Published by Luis Rodríguez Padial, Aula Médica Ediciones, Spain. 2008: 695 pages, 333 figures, and 208 tables. ISBN 978-84-7885-447-9.
Size matters for many circumstances as well as for books. The first virtue of the book about which it is my pleasure to write is that it is the ideal size. On the outside it looks like a manual, but on the inside it is really an authentic textbook on practical cardiology. In this way, it achieves the best of both worlds (the manageability and brevity of manuals and the thoroughness of textbooks) in a truly harmonious way, something few books of its style can claim. In addition, the clarity of the typography is stupendous, which makes reading, reviewing and assimilating the large quantity of information that it contains much easier.
Naturally, form matters too. Academic exclusivity, which is clearly evident in this text, is insidious in almost all intellectual pursuits (especially in universities), but in a work that is intended for instructional use, uniformity in criteria and approaches is much appreciated. That is why one can consider, though many highly professional authors are involved, that the second virtue of this manual has truly been the coordinator who has written the majority of the text and has added his style to the rest. This avoids the frequent discrepancies that make studying many other similar texts difficult. Also notable is the linguistic level of the text, frankly something that is unusual in these times, which is not full of loanwords, metonymies, poorly translated expressions and sloppy editing that make reading of many medical texts insufferable. This literary quality is combined with other notable qualities: the sober style (though it can be excessive in some chapters, even telegraphic); the reasonable use of abbreviations, which is an almost insurmountable modern plague that has been well-contained here; the scarce number (compared to the norm) of typographical errors and missing punctuation, and the precision of the terminology which is essential in a scientific-medical work. Because of this, the book is generally easy to read and facilitates, instead of impeding, its assimilation.
However, the most important factor is, logically, the content. This is where the third and principal virtue of this book is found. The authors can be proud of having included all the relevant aspects for the practical exercise of cardiology, presented in a systematic, logical and practical way. They begin with a discussion on diagnostic procedures, which are presented in the traditional manner and include both the classical and the new: clinical history, physical examination, electrocardiogram, chest x-ray, exercise stress tests, functional tests, echocardiography, nuclear studies, special radiological studies, coronary angiography and electrophysiological studies. In all these their indications and interpretation are described, without delving into overly technical dissertations. The second large block deals with cardiac diseases which are also presented in a more or less conventional manner: risk factors, atherothrombotic disease, arrhythmias, heart failure, valvular diseases, diseases of the myocardium and pericardium, congenital heart diseases, diseases of pulmonary circulation and special situations, among which are heart surgery, palliative care and other topics. In many cases, the presentation is focused on the most essential diagnostic and therapeutic aspects based on the most recent clinical practice guidelines. Finally, there are many chapters dedicated to protocols and procedures, not only technical (drugs, diet, genetics), but also of a "professional" nature (critical reading of trials, statistics, bibliographic searches), presented in a very practical way; inexperienced and veteran readers alike will find this last part to be extremely useful. Two other no less important virtues should also been attributed to the good judgement of the coordinator and editors: finally, a useful index and bibliography, instead of an endless number of citations repeated over and over that no one is going to consult and only serves to provide a thin useless erudite varnish.
There are also some deficiencies, though much less important than the achievements already mentioned. One of these is the statement of intentions by the principal author or coordinator which is customary at the beginning of all books that are of limited reach or which enter into an arena where there are many competitors. Besides facilitating the job of those of us who have to review these works, it also informs the reader of the work's approach, its objectives and the expectations of the public to whom it is directed. The possible audience for this work is both cardiologists in training as well as in practice, even possibly including medical students who we hope will enjoy and take advantage of it (as it fills the void mentioned in this humble review.) In addition, the price is not mentioned, thus we do not know whether it will be sold in book stores through normal channels. This would be desirable, since the quality of the book deserves it and it would surely contribute to its success. Given the path through which the practice of medicine runs these days, the scarce mention of two relevant aspects is notable: many would consider it reprehensible that no mention is made of ethical aspects, not even the so-called informed consent in the section of study protocols; less would condemn, and some would even praise the authors' good taste in omitting the economical aspects.
In conclusion, this is a notable editorial effort, a relevant addition to training and a useful tool for the practice of cardiology. This book will be welcome in the family of many different entities, among them the Spanish Cardiology Society, made available to those of us who are responsible for contributing to improving the cardiovascular health of our fellow men.