Saving the Heart: The Battle to Conquer Coronary Disease [Hardcover]

Stephen Klaidman (Author)

Book Description

ISBN-10: 0195112792 | ISBN-13: 978-0195112795 | Publication Date: January 15, 2000 | Edition: 1

Though still the leading cause of death, coronary heart disease is now killing half as many people in the U.S. as in the 1960s, partly because of innovative treatments like bypass surgery, balloon angioplasty, and thrombolytic drugs. This book tells the stories of the bold researchers who developed such treatments and explores the tough ethical questions raised by the big money being made in modern cardiology.
Klaidman shows how clinicians, engineers, and entrepreneurs have devised radically new ways to treat a diseased heart. He examines the startling extent to which financial ambition has shaped the dynamics of cardiology--now a multi-billion dollar medical/academic/industrial/governmental hybrid--and the inevitable conflicts of interest such ambition creates. Can a patient's needs come first when market share and profits skew the focus away from medical prudence? Can clinical trials be both free of bias and fast enough to keep up with the flood of new drugs and high-tech devices? Klaidman tackles these questions using real cases, often in the context of wrenching bedside decisions.
Immensely readable and packed with vivid detail, Saving the Heart explores the past, present and swiftly developing future of a high-stakes medical specialty. And it weaves into the fast moving narrative advice on how to make the right treatment choices and identify the best cardiologists and surgeons. If you are one of the 14 million Americans who suffers from coronary disease, Saving the Heart could save your life.

Editorial Reviews

From Publishers Weekly

Recent advances in the treatment of coronary artery disease based on collaborations between engineers, surgeons and cardiologists have led to procedures once undreamed of but now almost routine. Coronary angiography, bypass surgery, angioplasty and stent placement (supporting sagging arteries) have not cured coronary disease, which is still the country's leading cause of death, but they have contributed to a 50% decline in its morbidity rate since 1963. Klaidman's engrossing account traces the development of these interventions, the personalities behind them and the complex questions they raise. A senior research fellow at Georgetown University's Kennedy Institute of Ethics and author of Health in the Headlines, Klaidman finds that innovative surgeons share with artists the qualities of "courage, intuition, and imagination," but often bring monumental egos, arrogance and greed into the mix as well. Recognizing the obvious genius behind cutting-edge coronary research, Klaidman nevertheless suggests that high-tech interventions may now be overused, may be prescribed for the wrong reasonsAincluding increased profits for companies in which doctors or surgeons hold financial interestsAmay deflect attention in medical training away from important clinical skills, and may not offer patients better overall options than drugs. Klaidman offers specific guidelines for coronary patients and argues forcefully for balance between profit-driven research and patient-centered practice in this sometimes harrowing but always fair-minded analysis of some of the most pressing concerns facing modern medicine. 20 illustrations. (Jan.)
Copyright 1999 Reed Business Information, Inc.

From Library Journal

Anyone facing treatment for a cardiac condition should read this book. KlaidmanAwho's not a physician, he's a research fellow at the Kennedy Institute of EthicsAconducted extensive interviews in order to examine the people, the business aspects, and the ethical issues relating to cardiology. Using clear lay language, he humanizes the history of cardiology and explains the evolution of many of the procedures commonly used todayAincluding angioplasty, bypass surgery, and stenting. He also carefully weighs the advantages and disadvantages of commercialism in medical device technology. In the final chapters, he considers current research and hopes for future technologies, and concludes with a practical list of questions that patients might want to ask their doctors before making treatment choices. This useful book should help to remove some of the mystery and fear surrounding heart disease. Recommended for all public libraries.ATina Neville, Univ. of South Florida at St. Petersburg Lib.
Copyright 1999 Reed Business Information, Inc.

