BEDSIDE CARDIOLOGY
BEDSIDE CARDIOLOGY
Second Edition
Achyut Sarkar MD DM (Cardiology) FACC
Professor of Cardiology Institute of Postgraduate Medical Education and Research (IPGME&R) Senior Interventional Cardiologist BM Birla Heart Research Center Kolkata, West Bengal, India
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Bedside Cardiology / Achyut Sarkar
First Edition: 2012
Second Edition: 2020
9789389587579
Printed at
My students—past, present, and future
I am excited to bring you the second edition of “Bedside Cardiology”. This is because in its first edition, I expressed my concern that clinical cardiology would be relegated in the history of medicine! That hasn't happened.
As quoted by Silas Weir Mitchell at Transaction of the Congress of American Physicians and Surgeons held at Washington DC in 1892, “How useful, how simple, it seemed to count the pulse and respiration, or to put a thermometer under the tongue, and yet it took in one case a century, and in another far more, before the mass of the profession learned to profit by the wisdom of the few”. We love to forget those few, because we love only our present.
I will remind you Clark HG, who, in his article on “Execution of Magee: Post-mortem appearance” in 1858, reported that in a criminal, a single heart sound was audible for 90 minutes following execution! On opening the chest, “the ventricles were seen to be inert, but the right auricle was contracting regularly at 80 beats/min”, and was evidently responsible for the sound. And that was S4!
Clark auscultated a dead person for 90 minutes. Let us auscultate a living person for a few minutes!
Achyut Sarkar
Preface to the First Edition
For the sake of stethoscope, please read this preface!
Why another one? Why another one, when Bedside Cardiology, as a science, has been relegated in the History of Medicine and as an art, has been described an art of artifact!
There is no noble intention. This is only for stethoscope, for which I have a romantic nostalgia. Still, I cannot accept the image that a cardiologist is giving round in the ward or seeing patient in his chamber, with the echo Doppler probe of his palmtop echocardiogram machine hanging from his neck and no stethoscope!
Newer investigating tools, newer interventions are evolving almost every day and replacing the new ones. We are appreciating those. Even then, are we not thrilled when we detect an Austin Flint murmur or Graham Steell murmur, described two centuries back? Are we not thrilled when we detect a continuous murmur on the back of any patient?
May not be that useful, we all, still enjoy Bedside Cardiology. We completely agree to Dr Basil M RuDsky–“This is one of the few pleasures that can be derived from the ever-changing practice of medicine. It stimulates acquisition of a good doctor–patient relationship and provides a satisfying alternative to many of the idiopathic inconsistencies and inadequacies of medical practice. It is unquestionably an art and skill that must not be allowed to succumb to the way of the impossible dream of Don Quixote”.
Achyut Sarkar
Acknowledgments
I wish to thank M/S Jaypee Brothers Medical Publishers (P) Ltd New Delhi for whom the creation of this book has become possible. I thank my late mother and father. Their memories are still great inspiration. I thank my daughter Parnisha, my son Arjab, and my son-in-law Baishakh. Their academic aptitude has always been encouraging to me. And Dr Asima Sarkar, my wife who is a great blessing in my life. She has sacrificed her invaluable professional time and supported my academic activities. I thank her with immense gratitude.