Foreword
Cardiovascular disease has become the foremost cause of death and permanent disability in western countries, and is set to become the foremost cause of death and permanent disability worldwide by the year 2020. We are confronting a pandemic that will be a heavy burden on the population and that will cause much human suffering. The burden on health systems is also considerable in terms of healthcare expenditure, which looks set to continue growing. Cardiovascular disease is becoming increasingly common, in particular all types of atherothrombosis. This is driven by the rapid increase in the prevalence of risk factors among the world’s population, such as the increasing frequency of obesity, type 2 diabetes, smoking, physical inactivity and psychological stress combined with a gradual increase in consumption of energy-dense foods and lower consumption of fruit and vegetables. In this context, the burden of cardiovascular disease will continue to increase with a gradual increase in life expectancy in the population.
Despite major progress in this field over the last 50 years, there is still much to learn about the progression of cardiovascular disease, particularly in understanding the mechanism of disease, the pathophysiology and evolution of diagnostic methods. The explosion of imaging techniques combined with ever more refined biological assays, particularly those based on genomics and proteomics, have all helped to make the diagnosis of cardiovascular diseases considerably more accurate and rapid. This exponential progress is the result of very active research and heavy investment in this field. This exciting progress has been translated from basic research into clinical management, thanks to active clinical research in cardiovascular disease. A large number of clinical trials, surveys and registries have helped us to understand both the impact of cardiovascular disease on the population and the impact of new strategies for diagnosis and management. European cardiologists have played an active part in advancing research in cardiovascular disease in basic, clinical and population sciences. The overall result is an improvement in diagnostic and therapeutic potential, as well as better prevention measures. Patients now benefit from a greater diversity of therapeutic options than ever before. The dissemination of this increased knowledge base is of paramount importance because physicians need to be aware of the best evidence concerning the most suitable treatment strategies for a particular disease. They need to implement this information in their daily routine practice, and keep abreast of changes and improvements in the management of cardiovascular disease. The ESC mission statement is to improve the quality of life of the European population by reducing the burden of cardiovascular disease. To fulfil its mission, the ESC has taken on the responsibility of training cardiologists and disseminating knowledge through congress activity, writing and publication of guidelines and, now, publication of The ESC Textbook of Cardiovascular Medicine. This is the first textbook to be proposed by an international society of cardiology. More specifically, the goals of the textbook are to address the knowledge requirements specified in the ESC Core Syllabus, to be consistent with ESC Guidelines and best practice and to produce a clinically focused resource for cardiologists and trainees. In all, The ESC Textbook of Cardiovascular Medicine is set to become the new benchmark for cardiologists in Europe and beyond. The textbook is available in traditional printed format, as well as an online edition complete with CME-accredited self-assessment programmes. The online edition will be regularly updated, and it is hoped that translations will be available in the future. A large number of prominent European cardiologists have contributed to this comprehensive textbook that covers all aspects of cardiovascular disease from diagnosis to management and prevention. As a teaching text, this textbook covers knowledge that every general cardiologist needs to know and keep current, but does not address all the information needs of subspecialists. The concise and practical style was deliberately chosen to make this textbook easy to use. We would like to take this opportunity to thank all those who have contributed so generously their experience, and time, in order to produce this work, most particularly the authors and the co-editors. The wealth of their experience will be invaluable in bringing the most pertinent information to our colleagues throughout Europe and around the world. We are confident that this textbook will enjoy wide recognition, and hope that it will become a reference work for cardiologists around the globe.
Jean-Pierre Bassand President European Society of Cardiology 2002–2004
Michael Tendera President European Societ of Cardiology 2004-2006
Preface
The goal of every good medical textbook is to teach excellence in medicine. This is the main purpose of this new ESC Textbook of Cardiovascular Medicine. This book specifically attempts to draw together all up-to-date strands of relevant information and use all appropriate modern educational methods to ensure good and comprehensive learning. It is not merely a treatise on theory but a practical compendium on cardiac and vascular disease. Yogi Berra, the great Yankee baseball player, once said ‘theory and practice are in theory the same, but in practice they are not!’ It is the editors’ intention to harmonize theory and practice in this new teaching text. The ESC Textbook of Cardiovascular Medicine is the first ever cardiovascular textbook to be published in partnership with an international medical society, and is set to become the standard text in Europe and beyond. Initiated by the ESC Board and strongly supported by the President, it represents a major undertaking and long-term commitment from the ESC.
Everything a trainee or practising cardiologist needs to know
As a teaching or training text structured around the ESC Core Syllabus, The ESC Textbook of Cardiovascular Medicine contains the knowledge that every general cardiologist should strive to attain and keep current. It does not try to contain everything a subspecialist should know about the field. The textbook is consistent with the ESC Guidelines and with best practice. The book has 120 contributors from 12 European countries who were chosen as much for their ability as writers as for their knowledge. The result is a balanced, expert and comprehensive review of each topic. It covers the entire field of cardiovascular medicine and, unlike other texts, the first six chapters are dedicated to diagnostic imaging. Imaging modalities are also discussed within the subsequent chapters on different disorders and diseases and referenced back to the first chapters.
Easy to navigate and lavishly illustrated
All chapters follow the same format so that there are no inconsistencies in style or content. Each chapter opens with a brief ‘Summary’ box detailing the scope of the chapter and ends with a ‘Personal perspectives’ box in which the author outlines state-of-the-art and future directions for the area. The ESC Textbook of Cardiovascular Medicine is succinct, focused and practical to use. Only key references are included so that readability is not inhibited by overly dense text. It is also visually appealing, with an image on every two-page spread. There are over 700 full colour images and over 230 informative tables. All of the illustrations (and many of the ECG traces too) have been redrawn to ensure consistency of style and quality. This truly outstanding art programme means that techniques and concepts are easy to grasp.
Accompanying online version and CME accreditation
An online version of The ESC Textbook of Cardiovascular Medicine is provided with each printed copy. A card with the website address and a unique access number is bound into every book. The unique access number is used when registering, at which point a user name and password can be chosen. Using the website is straightforward and technical help is available if needed. The online version contains all the text and images from TheESC Textbook of Cardiovascular Medicine as well as: l an excellent full text search facility; l downloadable PDF chapter files; l links from reference lists to PubMed; l a database of video clips supplied by the authors; l chapter-based CME multiple choice questions. The provision of high-quality CME for cardiologists and trainees in Europe is a key priority of the ESC. In line with this aim, accreditation of chapters in The ESC Textbook of Cardiovascular Medicine is awarded by EBAC (The European Board for Accreditation in Cardiology). Having read a chapter, you are required to submit your answers to a set of multiple choice questions relating to the chapter’s content. Your score is then displayed and feedback is given on the correctly answered questions. Feedback is not given on incorrect answers so that the test may be attempted again. Having successfully completed a chapter (achieving a pass mark of 60% or above), you can download an EBAC certificate from the website. The editors wish to acknowledge the great help provided to them by the editorial staff at Blackwell Publishing. Gina Almond and Julie Elliott, in particular, have been engaged and involved in the production of this book from start to finish.
A. John Camm
Thomas F. Lüscher
Patrick W. Serruys