BOOK
Clinical Electrocardiography: A Simplified Approach E-Book
Ary L. Goldberger | Zachary D. Goldberger | Alexei Shvilkin
(2017)
Additional Information
Book Details
Abstract
Ideal for students and as a review for practicing clinicians, Goldberger's Clinical Electrocardiography explains the fundamentals of ECG interpretation and analysis, helping facilitate an understanding of rhythm disorders and the relevant clinical outcomes. The authors take readers through the nuts and bolts of ECG, using Dr. Ary Goldberger’s award-winning teaching style to clarify complex concepts in an easy-to-read manner. You'll learn simple waveform analysis and beyond to present ECGs as they are used in hospital wards, outpatient clinics, emergency departments, and most especially intensive care units — where the recognition of normal and abnormal patterns is the starting point in patient care.
- Includes Clinical Pearls and Review Points in each chapter, as well as indispensable self-tests on interpreting and using ECGs to formulate diagnoses.
- Covers the nuts and bolts of ECG, explaining how to read the data and then interpret the subsequent clinical findings.
- Features practical, comprehensive coverage of the true-to-life clinical appearance of ECGs.
- Provides ECG differential diagnoses so you can answer the question, "What else could it be?"
- Enhances your understanding of difficult concepts through several new illustrations and animations.
- Highlights the latest information on intraventricular and atrioventricular (AV) conduction disturbances; sudden cardiac arrest; myocardial ischemia and infarction; drug toxicities; and electronic pacemakers and ICDs.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Goldberger's Clinical Electrocardiography | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Table Of Contents | vii | ||
| Video Contents | ix | ||
| Introductory Remarks | xi | ||
| Overview | xi | ||
| ECG Skill Development and Increasing Demands for ECG Literacy | xi | ||
| Addressing “Three and a Half” Key Clinical Questions | xii | ||
| Additional Notes on the Ninth Edition | xii | ||
| I Basic Principles and Patterns | 1 | ||
| 1 Essential Concepts | 2 | ||
| ABCs of Cardiac Electrophysiology | 2 | ||
| Electrical Signaling in the Heart | 2 | ||
| Cardiac Automaticity and Conductivity: “Clocks and Cables” | 4 | ||
| Concluding Notes: Why Is the ECG so Useful? | 5 | ||
| Preview: Looking Ahead | 5 | ||
| 2 ECG Basics | 6 | ||
| Depolarization and Repolarization | 6 | ||
| Five Basic ECG Waveforms: P, QRS, ST, T, and U | 6 | ||
| ECG Segments vs. ECG Intervals | 8 | ||
| 5–4–3 Rule for ECG Components | 10 | ||
| ECG Graph Paper | 10 | ||
| 3 How to Make Basic ECG Measurements | 11 | ||
| Standardization (Calibration) Mark | 11 | ||
| ECG as a Dynamic Heart Graph | 11 | ||
| Components of the ECG | 12 | ||
| P Wave and PR Interval | 12 | ||
| QRS Complex | 12 | ||
| QRS Interval (Width or Duration) | 13 | ||
| ST Segment | 14 | ||
| T Wave | 15 | ||
| QT/QTc Intervals | 15 | ||
| QT Correction (QTc) Methods | 16 | ||
| 1. The Square Root Method | 16 | ||
| 2. A Linear Method | 16 | ||
| U Wave | 17 | ||
| RR Intervals and Calculation of Heart Rate | 17 | ||
| 1. Box Counting Methods | 18 | ||
| 2. QRS Counting Methods | 18 | ||
