PH IV. Hypoxemia in patients with PH V. Diagnosis: echocardiography; right and left heart catheterization VI. Treatment QUESTIONS AND ANSWERS References 26 Syncope I. Neurally mediated syncope (reflex syncope) II. Orthostatic hypotension and postural orthostatic tachycardia syndrome III. Cardiac syncope IV. Other causes of syncope V. Syncope mimic: seizure (see Table 26.1) VI. Clinical clues (see Table 26.2) VII. Diagnostic evaluation of syncope ( Figure 26.1 ) VIII. Tilt table testing (see Table 26.4)^{10, 40} IX. Indications for hospitalization X. Treatment of vasovagal syncope, orthostatic hypotension, and POTS QUESTIONS AND ANSWERS References 27 Chest Pain, Dyspnea, Palpitations 1. CHEST PAIN I. Causes (see Table 27.1) II. Features III. Management of chronic chest pain IV. Management of acute chest pain 2. ACUTE DYSPNEA I. Causes (see Table 27.2) II. Notes III. Management 3. PALPITATIONS I. Causes II. Diagnosis References 28 Infective Endocarditis and Cardiac Rhythm Device Infections 1. INFECTIVE ENDOCARDITIS I. Clinical diagnosis II. Echocardiography: timing and indications III. Organisms IV. Morphology V. Anatomical complications VI. Indications for valvular surgery and special situations 2. CARDIAC RHYTHM DEVICE INFECTIONS I. Organisms and mechanisms of infection II. Diagnosis III. Diagnosis in patients with bacteremia but no local or TEE signs of infection IV. Management References 29 Preoperative Cardiac Evaluation I. Steps in preoperative evaluation II. Surgical risk: surgery’s risk and patient’s risk III. CARP and DECREASE V trials IV. Only the highest-risk coronary patients require revascularization preoperatively V. Preoperative percutaneous revascularization VI. Surgery that needs to be performed soon after stent placement VII. Preoperative β-blocker therapy VIII. Other interventions that improve outcomes IX. Severe valvular disease X. Perioperative hypertension XI. Preoperative management of patients with pacemakers or ICDs QUESTIONS AND ANSWERS References 30 Miscellaneous Cardiac Topics 1.