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Doody's Review ServiceReviewer: Gabor F Matos, MD (Loyola University Stritch School of Medicine)
Description: This book provides a comprehensive review of the underlying physiology and technique of stress testing. It is an integrated collection of current research, pathophysiology and clinical applications of the technique. This new edition includes additional clinical pearls (unconventional markers of ischemia) to the arsenal of the cardiologist. There are also two new chapters, one on stress testing in congestive heart failure and one on exercise echocardiography. The previous edition was published in 1996.
Purpose: The purpose is to provide an integrated review of stress testing in a clinically relevant manner. This edition incorporates new data from recent research since 1996. It also includes the review of stress testing in heart failure and stress echocardiography. Providing this updated reference book to the practitioners of stress testing is an important and worthy objective as it may impact the use and interpretation of this frequently ordered diagnostic tool. The book meets the author's objectives.
Audience: The author's primary targets are cardiologists, general practitioners and exercise physiologists. The entire book or certain chapters can also be used by medical students and medical residents as well as nurse practitioners/physician assistants interested in stress testing. The author is credible authority.
Features: Following a historical overview, the book proceeds to lay down the principles of exercise physiology. Unequivocal identification of indications, contraindications to stress testing as well as recommendations for termination of the stress test is especially valuable for the clinical user. The book is educational in the interpretation of the ECG, physiological data, and imaging modalities in different clinical settings and populations. Major concepts are emphasized by "take home messages" and concise summaries, which seems especially practical to me. Disagreements in regard to certain clinical situations (interpretation of stress ECG in LBBB; relevance of ST elevation in leads with Q waves) are not unequivocally resolved. This can be confusing for practitioners.
Assessment: This is an excellent reference of very high quality and it is probably the best source for clinical practitioners and researchers in the field of exercise testing. The book is concise, easy to read and understand, and useful in everyday practice. It is less focused on nuclear imaging and intravascular ultrasound than Marwick's Cardiac Stress Testing and Imaging: A Clinician's Guide (Churchill Livingstone, 1996). It is also more comprehensive than Chung and Tighe's Pocket Guide to Stress Testing (Blackwell, 1997). This fifth edition is an important improvement over the previous edition because the new material carries clinical significance and impacts the way stress testing is used in the clinical practice.