Book Review

Cardiology for the Primary Care Physician

N Engl J Med 1997; 336:76-77January 2, 1997

Article

Cardiology for the Primary Care Physician
(Current Practice of Medicine.) Edited by Joseph S. Alpert. 374 pp., illustrated. St. Louis, Mosby, 1996. $99. ISBN: 0-8151-1557-1

Cardiovascular medicine has become highly specialized, but the front line of the battle against cardiovascular disease will always be the realm of primary care physicians. Therefore, primary care physicians must be familiar with the clinical presentation, diagnosis, and treatment of cardiovascular disease, even though many patients will be referred to a specialist for consultation and treatment. An up-to-date knowledge of cardiovascular medicine ensures better communication with consultants when they are needed and reduces the time needed for the complete workup of a patient, and even the costs involved.

This book, which is based on chapters prepared for the primary care medicine series Current Practice of Medicine, is specifically oriented toward primary care physicians. It begins with four chapters that deal with general tools (physical diagnosis, referrals, preoperative assessment, and noninvasive cardiac tests), followed by seven problem-oriented chapters that are based on the patient's symptoms (e.g., chest pain, heart failure, and syncope). The remaining 32 chapters deal with most cardiovascular disease entities in a disease-oriented fashion. In these chapters one can easily obtain information about common diseases such as hypertension, acute and chronic ischemic heart disease, and cardiomyopathy and less commonly encountered diseases or conditions, such as congenital heart disease in the adult, pulmonary hypertension, cardiac tumors, and being the recipient of a heart transplant.

The tables summarizing key points, figures, and algorithms give the reader quite a lot of information in a condensed format, which is always oriented toward the general clinical approach that is so important for primary care physicians. Each chapter concludes with a brief bibliography in which articles of special value are clearly designated. The book covers most of the cardiovascular problems that are commonly encountered by primary care physicians, but specific chapters on the diagnosis and management of atrial fibrillation and on cardiovascular disease in the diabetic patient, both very common, are missing.

This multiauthored book is well edited, but my personal preference would be to place chapters such as “Preoperative Consultation” and “Referrals” toward the end, rather than at the beginning. Primary care physicians will find this a valuable book.

Jesaia Benhorin, M.D.
Bikur Cholim Hospital, Jerusalem 91004, Israel