| How Are Heart Rate and RR Intervals Related? | 19 | ||
| PP and RR Intervals: Are They Equivalent? | 19 | ||
| ECG Terms Are Confusing! | 19 | ||
| The ECG: Important Clinical Perspectives | 19 | ||
| 4 ECG Leads | 21 | ||
| Limb (Extremity) Leads | 21 | ||
| Standard Limb Leads: I, II, and III | 21 | ||
| Augmented Limb Leads: aVR, aVL, and aVF | 24 | ||
| Orientation and Polarity of Leads | 25 | ||
| Relationship of Extremity Leads | 25 | ||
| Chest (Precordial) Leads | 25 | ||
| The 12-Lead ECG: Frontal and Horizontal Plane Leads | 27 | ||
| Cardiac Monitors and Monitor Leads | 28 | ||
| Bedside Cardiac Monitors | 28 | ||
| Ambulatory ECG Technology: Holter Monitors and Event Recorders | 30 | ||
| 5 The Normal ECG | 32 | ||
| Three Basic “Laws” of Electrocardiography | 32 | ||
| Physiologic (Normal) Sinus P Wave | 33 | ||
| Normal QRS Complex: General Principles | 35 | ||
| The Normal QRS: Chest Leads | 36 | ||
| The Normal QRS: Limb (Extremity) Leads | 38 | ||
| Normal ST Segment | 40 | ||
| Normal T Wave | 40 | ||
| 6 Electrical Axis and Axis Deviation | 41 | ||
| Mean QRS Axis: a Working Definition | 41 | ||
| Mean QRS Axis: Calculation | 41 | ||
| Axis Deviation | 46 | ||
| Axis Deviation: Instant Recognition | 47 | ||
| Clinical Significance | 48 | ||
| Mean Electrical Axis of the P Wave and T Wave | 49 | ||
| 7 Atrial and Ventricular Enlargement | 50 | ||
| Right Atrial Abnormality | 50 | ||
| Left Atrial Abnormality/Overload | 51 | ||
| Right Ventricular Hypertrophy | 53 | ||
| Left Ventricular Hypertrophy | 56 | ||
| The ECG in LVH: A Clinical Perspective | 59 | ||
| 8 Ventricular Conduction Disturbances | 61 | ||
| ECG in Ventricular Conduction Disturbances: General Principles | 61 | ||
| Right Bundle Branch Block | 61 | ||
| Complete and Incomplete RBBB | 63 | ||
| Clinical Significance | 63 | ||
| Left Bundle Branch Block | 64 | ||
| Complete and Incomplete LBBB | 66 | ||
| Clinical Significance | 66 | ||
| Differential Diagnosis of Bundle Branch Blocks | 67 | ||
| Fascicular Blocks (Hemiblocks) | 68 | ||
| Left Anterior Fascicular Block | 69 | ||
| Left Posterior Fascicular Block | 69 | ||
| Bifascicular and Trifascicular Blocks | 70 | ||
| Diagnosis of Hypertrophy in the Presence of Bundle Branch Blocks | 72 | ||
| Diagnosis of Myocardial Infarction in the Presence of Bundle Branch Blocks | 72 | ||
| 9 Myocardial Ischemia and Infarction, Part I | 73 | ||
| Myocardial Ischemia: General | 73 | ||
| Transmural and Subendocardial Ischemia | 73 | ||
| Myocardial Blood Supply | 74 | ||
| ST Segment Elevation Ischemia and Acute Myocardial Infarction | 75 | ||
| QRS Changes: Q Waves of Infarction | 79 | ||
| ECG Localization of Infarctions | 79 | ||
| Anterior Wall Q Wave Infarctions | 79 | ||
| Anteroseptal Infarctions | 79 | ||
| Anterior Free Wall/Antero-Apical Infarctions | 79 | ||
| High Lateral Infarctions | 81 | ||
| ECG Localization of Anterior Wall Infarctions: Comments and Caveats | 81 | ||
| Inferior Wall Infarctions | 82 | ||
| Posterior Infarctions | 82 | ||
| Right Ventricular Infarctions | 83 | ||
| Classic Sequence of ST-T Changes and Q Waves with STEMI | 84 | ||
| Normal and Abnormal Q Waves: A Brief Overview | 85 | ||
| Ventricular Aneurysm | 87 | ||
