THE BOOKSHELF LECTURE NOTES ON CARDIOLOGY. 2nd ed. By J. S. FLEMING and M. V. BRA I MBRIDGE. F. A. Davis Co., Philadelphia, 1974, 340 pp, 121 iIlus, ...

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LECTURE NOTES ON CARDIOLOGY. 2nd ed. By J. S. FLEMING and M. V. BRA I MBRIDGE. F. A. Davis Co., Philadelphia, 1974, 340 pp, 121 iIlus, $10.50. Any useful precis covering the breadth of cardiology and touching its complexities requires a degree of dogmatism and calculated simplification without being misleading in fact or concept. The distinguished authors of Lecture Notes on Cardiology have succeeded handsomely in doing just this and the book is warmly recommended as an introductory outline and practical review. Were this its first appearance (1967) that would suffice. But this is a new edition and, while nicely updated for many techniques and treatments, it could have benefited from some careful editing. \Vhile not detracting from the overall value of the book, the precision and completeness of some sections might have been improved without sacrificing its successfully compact format. We learn, for example, that "At the completion of ventricular depolarization all electrical activity within the heart ceases. . . ." (What happened to repolarization?) The able discussion of mitral regurgitation due to "ruptured chordae" actually applies more generally, ie, to papillary muscle and chordal abnormalities. Moreover, mitral regurgitant murmurs are not necessarily pansystolic, especially in cases with musculochordal impairments. The list of common congenital heart diseases somehow omits one of the commonest, bicuspid aortic valve. Hypertrophic obstructive cardiomyopathy is presented as only IHSS. While the diagnostic value of the brachial pulse is emphasized, the carotid is skimped as ~'also examined" (surely a surprise to most of us). The list of oral potassium therapy omits liquid preparations. The material on pericardial disease has several problems: unless there is a very large effusion, we are told that pericardial rubs are "always" present. Not so, and if there is a defensible use for "always" in medicine, it is always to avoid "always." Rubs are also the subject of rather opaque prose, being described as "neither systolic nor diastolic," and whereas Chapter 1 informs us that a rub "usually has 2 components," we learn in Chapter 16 that it is "triphasic." Somehow, pulsus paradoxus is described in detail for constrictive pericarditis, in which it is rarely marked, and not for cardiac tamponade, which it typifies. Indeed, tamponade itself is buried in the discussion

of traulna rather than in a general description of pericardial effusion where it belongs. Finally, there is no proof that constriction "does not occur" after adequate chemotherapy for tuberculous pericarditis. All the foregoing could easily be edited out of this valuable compendium, which is distinguished by an excellent presentation of most subjects. The explanation of surgical procedures, the presentations of congenital heart disease and the diagrams of embryology, valve and congenital lesions and of hemodynamics are outstanding and by themselves worth the price of the book. The items listed for touching up are heavily outweighed by the sheer mass of good material, accurately presented in this book. Those interested in an authoritative introduction, overview or review of cardiology will do well to examine Fleming and Braimbridge's Lecture Notes for themselves. I predict' the majority will buy it and be delighted with the results. David H. Spodick, AI.D. Boston INDICATIONS AND ALTERNATIVES IN XRAY DIAGNOSIS (2nd ed). Edited by MELVYN H. SCHREmER. Charles C Thomas, Springfield, Illinois, 1974, 176 pp, index, $11.50. In this introductory text, the author-editor has approached radiology by body systems and has presented common disease entities that may be detected on the roentgenogram. Illustrations are given of the most common processes and are of good quality. More important, a logical progression in the radiologic investigation of systemic disorders is presented. In addition, special procedures as applied to body systems are covered rather well, and the \vhys and why nots of special procedures are touched upon. Unfortunately, in the area of special procedures, the author's material is rather dated. Cine renal venous washout studies for measurement of renal blood How are advocated, a procedure \vhich is considered to have no utility by workers in this field. Renal vein renin determinations in the hypertensive patient are not mentioned. It is the inclusion of this type of dated material that precludes the unreserved recommendation of this text. It should, however, have some value as an introduction to a logical approach to radiology for medical students, interns and, to a lesser extent, residents of other specialties when faced with a problem outside their area of expertise. Thomas F. Aleaney, AI.D. Cleveland, Ohio