Search

Cardiovascular diseases are the most important causes of death in the world today. In adults, the most frequent heart disease is acute myocardial infarction, which can lead to sudden death. To prevent these diseases we need to fight against their main risk factors, which include smoking, lipid disorders, hypertension, diabetes and a sedentary life-style, among others. It has been demonstrated that physical exercise or sports at any age provide notable benefits and can help to decrease other risk factors and reduce the incidence of cardio­ vascular diseases. Exercise can be simply walking or cycling. Aerobic exercise con­ tributes to weight loss and also helps to control blood pressure, cholesterol and diabetes. It therefore plays an important role in prevention of heart diseases. Sports for young people are of great value and advisable not only because they con­ tribute to physical fitness but also because they help in psychological well-being. Young people should be encouraged to include general exercise, and particularly sports, into their daily activities. The following points however, should be kept in mind: I. Although winning at a sport is important, this is only so if it is achieved in natural physical conditions and with the correct training. Therefore, it is advisable to keep well away from any type of activity which artificially increases physical performance, that is, drug taking.

Therapy in cardiology has advanced enormously in recent years. This has resulted in the organization of many meetings and the publication of numerous books dedicated to examining the latest aspects of, for instance, pharmacolog­ ic, electrical and surgical treatment. However, only a few of these meetings and publications have attempted to present an overall review of all advances that have taken place in the field of therapy. In the last years the Spanish Society of Cardiology has shown a great interest in the continuous medical education in cardiology. The Society has organized various meetings and has published several books on the above-mentioned topics. Consequently, the Society has decided to publish this book, an update of the therapeutics in cardiology, of which a Spanish version is also available. World renowned experts and outstanding Spanish cardiologists were invited to review all aspects of therapy in cardiology. We would like to thank the Spanish Society of Cardiology and the Catalan Cardiac Society for the generous assistance they have given us during all stages of book preparation. We also would like to express our appreciation to all the authors for their valuable contributions. Their combined efforts enable us to put this volume in the hands of the reader.

Sudden death is probably the greatest challenge facing modem cardiology today. This is mainly due to the impact of its brusque appearance and the socioeconomic implications. The incidende is presently decreasing somewhat, mainly due to the decline in new cases of ischemic heart disease on one hand, and to better preven­ tion in risk patients on the other. Nevertheless, the figures are still high and represent over 300.000 patients per year in the United States alone. This book is an updating of the problem of sudden death from a multifactorial standpoint. It includes not only electrophysiologic data but also covers aspects ranging from epidemiology to prevention. Risk markers and triggering mechanicsms of sudden death are reviewed, with special emphasis on the role of electrical instability, ischemia and depressed ventricular function. The book includes the contributions from many experts, often pioneers in their respective fields. It is our hope that the book serves as an Updating for those cardiologist who are not specialized in these subjects, but may also be of interest to the expert. We wish to express our sincerest gratitude to the authors for sending in their work so promptly, and also Kluwer Academic Publishers for their exactitude and perfection in this edition.

In the last 15 years we have had the opportunity to teach Electrocardiography to many different types of student: doctors preparing to become cardiologists, cardiologists attending weekly'refresher'sessions at our hospital, general practitioners who wish to become adept at electrocardiography and attend our yearly courses and, finally, the medical students of the Universidad Aut6noma of Barcelona. We cover everything with these students from the basics of electrophysiology to applied electrocardiographic semiology. This quadruple experience has proved stimulating, constantly motivating the search for better and more precise material, and the most appropriate didactic presentation for each type of student, each of whom has different requirements. I have always felt that didactic capability is not related to the intelligence of the professor, or to the amount of knowledge this person possesses, but really depends on the'quality'of this knowledge, the'desire'to transmit it and the'capacity'to adapt to each teaching situation.