This is the  second edition of “Heart In Fours” and it  has its importance for  additions, updating and refinements

The  primary objective, as in the previous edition is its ‘uniqueness’ of compiling information in a  remarkable series of  quartets to suit  the title “HEART IN FOURS’, so that one can understand and remember the subject  with greater ease.  The book provides a rational and easily comprehensible  basis of  cardiology.
If the  book is to retain its popularity in the field of medical education, it must be kept completely  up to date in relation to the   evolutionary changes in medical science and technology, in particular the rapid advances in cardiology.  No effort has been spared to make the book thoroughly  up to date.  Quite a lot  of latest information is  collected  from the internet.  Therefore, I hope this will be found useful for those students and  practitioners, who may wish to make themselves acquainted with the latest information  in methods of  clinical investigations and treatment.  This book is useful as a ready reckoner in clinics, wards, lecture-theatres, in preparation for  higher examinations and for consultants. 
This book helps to remove some of the fears that are naturally felt, when starting  practice in medicine especially cardiology. It freely  allows the doctor’s clinical acumen to grow by  slow accretion of many days and  nights for years. As an  independent practitioner, this is the own experience of the Author. 
The  basic principles are stressed more to suit the undergraduates and the differential diagnosis of  various findings to suit the post-graduate students and general physicians.
It is made interesting to the students and teachers of cardiology.  How simple it is, if one understand the  fundamentals thoroughly.
There are many additions in this edition like  Hypertension and Heart failure, Insulin resistant hypertension, Hypertension and Ischemic heart disease,  Hypertension and peripheral vascular disease, Refractory hypertension,  Systolic and Diastolic dysfunction in Heart Failure, Electrophysiological studies that brought changes in the  management of atrial fibrillation and other arrhythmias, Dyslipidemias, Cytoprotective agents, Free radicals,   Epidemiology of  Coronary Artery Disease, Prevention of Coronary Artery Disease among Indians, Troponin, Comparative study of Thrombolytic drugs, Myocarditis, Cardiac emergencies in pregnancy, Obesity, Thyroid diseases, HIV/AIDS,  Primary tumors of the heart, Computer imaging /Tomography, Science, Medicine and Future etc.,
Rapid developments in the field of diagnosis have put a  strain  upon the judgement of  practitioner as well as on the finances of the patient.   Now, more than ever before, the doctor must  avoid thinking of ordering specialised investigations like  angiogram etc. in all cases of  chest pain to exclude cardiac causes. The practitioner’s mind is now baffled with recently introduced Consumer Protection Act (CPA).  The practitioners trend  now a days follow a defensive approach  by ordering  good number of tests which  he never did earlier. 
The patient feels  that the doctor is ordering unnecessary tests. To avoid this conflict  in the minds of patients, the doctor should  spare sufficient time for   history taking and clinical examination  before ordering for a list of investigations. This will prevent  unnecessary expenditure to the patient.  It is therefore appropriate that the medical profession should examine the impact of developing  technology and  new therapeutic modalities in  the practice  of cardiology.  This book  has  carefully conducted analysis, which could have potential impact in the cost of medicare without jeopardising the effectiveness of patient’s care. A lot of  improvement  has been made  in  various chapters to stress the importance of history and clinical examination in this edition.
The total number of points are increased from 2115 X 4  to 2868 X 4.
The total number of figures are increased from  197 to 294

From the student point of view, the problem is not  simply the quantity of  information gathered, but the  diversity of places  from which it is dispensed,  The students know  much, but when it  comes to bed-side, know little  application whereas a practitioner remembers little but applies on bed side with skill.  I hope this book will make this endeavour  for both students and practitioners to grasp easily and remember easily and recapitulate with greater ease when it comes to practical application.  This book would meet the needs of the teachers as well as those who could guide the  teacher-learning process as a SYSTEM.  Thus it has  been my desire to make this book as a  ‘teaching’ text, as well as  one,  that covers essentially all  the fundamentals and advances required for a student of medicine.