Essentials of Bedside Cardiology, Second Edition, like the first edition, is designed for those who wish to balance technological advances with increased personal skill in history taking and physical examination.
It is important to teach physicians that all technologies now in use for diagnosing cardiovascular disorders, such as echocardiography, can have false positive and false negative results. It is not always wise to rely on these technologies alone; indeed, they may not even be available in some settings. Even when the full panoply of up-to-date techniques is at the physician's disposal, the patient may not be a good candidate for an echocardiogram, or the technician or reader may not be well qualified, or the equipment itself may be substandard. Technology must be combined with physical examination to decide what is true and what is false.
The practice of expert history taking and physical examination returns the physician to the actual patient, where the physician can feel like a "real doctor" rather than a mere interpreter of laboratory data.
Essentials of Bedside Cardiology, Second Edition, strives to teach and not simply to tell the facts, relying on three basic methods derived from the psychology of teaching and learning:
1. Explain the facts.
2. Use a question and answer format—the Socratic method.
3. Provide tricks or mnemonics to help the reader remember the facts.
The value of the Socratic method is its ability to focus attention and stimulate thinking. The format of Essentials of Bedside Cardiology, Second Edition, supports this goal by allowing the reader to cover up the answer and so use the book as a programmed learning tool.
A demonstration of all the heart sounds and murmurs with detailed explanations of what is being heard is provided on the enclosed CD. No simulators have been used. In addition, the use of phonocardiograms and pulse tracings for teaching is encouraged throughout the text.
The index also is a learning tool, having been compiled by me, based on 40 years of teaching experience, with the goal of efficiently guiding the reader to the information needed. The glossary, too, is designed for all levels of readers, constituting a virtual encyclopedia of terms for the cardiologist, student, and noncardiologist alike. Terms that are fully explained in the glossary are typeset in boldface throughout the text as one more pedagogical aid.
Essentials of Bedside Cardiology, Second Edition, is the only book that teaches how to recognize normal jugular waves using updated terminology, how to measure jugular pressure accurately, how to record auscultation findings with an auscultogram, how to tell cardiac function by the blood pressure cuff and Valsalva method, how to diagnose cardiomegaly on an X-ray without using the outdated cardiothoracic ratio, and how to tell whether the apex beat is due to the right or left ventricle. It also gives the latest explanation for the changing loudness of the first heart sound with changing P-R intervals and updates methods for recording and taking an accurate blood pressure.
Jules Constant, md, facc
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