| Multiple Q Wave Infarctions | 87 | ||
| “Silent” Myocardial Infarction | 88 | ||
| Diagnosis of Myocardial Infarction in the Presence of Bundle Branch Block | 88 | ||
| Right Bundle Branch Block with Myocardial Infarction | 88 | ||
| Left Bundle Branch Block with Myocardial Infarction | 88 | ||
| ST Segment Elevation MI: Non-Atherosclerotic Causes | 91 | ||
| 10 Myocardial Ischemia and Infarction, Part II | 92 | ||
| Subendocardial Ischemia | 92 | ||
| ECG Changes with Angina Pectoris | 92 | ||
| Exercise (Stress) Testing and Coronary Artery Disease | 93 | ||
| “Silent” Myocardial Ischemia | 95 | ||
| Non-Q Wave Infarction | 95 | ||
| Other ECG Changes Associated with Ischemia | 95 | ||
| Prinzmetal’s (Variant or Vasospastic) Angina | 96 | ||
| Acute Stress/Takotsubo Cardiomyopathy | 97 | ||
| ECG Differential Diagnosis Ischemia and Infarction: ST-T Changes Simulating MI | 99 | ||
| ST Elevations | 99 | ||
| ST Segment Depressions: Differential Diagnosis | 100 | ||
| Deep T Wave Inversions | 100 | ||
| ECG in Context of Complications of MI | 101 | ||
| ECG After Coronary Reperfusion | 102 | ||
| The ECG in MI: Clinical Overview | 102 | ||
| 11 Drug Effects, Electrolyte Abnormalities, and Metabolic Disturbances | 104 | ||
| Drug Effects | 104 | ||
| Drugs Used to Treat Cardiac Arrhythmias | 104 | ||
| Psychotropic and Related Drugs | 105 | ||
| Electrolyte Disturbances | 107 | ||
| Hyperkalemia | 107 | ||
| Hypokalemia | 107 | ||
| Hypercalcemia and Hypocalcemia | 109 | ||
| Hypomagnesemia and Hypermagnesemia | 109 | ||
| Other Metabolic Factors | 110 | ||
| Hypothermia | 110 | ||
| Endocrine Abnormalities | 110 | ||
| Metabolic Acidosis and Alkalosis | 111 | ||
| ST-T Changes: Specific and Nonspecific | 111 | ||
| 12 Pericardial, Myocardial, and Pulmonary Syndromes | 114 | ||
| Acute Pericarditis, Pericardial Effusion, and Constrictive Pericarditis | 114 | ||
| Acute Pericarditis | 114 | ||
| Pericardial Effusion | 116 | ||
| Constrictive Pericarditis | 116 | ||
| Myocarditis | 117 | ||
| Chronic Heart Failure | 118 | ||
| Pulmonary Embolism (Acute and Chronic) | 118 | ||
| Chronic Obstructive Lung Disease (Emphysema) | 120 | ||
| Pulmonary Parenchymal Disease | 120 | ||
| II Cardiac Rhythm Disturbances | 121 | ||
| 13 Sinus and Escape Rhythms | 122 | ||
| Sinus Rhythms | 122 | ||
| “Normal” Sinus Rhythm | 122 | ||
| Regulation of the Heart Rate | 124 | ||
| Sinus Tachycardia | 124 | ||
| Sinus Bradycardia | 125 | ||
| Sinus Arrhythmia | 126 | ||
| Sinus Pauses, Sinus Arrest, and Sinoatrial Block | 127 | ||
| Secondary Pacemakers and Escape Rhythms | 128 | ||
| 14 Supraventricular Arrhythmias, Part I | 130 | ||
| General Principles | 130 | ||
| Atrial and Other Supraventricular Premature Beats | 130 | ||
| Clinical Significance | 131 | ||
| Paroxysmal Supraventricular Tachycardias (PSVTs) | 132 | ||
| Atrial Tachycardias | 134 | ||
| Initiation and Termination of Atrial Tachycardias | 135 | ||
| Conduction Patterns with Atrial Tachycardias and Other PSVTs | 135 | ||
| Multifocal Atrial Tachycardia: an Important Variant | 136 | ||
| Atrial Tachycardias: Clinical Considerations | 136 | ||
| AV Nodal Reentrant Tachycardia | 137 | ||
| Initiation and Maintenance of AVNRT | 137 | ||
| Termination of AVNRT | 138 | ||
