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Clinical Cardiology in the Elderly
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Elliot Chesler; ed. 598 pages. Armonk, NY: Futura; 1994. $95.00. ISBN 0-87993-5855. Order phone 800-877-8761.
Texts dealing specifically with cardiology in the elderly were last printed in 1986 and acknowledged that the elderly are a unique group whose needs and responses differ in important ways from those of younger adults. Dramatic changes in the past decade in cardiovascular medical and surgical therapy and in nonsurgical intervention have made this update appropriate.
The format of this text is logical; it begins with anatomical, physiologic, and metabolic considerations peculiar to the elderly and then proceeds to discuss specific clinical problems. The chapter dealing with cardiovascular physiology in the elderly is particularly comprehensive and well written and sets a good foundation for the clinical discussions that follow. Common conditions, such as ischemic heart disease, hypertension, heart failure, and syncope, receive thorough and up-to-date discussion. Generally comprehensive bibliographies are included. The closing chapters deal with socioeconomic and philosophic issues and provide a natural culmination to the book.
For the most part, the presentations in the various chapters are well balanced, but there are some exceptions. The chapter on pulmonary hypertension seems overly long and detailed and better suited to a general cardiology text. On the other hand, the thoughtful and reflective discussions provided in the four closing chapters on autonomy, socioeconomic circumstances, bioethics, and cardiopulmonary resuscitation in the elderly are welcome. These chapters could even be expanded, given the dilemmas so often faced in caring for the aged.
In the balance, this is a well written and well annotated book that is easy to read and practical in its approach. It is suitable for the general internist and the specialist alike and is a worthwhile addition to the library of any clinician who routinely deals with the elderly cardiac patient.
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