By Ong Yong Yau, Woo Keng Thye, Ng Han Seong, Patrick Tan, Tang Ong Teng
During this re-creation of A medical method of drugs, the editor has assembled a panel of best clinicians and researchers, and reorganized the cloth within the key components of medication, cardiology, endocrinology, gastroenterology, hematology, neurology, oncology, rheumatology, renal medication and respiration medication. This e-book is exclusive -- it displays the event of top specialists on styles of ailment within the Asia-Pacific sector. There are numerous different related books, yet these are via authors from the West and accordingly supply a unique standpoint. The e-book additionally contains discussions on genetic ailments, an infection and antimicrobial resistance to antibiotics, highlighting neighborhood incidences and records. each one bankruptcy begins with the fundamental options of a selected subject and steadily develops the subject to provide the state-of-the-art within the subject. With its concentrate on practices specified to Asia-Pacific, this publication is a needs to for the coed, working towards clinician and learn scientist attracted to the most recent advancements during this a part of the area.
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Additional resources for A Clinical Approach to Medicine
Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomized trial. HOT Study Group, Lancet 351:1755–1762, 1998. This page intentionally left blank 3 Ischemic Heart Disease Lim Yean Leng and Mak Koon Hou INTRODUCTION Ischemic heart disease (IHD), once thought to be uncommon at the turn of this century, is now one of the commonest medical conditions. Indeed, in 1997, they accounted for Ͼ15 million deaths worldwide, second only to infections.
Acute LV dilatation produces increased wall tension and correspondingly raises oxygen demand, in accordance to the Law of Laplace. Decubitus angina typically improves when the patient assumes an upright position. ” Both Ischemic Heart Disease 35 decubitus and postprandial angina occur only when coronary perfusion is critically balanced and imply a significant amount of myocardium is in jeopardy. These are often associated with extensive atherosclerotic disease. Angina is a result of reversible myocardial ischemia without necrosis.
Angina may be associated with symptoms of cold sweat, breathlessness or giddiness. The CCS Grading Scale is most commonly used to classify the clinical severity of anginal symptoms (Table 1). Table 1 Canadian Cardiovascular Society (CCS) Functional Classification of Angina Pectoris Class Ordinary Activity Description I No limitation II Slight limitation* III Marked limitation IV Inability to perform Angina from rapid, strenuous or prolonged exertion Angina from walking Ͼ 2 blocks or up Ͼ 1 flight of stairs Angina from walking Ͻ 2 blocks or up Ͻ 1 flight of stairs Angina at rest or minimal exertion *Angina occurs during walking or climbing of stairs rapidly or under additional stress, such as after meals, in cold or hot weather, against a strong wind or emotional tension, and first few hours after awakening.