| AVNRT: Clinical Considerations | 139 | ||
| Atrioventricular Reentrant Tachycardia (AVRT) | 139 | ||
| AVRT: Initiation and Conduction | 140 | ||
| AVRT: Termination | 141 | ||
| AVRT: Other Clinical Considerations | 141 | ||
| Differential Diagnosis and Treatment of PSVT | 142 | ||
| Management of Acute PSVT Episodes | 142 | ||
| Long-Term Management of PSVT | 143 | ||
| 15 Supraventricular Arrhythmias, Part II | 144 | ||
| Atrial Flutter: ECG Considerations | 144 | ||
| Atrial Fibrillation (AF): ECG Considerations | 146 | ||
| Atrial Fibrillation and AV Nodal Conduction | 148 | ||
| Atrial Fibrillation with a Regularized Ventricular Response | 149 | ||
| Atrial Fibrillation vs. Atrial Flutter | 149 | ||
| Atrial Fibrillation: ECG Differential Diagnosis | 151 | ||
| Atrial Fibrillation and Flutter: Major Clinical Considerations | 152 | ||
| Symptoms and Settings | 152 | ||
| Thromboembolic and Cardiac Function Complications | 153 | ||
| Treatment of Atrial Fibrillation/Flutter: Acute and Long-Term Considerations | 153 | ||
| Rate Control | 153 | ||
| Rhythm Control | 154 | ||
| 16 Ventricular Arrhythmias | 156 | ||
| Ventricular Premature Complexes | 156 | ||
| Features | 157 | ||
| Frequency | 157 | ||
| Morphology and Axis | 158 | ||
| Coupling Interval | 160 | ||
| Compensatory Pauses | 160 | ||
| Uniform vs. Multiform PVCs | 161 | ||
| “R on T” Phenomenon | 162 | ||
| PVCs: General Clinical Considerations | 163 | ||
| Ventricular Tachycardias: Classification Schemes | 163 | ||
| Monomorphic Ventricular Tachycardia: General Considerations | 163 | ||
| Monomorphic Ventricular Tachycardia: Clinical Importance | 166 | ||
| Polymorphic Ventricular Tachycardias | 166 | ||
| Torsades de Pointes (TdP) | 166 | ||
| Acquired Long QT Syndrome | 167 | ||
| Hereditary Long QT Syndromes | 167 | ||
| The “Big Picture”: Monomorphic vs. Polymorphic Ventricular Tachycardias | 168 | ||
| Accelerated Idioventricular Rhythm | 169 | ||
| Ventricular Fibrillation | 170 | ||
| Differential Diagnosis of Wide Complex Tachycardias | 171 | ||
| 17 Atrioventricular (AV) Conduction Abnormalities, Part I | 172 | ||
| What Is the Degree of AV Block? | 172 | ||
| First-Degree AV Block (PR Prolongation) | 172 | ||
| Second-Degree AV Block | 172 | ||
| Third-Degree (Complete) AV Block | 174 | ||
| What Is the Location of Block? Nodal vs. Infranodal | 175 | ||
| 2 : 1 AV Block: a Special Subtype of Second-Degree Heart Block | 177 | ||
| Atrial Fibrillation or Flutter With AV Heart Block | 179 | ||
| General Clinical Considerations | 179 | ||
| Symptoms | 179 | ||
| Treatment Approaches | 179 | ||
| AV Heart Block in Acute Myocardial Infarction | 179 | ||
| AV Dissociation Syndromes | 180 | ||
| 18 Atrioventricular (AV) Conduction Disorders, Part II | 183 | ||
| Preexcitation via AV Bypass Tracts | 183 | ||
| The Classic WPW Triad | 183 | ||
| The QRS Complex as a Fusion Beat in WPW | 184 | ||
| ECG Localization of Bypass Tracts | 186 | ||
| Highlight: Some Points of Confusion | 186 | ||
| Basis of Narrow Complex Tachycardia (NCT) with WPW | 186 | ||
| Atrial Fibrillation (or Flutter) With WPW Preexcitation | 189 | ||
| Summary: Clinical Significance of WPW | 189 | ||
| Other Preexcitation Variants and Simulators | 189 | ||
| Treatment Principles | 190 | ||
