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Cardiology book ‘Heart in Fours’ for students and practitioners.

PREFACE TO THE SECOND EDITION

This is the second edition of “Heart in Fours” and it has its importance for additions, updating
and refinements

The primary objective, as in the previous edition is its ‘uniqueness’ of compiling information in a
remarkable series of quartets to suit the title “HEART IN FOURS’, so that one can understand
and remember the subject with greater ease. The book provides a rational and easily
comprehensible basis of cardiology. If the book is to retain its popularity in the field of medical
education, it must be kept completely up to date in relation to the evolutionary changes in
medical science and technology, in particular the rapid advances in cardiology. No effort has
been spared to make the book thoroughly up to date. Quite a lot of latest information is collected
from the internet. Therefore, I hope this will be found useful for those students and practitioners,
who may wish to make themselves acquainted with the latest information in methods of clinical
investigations and treatment. This book is useful as a ready reckoned in clinics, wards, lecture-
theatres, in preparation for higher examinations and for consultants.

This book helps to remove some of the fears that are naturally felt, when starting practice in
medicine especially cardiology. It freely allows the doctor’s clinical acumen to grow by slow
accretion of many days and nights for years. As an independent practitioner, this is the own
experience of the Author.
The basic principles are stressed more to suit the undergraduates and the differential diagnosis
of various findings to suit the post-graduate students and general physicians.
It is made interesting to the students and teachers of cardiology. How simple it is, if one
understands the fundamentals thoroughly.

There are many additions in this edition like Hypertension and Heart failure, Insulin resistant
hypertension, Hypertension and Ischemic heart disease, Hypertension and peripheral vascular
disease, Refractory hypertension, Systolic and Diastolic dysfunction in Heart Failure,
Electrophysiological studies that brought changes in the management of atrial fibrillation and
other arrhythmias, Dyslipidemias, Cytoprotective agents, Free radicals, Epidemiology of
Coronary Artery Disease, Prevention of Coronary Artery Disease among Indians, Troponin,
Comparative study of Thrombolytic drugs, Myocarditis, Cardiac emergencies in pregnancy,
Obesity, Thyroid diseases, HIV/AIDS, Primary tumors of the heart, Computer imaging
/Tomography, Science, Medicine and Future etc.,

Rapid developments in the field of diagnosis have put a strain upon the judgement of
practitioner as well as on the finances of the patient. Now, more than ever before, the doctor
must avoid thinking of ordering specialised investigations like angiogram etc. in all cases of
chest pain to exclude cardiac causes. The practitioner’s mind is now baffled with recently
introduced Consumer Protection Act (CPA). The practitioners trend now a days follow a
defensive approach by ordering good number of tests which he never did earlier.

The patient feels that the doctor is ordering unnecessary tests. To avoid this conflict in the
minds of patients, the doctor should spare sufficient time for history taking and clinical
examination before ordering for a list of investigations. This will prevent unnecessary
expenditure to the patient. It is therefore appropriate that the medical profession should examine
the impact of developing technology and new therapeutic modalities in the practice of
cardiology. This book has carefully conducted analysis, which could have potential impact in the
cost of medicare without jeopardising the effectiveness of patient’s care. A lot of improvement
has been made in various chapters to stress the importance of history and clinical examination
in this edition.
The total number of points is increased from 2115 X 4 to 2868 X 4.
The total number of figures is increased from 197 to 294

From the student point of view, the problem is not simply the quantity of information gathered,
but the diversity of places from which it is dispensed, The students know much, but when it
comes to bed-side, know little application whereas a practitioner remembers little but applies on
bed side with skill. I hope this book will make this endeavour for both students and practitioners
to grasp easily and remember easily and recapitulate with greater ease when it comes to
practical application. This book would meet the needs of the teachers as well as those who
could guide the teacher-learning process as a SYSTEM. Thus it has been my desire to make
this book as a ‘teaching’ text, as well as one, that covers essentially all the fundamentals and
advances required for a student of medicine.
Price in India including packing and forwarding charges: Rs.625-00. Price for all other countries
including packing and forwarding charges: US$.30-00