Subduing the Dragon; Living Through a Heart Attack

About the Book

This book was originally aimed at the intelligent layman who has had a heart attack and who wants to understand what has happened to him, how it has happened and why. It was designed to explain the workings of the heart, how it gets sick and how doctors diagnose, treat and prevent heart attacks. As it developed, however, it became more than just a book for the interested layman. Although written in lay language, it has evolved into a simplified textbook on the physiology, pathology, and mechanisms of heart disease and of heart attack, atherosclerosis and coronary disease in particular. The book includes sections on how the normal heart works, its anatomy, and how it requires and gets oxygen and fuels to support its function. It describes the interplay between the heart and the influences of the sympathetic (adrenalin) and parasympathetic nervous systems. The coronary arteries and how they function and how they become blocked are discussed at length. The mechanisms of atherosclerosis and the current concepts with regard to plaque rupture and balance between clotting and clot breakup is presented as are the current theories with regard to the role the endothelium (lining cells) of the coronary arteries play in the full scope of heart attacks. The current management of heart attack and of coronary disease is discussed in depth including thrombolysis (use of "clot busters"), angioplasty (using tiny balloons to open up blocked coronary arteries), stents (tiny scaffolds to keep blood vessels open), coronary bypass surgery, and the myriad of medications used in treatment. The medicines and their modes of action are presented in detail. The mechanisms of the electrical events that initiate the heart beat are presented and the rhythm abnormalities seen during heart attacks (and also without heart attacks) are discussed. The book describes the diagnostic methods used including electrocardiography, blood tests for heart attack markers, stress testing and cardiac catheterisation. The concept of risk factors, including smoking, diabetes, hypertension, and elevated blood cholesterol levels is explained and treatment is discussed. Complications of heart attack are discussed and the syndrome of heart failure is described and the rationale for its current treatment is presented. The use of various preventive methods including diet, drugs, exercise and changes in lifestyle are emphasized and specific advice is offered for the patient recovering from a heart attack.

The book is supplemented by a case report of a patient who lived through a complicated heart attack. This case study is not as simplified as the book is and can be read before, or for a layman who knows little about heart disease, after reading most of the book.

To help get through the book, there are summaries at the beginning of each section that present the highlights and aspects that especially interest the specific reader can be turned to immediately.

As the project evolved, numerous people have read the book. Those who have enjoyed the book and gotten the most out of it have included EMT personnel, detail people and sales people who work for drug companies that sell cardiac, antihypertensive, antiarrhythmic, and cholesterol lowering medicines and especially those who sell and detail cardiac devices such as pacemakers, defibrillators, angioplasty balloons,and stents. Technicians who work in catheterisation labs, in stress labs, and in nuclear cardiology labs have also found that the book has helped them to see the big picture. Medical students who have read the book have found that it has helped to understand basic and specific concepts. Interns and residents have breezed through it and found it a helpful review before they start their rotations through the cardiology service, the coronary care unit or the emergency room (and their wives have also enjoyed reading it.) For a physician who is not a cardiologist it has been a painless way to rapidly

About the Author

For over 2 decades, Dr. Haft was Chief of Cardiology at St. Michaels Medical Center in Newark, one of the 14 cardiac centers in New Jersey. He is board certified in Medicine, Cardiology, and Clinical Electrophysiology and has published over 150 papers in the medical literature on coronary artery disease, arrhythmias, cardiac therapeutics, angioplasty and myocardial infarction (see www.pubmed.gov/ for a partial list). He is a Clinical Professor of Medicine at UMDNJ and a Fellow of the American College of Physicians and the American College of Cardiology. He currently practices cardiology in Newark and Hackensack, New Jersey.