| Brief Overview: Differential Diagnosis of Wide QRS Complex Patterns | 191 | ||
| III Special Topics and Reviews | 193 | ||
| 19 Bradycardias and Tachycardias | 194 | ||
| Bradycardias (Bradyarrhythmias) | 194 | ||
| Sinus Bradycardia and Related Rhythms | 194 | ||
| Wandering Atrial Pacemaker | 194 | ||
| Sinus Rhythm with Frequent Blocked PACs | 194 | ||
| AV Junctional (Nodal) and Related Rhythms | 195 | ||
| AV Heart Block (Second- or Third-Degree)/AV Dissociation | 195 | ||
| Atrial Fibrillation or Flutter with a Slow Ventricular Rate | 196 | ||
| Idioventricular Escape Rhythm | 197 | ||
| Tachycardias (Tachyarrhythmias) | 197 | ||
| Differential Diagnosis of Narrow Complex Tachycardias (NCTs) | 198 | ||
| Sinus Tachycardia and CSM | 200 | ||
| Paroxysmal Supraventricular Tachycardias and CSM | 200 | ||
| Atrial Flutter and CSM | 200 | ||
| RACE: Simple Algorithm for Diagnosing Narrow Complex Tachycardias (NCTs) | 200 | ||
| Differential Diagnosis of Wide Complex Tachycardias (WCTs) | 200 | ||
| Differentiation of SVT with Aberrancy from VT | 200 | ||
| SVT with Aberrancy | 201 | ||
| SVT with the Wolff–Parkinson–White Preexcitation Syndrome | 201 | ||
| VT vs. SVT with Aberration: Important Diagnostic Clues | 202 | ||
| Clinical Considerations | 202 | ||
| ECG Considerations | 202 | ||
| Tachycardias: Additional Clinical Perspectives | 209 | ||
| Slow and Fast: Sick Sinus Syndrome and Tachy-Brady Variants | 210 | ||
| 20 Digitalis Toxicity | 211 | ||
| Mechanism of Action and Indications | 211 | ||
| Digitalis Toxicity vs. Digitalis Effect | 211 | ||
| Digitalis Toxicity: Signs and Symptoms | 211 | ||
| Digitalis Toxicity: Predisposing Factors | 214 | ||
| Electrolyte Disturbances | 214 | ||
| Coexisting Conditions | 214 | ||
| Drug–Drug Interactions | 215 | ||
| Digitalis Toxicity: Prevention | 215 | ||
| Digitalis Toxicity: Treatment Principles | 216 | ||
| Serum Digoxin Concentrations (Levels) | 216 | ||
| 21 Sudden Cardiac Arrest and Sudden Cardiac Death Syndromes | 217 | ||
| Clinical Aspects of Cardiac Arrest | 217 | ||
| Basic ECG Patterns in Cardiac Arrest | 217 | ||
| Ventricular Tachyarrhythmia (Ventricular Fibrillation or Pulseless VT) | 217 | ||
| Ventricular Asystole and Brady-Asystolic Rhythms | 218 | ||
| Pulseless Electrical Activity (Electromechanical Dissociation) | 221 | ||
| Sudden Cardiac Death/Arrest | 221 | ||
| Clinical Causes of Cardiac Arrest | 221 | ||
| 22 Pacemakers and Implantable Cardioverter–Defibrillators | 226 | ||
| Pacemakers: Definitions and Types | 226 | ||
| Single- and Dual-Chamber Pacemakers | 227 | ||
| ECG Morphology of Paced Beats | 227 | ||
| Electronic Pacemaker Programming: Shorthand Code | 229 | ||
| Single-Chamber Pacemaker Programming | 230 | ||
| Dual-Chamber Pacemaker Programming | 230 | ||
| Managing Adverse Effects of Right Ventricular Pacing | 232 | ||
| Biventricular Pacemakers: Cardiac Resynchronization Therapy | 232 | ||
| Major ECG Diagnoses in the Presence of Paced Rhythms | 232 | ||
| Atrial Fibrillation | 232 | ||
| Acute Myocardial Ischemia | 233 | ||
| Cardiac “Memory” T Wave Inversions | 233 | ||
| Implantable Cardioverter–Defibrillators | 235 | ||
| Recognizing Pacemaker and ICD Malfunction | 237 | ||
| Magnet Response of Pacemakers and ICDs | 238 | ||
