REVIEW OF CHIZNER: CLINICAL CARDIOLOGY MADE RIDICULOUSLY SIMPLE

By Robin B. McFee, DO, MPH
Associate Editor, Johns Hopkins Advanced Studies in Medicine

Clinical Cardiology Made Ridiculously Simple is a 354-page softcover book well suited for use as a reference book for a wide range of clinicians, and an excellent resource for fellows and clinical trainees—both pre- and postgraduate. The latest in the highly successful “Made Ridiculously Simple” franchise, Clinical Cardiology Made Ridiculously Simple is by far the most high-tech. Accompanying the extremely well-written text is a CD ROM that is a treasure trove of heart sounds and murmurs vocalized by Dr. Michael Chizner, who is the chief medical director of the Heart Center of Excellence of the North Broward Hospital District in Ft. Lauderdale, Florida and a former fellow of the legendary cardiologist and master auscultator Dr. W. Proctor Harvey. What makes the CD especially valuable are the many opportunities to practice skills learned from reading the book, with multiple examples of ECG tracings, clinical scenarios, quizzes, and chest x-rays. The CD provides a highly effective tutorial and introduction to echocardiography. This is especially useful because few introductory or review books in cardiology offer such a readable and concise explanation of basic echocardiography; usually one must wade through advanced level echocardiography texts designed for the subspecialist.

Dr. Michael Chizner is a nationally recognized cardiologist, well-published proponent of patient-centered treatment and a highly respected teacher of auscultation and clinical diagnosis. His book serves as a reminder that “the lost art of auscultation” can be rediscovered and waning skills in the bedside evaluation of cardiac signs and symptoms can be reacquired. In an era in which concerns that clinical acumen and bedside diagnosis have given way to technology-dependent decision making, it is refreshing to have a reference that reminds us of the old adage “if you look and listen carefully to the patient you will be able to make the correct diagnosis.”

As evidenced by numerous studies and articles presented in the medical literature, such bedside practices—especially proper use of the stethoscope—are being replaced by high-tech tests. Whereas expensive diagnostic testing modalities are valuable tools in the clinicians' armamentarium, they should not be used in lieu of critical patient evaluation that starts with the patient. With this overdependence on technology comes an erosion of skills, diminished confidence in information gained at the bedside and further reliance on technology—a vicious circle. If the teacher's skills erode, what can we expect from students and trainees who will ultimately replace their teachers as attending clinicians? Fortunately it is not too late; the skills required can be taught and practiced readily and Chizner's book is a great way to get back to the patient bedside. The strength of this book is in the emphasis on explaining bedside diagnosis, underscoring the relevance of clinical clues even in a world of high-tech diagnostic modalities. The value of a careful history in making the diagnosis is as true today as it was before the advent of cardiac catheterization or color echocardiography.

The book draws heavily from Dr. Harvey's teachings, which emphasize bedside diagnosis. Dr. Chizner, like Dr. Harvey, is a skilled storyteller; Clinical Cardiology Made Ridiculously Simple conveys information in an easy-to-read format. Clinical pearls permeate. Like the other books in the MedMaster series, it liberally utilizes cartoons, figures, summary tables, and illustrations that take the reader step by step into the field of clinical cardiology.

In a word this is an example of one-stop shopping for reviewing cardiology, enhancing one's approach to the cardiac examination, as well as understanding the major diagnostic tests that most clinicians rely upon. Clinical Cardiology Made Ridiculously Simple should prove to be a most valuable reference—a review for the unpracticed and a guide for the uninitiated. Clinical Cardiology Made Ridiculously Simple is a valuable resource to providing excellence in care for our patients.