Chest Pain

J. Willis Hurst, MD, a pioneer in the development of cardiology, and his colleague, Douglas C. Morris, M.D., both of Emory University, have edited this book and chose its unusual title for very specific reasons. Patients sometimes have an odd view as to anatomic landmarks that identify the location of the chest, and may assign terms other than pain to their discomfort. Hence the quotation marks around "chest pain." The arrow (—>) after "chest pain" indicates that the physician initially may not know the cause of the symptom, so a differential diagnosis must be established.

This book was written to reintroduce in the modern clinical setting the knowledge and skills needed to analyze symptoms, physical findings, and ECG and x-ray abnormalities in order to accurately diagnose more than 50 different conditions that may bring about a complaint of "chest pain." Experts in the fields of cardiology, pulmonology, dermatology, orthopedics, thoracic surgery, and psychiatry contribute a unique perspective on this common but compelling medical problem. Each chapter concentrates on one causative syndrome or malady, from its initial presentation to its etiology, to differential diagnosis and treatment, while an abundance of well-designed figures serve to illustrate the location of the "chest pain."

Any cardiologist, primary care, or emergency care physician who may encounter a patient complaining of "chest pain" will benefit from this book''s clear, concise and thorough approach to the problem.

J. Willis Hurst, MD, a pioneer in the development of cardiology, and his colleague, Douglas C. Morris, M.D., both of Emory University, have edited this book and chose its unusual title for very specific reasons. Patients sometimes have an odd view as to anatomic landmarks that identify the location of the chest, and may assign terms other than pain to their discomfort. Hence the quotation marks around "chest pain." The arrow (—>) after "chest pain" indicates that the physician initially may not know the cause of the symptom, so a differential diagnosis must be established.

This book was written to reintroduce in the modern clinical setting the knowledge and skills needed to analyze symptoms, physical findings, and ECG and x-ray abnormalities in order to accurately diagnose more than 50 different conditions that may bring about a complaint of "chest pain." Experts in the fields of cardiology, pulmonology, dermatology, orthopedics, thoracic surgery, and psychiatry contribute a unique perspective on this common but compelling medical problem. Each chapter concentrates on one causative syndrome or malady, from its initial presentation to its etiology, to differential diagnosis and treatment, while an abundance of well-designed figures serve to illustrate the location of the "chest pain."

Any cardiologist, primary care, or emergency care physician who may encounter a patient complaining of "chest pain" will benefit from this book''s clear, concise and thorough approach to the problem.

Doody Review Services

Reviewer:John F. Moran, MD(Loyola University Stritch School of Medicine)
Description:This book presents all aspects of the differential diagnosis of chest pain. The title appears in quotes because patients often have a different understanding of the meaning of chest, which may include arms and shoulders and neck, for example. Each of the 14 parts of this multiauthored book is initiated by the same four paragraphs describing the definition of chest pain and its relationship to angina pectoris.
Purpose:The purpose, according to the editor, is to sharpen our differential diagnosis skills in evaluating histories of chest pain. He has determined that physicians have become sloppy in their assessment of chest pain and wishes to remove diagnoses such as atypical chest pain or noncardiac chest pain from the medical lexicon.
Audience:All clinicians ought to enjoy a read of this book, but perhaps especially emergency room physicians. Medical students in physical diagnosis might find the book too detailed at their stage of medical school, but it certainly would be worth noting as a reference for them.
Features:The editor's goal is to sharpen our history-taking skills, and he refers back to the WEED system of the problem-oriented medical record (1967) which noted, "It takes a lifetime to learn how to take a history." All aspects of chest pain are considered here. Each chapter has torso drawings which show pain distribution and radiation graphically shaded. The location, the size of the area, duration, precipitating causes of the pain, as well as physical examination, tests, and treatments are discussed. There are chapters on arthritis, tendonitis, bursitis, and rotator cuff tears involving the shoulders and their relationship to chest pain. In addition, the gastrointestinal track is well covered with discussions of gastro-esophageal reflux, esophagitis, and biliary colic. The largest section of the text is devoted to cardiac causes of chest pain, which range from arrhythmia, angina, and myocardial infarction to valvular heart disease hypertension. Dr. Hurst has written a particularly interesting chapter on angina pectoris. There is also material here on psychiatric causes of pain in the chest.
Assessment:All clinicians should find this a worthwhile review of chest pain. The book is worthwhile in a time when technology seems to be overwhelming history taking and physical examination skills.

Hurst, J. Willis, MD; Morris, Douglas C., MD