| Pacemaker and ICD Implantation: Specific Uses | 239 | ||
| 23 Interpreting ECGs | 240 | ||
| ECG Reading: General Principles | 240 | ||
| The Importance of Being Systematic: 14 Points | 240 | ||
| 1. Standardization (Calibration and Technical Quality) | 240 | ||
| 2. Heart Rate(s): Atrial and Ventricular | 241 | ||
| 3. Rhythm/AV Conduction | 242 | ||
| 4. PR (AV) Interval | 242 | ||
| 5. QRS Interval (Width or Duration) | 242 | ||
| 6. QT/QTc Intervals | 242 | ||
| 7. Mean QRS Electrical Axis | 242 | ||
| 8. P Waves (Width, Amplitude, and Shape) | 242 | ||
| 9. QRS Voltages | 243 | ||
| 10. R Wave Progression in Chest Leads | 243 | ||
| 11. Abnormal Q Waves | 243 | ||
| 12. ST Segments | 243 | ||
| 13. T Waves | 243 | ||
| 14. U Waves | 243 | ||
| Formulating an Interpretation | 243 | ||
| Caution: Computerized ECG Interpretations | 244 | ||
| ECG Artifacts | 244 | ||
| 60-Hertz (Cycle) and Related Electrical Interference | 245 | ||
| Muscle Tremor | 245 | ||
| Poor Electrode Contact or Patient Movement | 246 | ||
| Improper Standardization | 246 | ||
| Limb Lead Reversal | 246 | ||
| 24 Limitations and Uses of the ECG | 247 | ||
| Important Limitations of the ECG | 247 | ||
| Utility of the ECG in Special Settings | 247 | ||
| Myocardial Infarction (MI) | 247 | ||
| Acute Pulmonary Embolism | 248 | ||
| Pericardial Tamponade | 248 | ||
| Aortic Valve Disease | 248 | ||
| Mitral Valve Disease | 248 | ||
| Atrial Septal Defect | 248 | ||
| Hyperkalemia | 248 | ||
| Renal Failure | 248 | ||
| Thyroid Disease | 248 | ||
| Chronic Lung Disease | 248 | ||
| Dilated Cardiomyopathy | 249 | ||
| Some Other Medical Applications of the ECG | 249 | ||
| Syncope | 249 | ||
| Coma | 250 | ||
| Shock | 250 | ||
| Weakness | 250 | ||
| Reducing Medical Errors: Common Pitfalls in ECG Interpretation | 250 | ||
| ECGs: Past, Present, and Future | 253 | ||
| 25 ECG Differential Diagnoses | 254 | ||
| 1 Mini-Review Demon | e1 | ||
| Part I: Basic Principles and Patterns | e1 | ||
| Chapter 1: Essential Concepts | e1 | ||
| Review | e1 | ||
| Chapter 1: Questions | e1 | ||
| Chapter 1: Answers | e2 | ||
| Chapter 2: ECG Basics: Waves, Intervals, and Segments | e2 | ||
| Review | e2 | ||
| Chapter 2: Questions | e3 | ||
| Chapter 2: Answers | e3 | ||
| Chapter 3: How to Make Basic Measurements | e3 | ||
| Review | e3 | ||
| Chapter 3: Questions | e4 | ||
| Chapter 3: Answers | e5 | ||
| Chapter 4: ECG Leads | e5 | ||
| Review | e5 | ||
| Chapter 4: Questions | e6 | ||
| Chapter 4: Answers | e6 | ||
| Chapter 5: The Normal ECG | e7 | ||
| Review | e7 | ||
| Chapter 5: Questions | e8 | ||
| Chapter 5: Answers | e8 | ||
| Chapter 6: Electrical Axis and Axis Deviation | e9 | ||
| Review | e9 | ||
| Chapter 6: Questions | e9 | ||
| Chapter 6: Answers | e10 | ||
| Chapter 7: Atrial and Ventricular Enlargement | e11 | ||
| Review | e11 | ||
| Chapter 7: Questions | e12 | ||
| Chapter 7: Answers | e13 | ||
| Chapter 8: Ventricular Conduction Disturbances: Bundle Branch Blocks and Related Abnormalities | e13 | ||
| Review | e13 | ||
| Chapter 8: Questions | e13 | ||
| Chapter 8: Answers | e16 | ||
| Chapter 9: Myocardial Infarction and Ischemia, Part I: ST Segment Elevation and Q Wave Syndromes | e16 | ||
