Preface

“Use a picture, it’s worth a thousand words,” wrote influential newspaper editor Arthur Brisbane in 1911. However, a medical image may be worth very little to the untrained observer. Even experienced clinicians may find they lack the specific skills to read complex diagnostic images. This atlas is designed to empower the reader to correctly interpret cardiovascular medical images, and, in particular, time critical images for emergency management.

It has been 119 years since the very first non-artist rendered image representing heart function was published by Willem Einthoven in 1895.¹ This was a very simple one-lead electrocardiogram, which gave us the designations for the now familiar wave forms: Q, R, S, and T. At approximately the same time, Conrad Roentgen discovered X-rays,² but it would be decades before these devices would be used to manage patients with emergencies. Indeed at this point in history, emergency care was provided by general practitioners making house calls, and diagnoses were made on the basis of history and physical exam alone. Critically ill patients rarely survived long enough to be tested. Much has changed in the past 100 to 120 years. Now pattern recognition of findings on electrocardiograms, plain radiographs, ultrasound images, computed tomography images, magnetic resonance images, and other sophisticated cardiovascular images is essential to making real-time diagnoses in the emergency department.

¹ Einthoven W. “Ueber die Form des menschlichen Electrocardiogramms.” Arch f d Ges Physiol. 1895;60:101-123.

² Stanton A. Wilhelm Conrad Röntgen On a New Kind of Rays: translation of a paper read before the Würzburg Physical and Medical Society, 1895. Nature. 1896;53(1369):274–276.

This atlas was written as a concise guide to acute care cardiovascular image interpretation for the diagnosis and management of emergency conditions. Just as the management of these patients requires the input from a number of specialists, including emergency physicians, cardiologists, radiologists, and cardiovascular surgeons, this book has drawn on the expertise of these specialists to write chapters, review materials, critique content, or provide classic images. We the editorial team are deeply grateful to all the contributors who made this atlas a possibility.

Cedric Lefebvre, MD

James C. O’Neill, MD

David M. Cline, MD