The first edition of this book was published in 1990 under the same editors. I believe that the book's rationale remains as valid today. Within the past two decades there has been a rapid increase in knowledge of heart disease and the techniques of diagnosis and treatment, and striking changes in the approach to acute unstable ischemic heart disease. Advances in the basic sciences have given a better understanding of the pathophysiology of acute myocardial infarction. The result has been a significant change in diagnosis and therapy with attendant reduction of morbidity and mortality. There has been steady improvement in myocardial perfusion therapy and angioplasty as well as in pharmacologic management and, underlying it all, understanding of the absolute need for rapid intervention. With each area of advancement, new problems and complications have arisen, and each concept has been examined, reexamined, modified, and reshaped.
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