| Review | e16 | ||
| Chapter 9: Questions and Answers | e17 | ||
| Chapter 10: Myocardial Infarction and Ischemia, Part II: Non-ST Segment Elevation and Non-Q Wave Syndromes | e18 | ||
| Review | e18 | ||
| Chapters 9 and 10: Questions | e19 | ||
| Chapters 9 and 10: Answers | e21 | ||
| Chapter 11: Drug Effects, Electrolyte Abnormalities, and Metabolic Disturbances | e22 | ||
| Review | e22 | ||
| Chapter 11: Questions | e22 | ||
| Chapter 11: Answers | e23 | ||
| Chapter 12: Pericardial, Myocardial, and Pulmonary Syndromes | e23 | ||
| Review | e23 | ||
| Chapter 12: Questions | e24 | ||
| Chapter 12: Answers | e25 | ||
| Part II: Cardiac Rhythm Disturbances | e25 | ||
| Chapter 13: Sinus and Escape Rhythms | e25 | ||
| Review | e25 | ||
| Chapter 13: Questions | e26 | ||
| Chapter 13: Answers | e26 | ||
| Chapter 14: Supraventricular Arrhythmias, Part I: Premature Beats and Paroxysmal Supraventricular Tachycardias (PSVTs) | e27 | ||
| Review | e27 | ||
| Chapter 14: Questions | e28 | ||
| Chapter 14: Answers | e29 | ||
| Chapter 15: Supraventricular Arrhythmias, II: Atrial Flutter and Atrial Fibrillation | e29 | ||
| Review | e29 | ||
| Chapter 15: Questions | e31 | ||
| Chapter 15: Answers | e32 | ||
| Chapter 16: Ventricular Arrhythmias | e32 | ||
| Review | e32 | ||
| Chapter 16: Questions | e33 | ||
| Chapter 16: Answers | e34 | ||
| Chapter 17: Atrioventricular (AV) Conduction Abnormalities: Part I: Delays, Blocks, and Dissociation Syndromes | e35 | ||
| Review | e35 | ||
| Chapter 17: Questions | e36 | ||
| Chapter 17: Answers | e38 | ||
| Chapter 18: Atrioventricular (AV) Conduction Abnormalities, Part II: Preexcitation (Wolff–Parkinson–White) Patterns and Syndromes | e39 | ||
| Review | e39 | ||
| Chapter 18: Questions | e40 | ||
| Chapter 18: Answers | e41 | ||
| Part III: Special Topics and Reviews | e41 | ||
| Chapter 19: Bradycardias and Tachycardias: Review and Differential Diagnosis | e41 | ||
| Review | e41 | ||
| Chapter 19: Questions | e42 | ||
| Chapter 19: Answers | e44 | ||
| Chapter 20: Digitalis Toxicity | e45 | ||
| Review | e45 | ||
| Chapter 20: Questions | e45 | ||
| Chapter 20: Answers | e46 | ||
| Chapter 21: Sudden Cardiac Arrest and Sudden Cardiac Death | e46 | ||
| Review | e46 | ||
| Chapter 21: Questions | e47 | ||
| Chapter 21: Answers | e47 | ||
| Chapter 22: Pacemakers and Implantable Cardioverter–Defibrillators: Essentials for Clinicians | e47 | ||
| Review | e47 | ||
| Chapter 22: Questions | e48 | ||
| Chapter 22: Answers | e50 | ||
| Chapter 23: Interpreting ECGs: Integrative Approach | e50 | ||
| Review | e50 | ||
| Chapter 24: Limitations and Uses of the ECG | e51 | ||
| Review | e51 | ||
| Chapter 24: Questions | e51 | ||
| Chapter 24: Answers | e52 | ||
| Chapter 25: ECG Differential Diagnoses: Instant Replays | e53 | ||
| Chapter 25: Questions and Answers | e53 | ||
| 2 Supplemental Extras | e54 | ||
| General | e54 | ||
| Supplement to Chapters 1–6 | e54 | ||
| Basic Cardiac Electrophysiology: Mini-Review | e54 | ||
| The Heart as an Electrically Excitable Medium | e54 | ||
| Transmembrane Potential (Voltage) Differences (Gradients) | e55 | ||
| The Action Potential: Key to the Heart’s Electrical Properties | e55 | ||
| Sinus and AV Node Action Potentials | e57 | ||
