Emergency Medicine's Top Clinical Problems, G. Katz, H. Nayak. Emergency Medicine Residents Association (2004), 170 pages, $19.95 ISBN 1-929854-08-0

THE VAST AMOUNT OF DATA PRESENTED IN MULTIPLE CLINIcal trials and their application to daily medical practice represents a significant challenge in medicine. Thus, every practicing cardiology consultant faces the question of how to keep up with the never-ending supply of new heterogeneous information in the form of weekly journal manuscripts, in addition to endless free printings from scientific or business sources. The third edition of Management of Complex Cardiovascular Problems: The Evidence-Based Medicine Approach confronts this challenge and from the first page to the last becomes a very useful and concise tool that will assist physicians to be aware of evidence-based therapies and their use in patient care in the field of cardiology. The editors, led by Dr Thach Nguyen and well-recognized authors in the field of cardiology, have accomplished a monumental task and have produced a book that is well organized, easy to read, and enhanced with tables and that also includes an extensive amount of current useful references. The topic areas and chapters include common problems such as acute coronary syndrome, ST-segment elevation myocardial infarction, coronary artery bypass grafting, heart failure, arrhythmias, syncope, and mitral regurgitation. Other important areas in cardiology, such as cardiogenic shock, pulmonary hypertension, congenital heart disease, and stroke are comprehensively described. Each chapter is structured, and throughout the text the authors provide challenging, stimulating, and clinically pertinent questions that cardiologists will encounter on a daily basis. Each question is answered in light of related data from randomized controlled trials or meta-analyses. At the end of each chapter, a summary with a “Take Home Message” table is included. Valuable information is likewise incorporated into several boxes entitled “Critical Thinking” (new concepts), “Evidence-Based Medicine” (results of important clinical trials), and “Clinical Pearls.” The latter, formulated by expert clinicians, are uniquely instructive and educational. Because of our daily involvement in the field of heart failure and pulmonary hypertension, we found 2 chapters particularly useful. The chapter dealing with heart failure is up-to-date and describes the major randomized controlled trials (eg, Studies of Left Ventricular Dysfunction [SOLVD], US Carvedilol Heart Failure Trial, Sudden Cardiac Death Heart Failure Trial [SCD-HeFT]) in this selected field. In addition, it contains clinical findings and strategies for the treatment of patients with heart failure encountered in daily practice. However, the notable absence of the topic of cardiac transplantation and the limited discussion of available therapies for advanced heart failure were a disappointment. The chapter on pulmonary hypertension is informative and summarizes the aspects of its diagnosis and recognized treatment algorithms. In addition, randomized controlled trials of bosentan, epoprostenol, and phosphodiesterase 5 inhibitors are summarized in an easy-to-read table format. What is also interesting about this chapter is that it provides a wealth of information about pulmonary hypertension in the form of real-world questions and answers in circumstances in which clear-cut evidence-based strategies have been tenuous and uncertain.