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Vol. 62. Issue 8.
Pages 955 (August 2009)
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Vol. 62. Issue 8.
Pages 955 (August 2009)
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All the answers regarding heart failure
Todas las respuestas en insuficiencia
Manuel Anguita Sáncheza
a Servicio de Cardiología, Hospital Reina Sofía, Córdoba, Spain
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Edited by Javier Segovia Cubero, Manuel Gómez Bueno, Arturo García-Touchard, and Luis Alonso-Pulpón. Ediciones McGraw-Hill Interamericana de España, Madrid; 2009: 246 pages, 45 figures, and 49 tables. ISBN 978-84-481-7102-5.

When a new book about heart failure is released, the first thing people think is: "Another book!" As, in effect, many books about the different aspects of heart failure have been published over the last few years, including: monographs, manuals, academic books, books for general practitioners... This phenomenon is justified, since heart failure is a very important topic in today's medicine due to its growing incidence and prevalence, its elevated morbidity-mortality, the numerous advances being made regarding its diagnosis and treatment in the last few decades and the awareness-raising of patients, their families and all health professionals about its severity and transcendence, not only medical but also social and economical. There is no doubt that all these publications increase knowledge about a specific problem, at least by improving the spreading of this knowledge; however, it seems that there is not new information enough to justify the numerous book releases on heart failure.

Nonetheless, I believe that this book is absolutely appropriate and justified, as it covers the different problems and questions concerning the treatment of patients with heart failure in a very practical manner, which usually lacks in most books of this type. Instead of a classical tome with its chapters dedicated to reviewing each specific topic about heart failure (epidemiology, aetiology, physiopathology, clinical practice, diagnose methods, natural history, prognosis, and treatment forms) in an academic manner, the authors take a different approach, focused on the resolution of the practical problems that physicians face with each heart failure patient. Therefore, 200 very concrete questions are dealt with, with 1 to 2 page responses for each. For each question (such as "Is heart failure frequent?," "Regarding remodelling, what is it and what is it for?," or "I have received an ECG from a young patient with an unknown 25% LVEF. Should I continue with the aetiological diagnosis, start treatment, or refer him/her to hospital?"), the authors, basing themselves on the known evidence and their own personal experience, which is extensive, respond in a clear, concise, and practical manner to the topic or case at hand.

The book is structured into 3 large sections: heart failure at outpatient facilities, everything a physician should know about heart failure (basically dedicated to general practitioners, clinical cardiologists, and other specialists); in-hospital heart failure (dedicated to acute and advanced heart failure, and thus more directed to cardiologists, internists, and geriatric physicians); and palliative care for terminal heart failure (a little treated aspect in the majority of the manuals about this topic). The first section includes 13 chapters with a total of 112 questions about epidemiology, general physiopathology, diagnosis, differential diagnosis, prognosis, and treatment of heart failure, including a chapter about follow-up and the role of out-of-hospital units for heart failure patients. The last chapter of this section seems especially interesting to me, as it responds to very specific questions that patients usually ask during their visits with physicians (about travel, exercise, sports, depression, pregnancy, work problems, sexual dysfunction, etc). In the second section, the authors cover acute and advanced heart failure during hospital stays in 12 chapters and 76 questions about the diagnosis, handling, and treatment of these patients. Special emphasis is given to the new modalities of treatment (electric devices, surgical treatment, heart transplants, cell therapy, and heart failure hospital units). In the last 2 chapters, there are 12 questions and answers about palliative care and terminal patients with heart failure.

Finally, this is a signature book that can be understood as a cardiology department. In it, the daily work and manner of understanding cardiology and the treatment of patients is reflected from all the members of the Cardiology Department of the Puerta de Hierro Clinic of Madrid. This provides an enormous homogeneity to the information supplied, something that is often lacking in the usual books. Despite all the members of the Cardiology Department of the Puerta de Hierro Clinic participate, the coordination of the project, where the editors' input is evident, was carried out by the following doctors: Segovia, Gómez Bueno, and García Touchard, and the head of the Cardiology Department of said centre, Dr Luis Alonso-Pulpón. In addition to this, the extensive experience of the editors in the field of heart failure and heart transplants is reflected in this book.

Therefore, I believe this is a great book on heart failure, that I highly recommend for all professionals that treat these patients, and that should be at hand for any physician to look up any specific aspect when doubt arises. It is possible that some readers may miss certain topics that are not covered, but I believe the information provided is exhaustive and covers the great majority of the important theoretical and practical aspects to treat patients with heart failure.

Revista Española de Cardiología (English Edition)

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