| Intracardiac Recording | e58 | ||
| Supplement to Chapters 7 and 8 | e58 | ||
| How do you measure the mean QRS axis with a bundle branch block? | e58 | ||
| What are the cutoff thresholds for left anterior fascicular and left posterior fascicular blocks? | e59 | ||
| RBBB with Right Axis Deviation | e59 | ||
| Bundle Branch Block vs. “Bundle Branch Block Plus” | e59 | ||
| Supplement to Chapters 9 and 10: Acute Myocardial Ischemia and Infarction | e60 | ||
| Supplement to Chapter 13: Sinus and Escape Rhythms | e61 | ||
| Sinus Tachycardia: More Detailed Classification | e61 | ||
| Selected References | e62 | ||
| Heart Rate Variability and Autonomic Tone | e62 | ||
| Reference | e63 | ||
| Supplement to Chapters 14 and 15 | e63 | ||
| Short vs. Long RP Tachycardias | e63 | ||
| Supplement to Chapter 15 | e64 | ||
| On Reporting the Ventricular Rate in Atrial Fibrillation (AF) | e64 | ||
| Atrial Fibrillation and the Pulse Deficit Phenomenon | e64 | ||
| Supplement to Chapter 16 | e64 | ||
| Supplement to Chapter 19 | e65 | ||
| Supplement to Chapter 21 | e65 | ||
| Selected References | e65 | ||
| Supplement to Chapter 22: Pacemakers and ICDS | e65 | ||
| Chest X-Ray with Electronic Devices | e65 | ||
| Post-Pacemaker T Wave Inversions: Cardiac Memory and the Differential Diagnosis of Precordial T Wave Inversions | e65 | ||
| Selected References | e68 | ||
| Pacemakers and ICDs: Frequently Asked Questions (FAQs) | e69 | ||
| Chapter 23: Interpreting ECGs: An Integrative Approach | e70 | ||
| References | e71 | ||
| 3 Quiz Master | e72 | ||
| Questions | e72 | ||
| Life-Savers: Stat ECG Diagnoses | e72 | ||
| Triage Tryout | e74 | ||
| Four Cases of Mistaken Identity | e75 | ||
| Syncopated Rhythms | e77 | ||
| Incomplete Diagnoses of Complete Right Bundle Branch Block | e78 | ||
| Morphing P Waves | e79 | ||
| Tearful Patient | e79 | ||
| Tricky Business | e80 | ||
| Heart Failure After Myocardial Infarction | e80 | ||
| Common Theme | e81 | ||
| Drug Dilemma | e82 | ||
| Narrowed-Down Differential Diagnoses | e82 | ||
| Pause for Thought | e83 | ||
| Look-Alike Tachycardias | e84 | ||
| Silent History | e85 | ||
| Three Patients with Recurrent Syncope | e85 | ||
| Heartburn | e87 | ||
| Hidden P Wave “ST-ories” | e87 | ||
| Myocardial Infarction Simulator | e88 | ||
| Irregular Behavior | e88 | ||
| Quick Changes | e89 | ||
| Missing Bifocals | e90 | ||
| Long and Short of It | e90 | ||
| Pacemaker Plus | e91 | ||
| ECG/Coronary Arteriogram Matchup | e92 | ||
| Calculation Leads to Diagnosis | e94 | ||
| Interest-Piquing T Waves | e94 | ||
| Fitting Finale | e95 | ||
| Answers | e95 | ||
| Select Bibliography | 261 | ||
| Basic Concepts and History | 261 | ||
| Normal and Abnormal P–QRS–T–U Patterns | 261 | ||
| Arrhythmias, Pacemakers, Implantable Cardioverter–Defibrillators, Cardiac Arrest | 261 | ||
| Free Web-Based Ecg/Arrhythmia Resources | 262 | ||
| Index | 263 | ||
| A | 263 | ||
| B | 264 | ||
| C | 265 | ||
| D | 265 | ||
| E | 266 | ||
| F | 267 | ||
| G | 267 | ||
| H | 267 | ||
| I | 268 | ||
| J | 268 | ||
| K | 268 | ||
| L | 268 | ||
| M | 269 | ||
| N | 270 | ||
| O | 270 | ||
| P | 270 | ||
| Q | 271 | ||
| R | 272 | ||
| S | 273 | ||
| T | 274 | ||
| U | 274 | ||
| V | 275 | ||
| W | 275 |