Book Review

Atlas of Heart Diseases: Cardiomyopathies, myocarditis, and pericardial disease

Atlas of Heart Diseases: Cardiopulmonary diseases and cardiac tumors

N Engl J Med 1995; 333:1788-1789December 28, 1995

Article

Atlas of Heart Diseases: Cardiomyopathies, myocarditis, and pericardial disease
(Vol. 2.) Edited by Walter H. Abelmann. Approximately 250 pp., illustrated. St. Louis, Mosby, 1995. $125. ISBN: 1-878132-24-5

Atlas of Heart Diseases: Cardiopulmonary diseases and cardiac tumors
(Vol. 3.) Edited by Samuel Z. Goldhaber. Approximately 250 pp., illustrated. St. Louis, Mosby, 1995. $125. ISBN: 1-878132-23-7

Volumes 2 and 3 of the Atlas of Heart Diseases are well-documented and superbly illustrated textbooks. Each volume appropriately fulfills the role of atlas with outstanding illustrative material, and the subsections reflect a broad degree of diverse clinical experience. Each entity in the Atlas is thoroughly described in terms of clinical data, pathophysiology, diagnostic imaging, differential diagnoses, and treatments.

Volume 2, which focuses on the cardiomyopathies, myocarditis, and pericardial diseases, is not intended to be comprehensive. It more than adequately fulfills its purpose in presenting the most common forms of cardiomyopathy, as well as typical illustrative forms. In addition to chapters devoted to hypertrophic cardiomyopathy, idiopathic dilated cardiomyopathy, and specific diseases of heart muscle such as that associated with the acquired immunodeficiency syndrome, there is a chapter on experimental cardiomyopathies. As Dr. Abelmann, the volume editor, explains in his introduction, “much of our understanding of the pathogenesis and, more recently, the molecular biology of cardiomyopathies has been gained from such experimental models.”

Volume 3 contains an excellent overview of cardiopulmonary diseases, including chronic cor pulmonale, acute and chronic pulmonary embolic disease, primary pulmonary hypertension, and high-altitude pulmonary edema. The second section focuses on surgical interventions such as pulmonary embolectomy, pulmonary thromboendarterectomy, and heart–lung transplantation. Chapter 7, “A Multidisciplinary Approach to Chronic Thromboembolic Pulmonary Hypertension,” and chapter 8, “Pulmonary Thromboendarterectomy,” contain comprehensive discussions of a clinical entity that has only recently been appreciated. To my knowledge, this is the only source that thoroughly covers these topics; heretofore, any such information could only be found piecemeal in the medical literature.

The subject of venous thrombosis is also thoroughly covered in the third section, with chapters on the diagnosis, treatment, and prevention of this disorder, as well as a clinical overview of chronic venous insufficiency.

The fourth and final section of volume 3 deals with primary and secondary tumors of the heart. The complexities of the benign and malignant primary tumors of the heart and pericardial tissues are well covered in this section, which includes eight excellent case presentations for some of the more common cardiac tumors.

The illustrative material in both volumes is outstanding. For the Atlas series, several thousand images, with detailed legends, were selected by expert authors and reviewed by distinguished volume editors. Dr. Eugene Braunwald, the series editor, explains in his preface that “cardiovascular medicine is the most `visual' of medical specialties.” Diagnoses are based on “the recognition and understanding of a variety of graphic waveforms, images, decision trees, and microscopic sections.” In addition, the correction of cardiovascular disorders, whether by catheter intervention or surgery, is also best described pictorially. Thus, a comprehensive guide to each cardiovascular disorder or disease entity is provided by way of photographs of patients, echocardiograms, computed tomography and magnetic resonance imaging scans, angiograms, and gross and microscopical pathological pictures. High-quality line drawings and charts are interspersed throughout to provide information on the signs, symptoms, and treatment of specific disorders, as well as statistical information.

Most of the illustrations are in color. Color is also used effectively to guide the reader through the text. Major headings for each chapter, for example, are consistently highlighted within a gray box that extends across the page. Tables are highlighted in yellow throughout; graphs and charts are in green.

The text is clear and concise. Most of the chapters have a consistent format, beginning with an introduction (history and background), then moving through the illustrative material (with extensive legends) to discuss clinical findings, diagnosis, and treatment approaches. References are limited to articles of historical importance or current trends. Volume 2, however, includes a list of selected relevant monographs after the introduction.

The books have some drawbacks. Though the expense may be justified by the quality — in terms of the writing, graphics, design, and color — the cost of $125 per volume may be too high for most students. In addition, the pagination, which consists of chapter numbers preceding page numbers for each section (2.1, 2.2, and so on), is awkward.

The format of the Atlas series makes it a formidable teaching tool. The approach is reminiscent of a grand-rounds presentation: a succinct, crisp narrative supported by distinct, visual images. If volumes 2 and 3 are indicative of the level of quality of the complete 12-volume set, then I can enthusiastically recommend it as a valuable addition for both personal and institutional libraries. The series will be useful to anyone interested in cardiovascular disease, but it will be of particular benefit to students and trainees. The images throughout the 12-volume series are now available separately in print and slide form, and Dr. Braunwald's promise to offer these pictures in CD-ROM format is most exciting. The former will be very valuable to instructors, the latter to students of cardiovascular medicine.

Robert J. Hall, M.D.
Texas Heart Institute, Houston, TX 77030