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Product Details

• Hardcover: 272 pages
• Publisher: Oxford University Press, USA; 1 edition (January 15, 2000)
• Language: English
• ISBN-10: 0195112792
• ISBN-13: 978-0195112795
• Product Dimensions: 9.3 x 6 x 1 inches
• Shipping Weight: 1.2 pounds
• Average Customer Review: 4.0 out of 5 stars  See all reviews (2 customer reviews)
• Amazon Best Sellers Rank: #1,862,763 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

7 of 8 people found the following review helpful:

5.0 out of 5 stars HEARTily recommended, April 11, 2000

By 

Philip Greenspan - See all my reviews

This review is from: Saving the Heart: The Battle to Conquer Coronary Disease (Hardcover)

Stephen Klaidman has provided us with a very interesting, easy reading book that I recommend to anyone who has a heart condition or is interested in the subject. The major portion of the book discloses chronologically how heart conditions were treated from its earliest practitioners to the present day. Biographical sketches of medical developers, practitioners, entrepreneurs, etc. provide human interest to the emerging history.

All major surgical developments, most of which occurred in the twentieth century, are explained in detail. The struggles of medical pioneers to gain acceptance of what at the time were radical innovations are amply explored. Among these innovations are angiography (imaging technology), heart-lung machine, coronary bypass surgery (with and without the heart-lung machine), angioplasty, and minimally invasive bypass surgery.

Hi-tech heart surgery-an extremely complex and difficult subject-is explained for the layman to understand. The benefits and problems of each of the current procedures are explained.

Klaidman explores hi-tech surgical instruments, a highly profitable multi-billion dollar business. His biographical profiles of some developers (doctor-engineer-inventors) and entrepreneurs disclose how the competitive race of developers to market first and the rivalry of entrepreneurs for market share may be detrimental to the best interests of patients.

None of the many present sophisticated treatments provide a cure! They just alleviate symptoms. The pioneers of today are searching for cures. Their approaches are described and are not only fascinating but also innovative.

The final chapter discusses the ethical questions raised by our current medical system: conflicts of interest between practitioners with financial stakes in various treatments; competition between advocates of various treatment options; competition between various surgical equipment manufacturers for market share; the pressure to reduce costs by HMOs; etc.

If there is one fault to the book, it is that the title "Saving the Heart: The Battle to Conquer Coronary Disease" led me to believe that it would be more comprehensive. The drugs-nitroglycerin, Coumadin, beta-blockers, calcium channel blockers, statins--were mentioned only as they pertained to a topic then being explored, not in the detail the surgical treatments were given. Not even mentioned are life style changes--diet, exercise and meditation--that Dean Ornish has proposed. A book on these topics written as well as this one would definitely be welcomed.

But for what this book does it does it so well a five star rating is most appropriate.

5 of 7 people found the following review helpful:

3.0 out of 5 stars Good read, but..., April 16, 2001

By A Customer

This review is from: Saving the Heart: The Battle to Conquer Coronary Disease (Hardcover)

I am a medical student/researcher with plans to become a cardiac surgeon or cardiologist. I enjoyed learning some of the history of the Cleveland Clinic and am personally involved in some of the new developments that the author mentioned in the last chapter. My only problem is that the book was not representative of american cardiology or cardiac surgery as a whole. It seems that the author did all of his research in Ohio and the Northeast, whereas significant advances have taken place in other parts of the country (U. of Alabama, Mayo, Texas Medical Center). Two of the most famous cardiac surgeons the world has known - Michael Debakey and Denton Cooley were only mentioned in a few short sentences. The reader gets the impression that some less important surgeons (that happen to work at the Cleveland Clinic) invented cardiac bypass surgery when it was actually the work of hundreds. In the last chapter, the author mentions a technique called OCT. Yes, this technique shows promise (I work with it) but it was only mentioned because someone at Harvard is working on it. I can think of 10 examples of techniques that show as much promise. I wish writers that wanted to tell the world about American medicine would search all of America before they sat down to write. In sum, it was readable but had some holes that made me feel incomplete after I read it.