An Aid to Electrocardiogram by HN Sarker is a concise guide to ECG for trainees. Divided into six sections – elementary knowledge, ECG interpretation, arrhythmia, systemic ECG and pericarditis (inflammation of the pericardium, the sac that surrounds the heart); it provides both basic and advanced knowledge on ECG changes in different diseases.
The primary aim of the book is to help with pattern recognition, point out key salient features and help trainees understand the logic behind ECG manifestations. Emphasis is placed on diagnosis, cause of abnormalities, their clinical relevance and management of the related conditions.
Key points
- Concise guide to ECG for trainees
- Covers basic and advanced knowledge on ECG changes for different diseases
- Helps trainees with pattern recognition, points out salient features and helps with understanding of logic
- Includes more than 126 ECG images
About the Author
HN Sarker MBBS FCPS (Medicine) MRCP (UK) Associate Professor, Department of Medicine, Sher-e-Bangla Medical College, Barisal, Bangladesh
Contents
PART ONE
Section 1 Elementary Knowledge 1
□ Definition 1
□ ECG Paper 1
□ Leads 1
□ Einthoven’s Triangle 2
– Precordial Leads 2
□ Basic ECG Deflexions 3
□ Direction of Wave 4
□ Orientation of Leads 4
□ Mode of Activation of Atria and Ventricles 4
□ Genesis of Normal ECG Complex 4
– Genesis of the Normal P Wave 4
– Genesis of QRS Complex 5
□ QT Interval 6
□ Ventricular Activation Time 6
□ Causes of prolonged QTC 6
□ Causes of QTC Interval Shortening 7
□ Determination of Frontal Plane Axis 7
– Perpendicular Lead 7
□ Causes of Left Axis Deviation 8
□ Causes of Right Axis Deviation 8
Section 2 ECG Interpretation 9
□ Determination of Heart Rate 9
– Useful Rules of Thumb 9
□ Rhythm 9
□ Individual Waves 9
– P Wave 9
– PR Interval 13
– QRS Complex 14
– Q Wave 14
– R Wave 15
– ST Segment 18
– T Wave 19
– Generalized Low Voltage 20
Section 3 Arrhythmia 21
□ Definition 21
– Disturbance of Impulse Formation 21
– Disturbance of Impulse Conduction 29
– WPW Syndrome (Wolff-Parkinson-White
Syndrome) 38Section 4 Myocardial Infarction 40
□ Summary of ECG Change of Fully Evolved Acute
Myocardial Infarction 40
□ Sequential Changes of Acute
Myocardial Infarction 40
□ ECG Changes of Hyperacute Phase of
Myocardial Infarction 41
□ ECG Changes of Chronic Stabilized Phase of MI 41
□ Localization of Myocardial Infarction 41
– Left Ventricular Infarction 41
– Right Ventricular Infarction 45
– Subendocardial Infarction 45
– ECG Features of Adverse Prognosis in Acute MI 45
– Chronic Stabilized Phase 46
– Diagnosis of Myocardial Infarction 46
– Ventricular Aneurysm 46
□ Coronary Insufficiency/Myocardial Ischemia 46
– Classic Form of Angina (Heberden’s Angina) 48
– Prinzmetal’s Angina 48
– Criteria of Unstable Angina Pectoris 48
– Prognosis of Coronary Insufficiency 48
□ Exercise Tolerance Test (ETT) 48
– Clinical Parameters of Positive ETT 49
– Major Adverse Prognostic Factors 49
– Causes of False-positive ETT 50
□ Causes of Nonprogression of R Wave 50
□ Causes of Tall R Wave in Lead V
1 50
PART TWO
Section 5 Systemic ECG 51
□ Arrhythmia 51
– Sinus Arrhythmia 51
– Sinus Bradycardia 51
– Sinus Tachycardia 53
– Atrial Extrasystole 53
– Atrial Tachycardia (Paroxysmal/Extrasystolic) 55
– Atrial Flutter 56
– Atrial Fibrillation 57
– Supraventricular Tachycardia (SVT) 61
– The Wolff-Parkinson-White Syndrome
(WPW Syndrome) 63
– Lown-Ganong-Levine (LGL) Syndrome 65
– Ventricular Extrasystoles/Premature
Beats/Ectopic Beats 65
– Ventricular Tachycardia 67
xii An Aid to Electrocardigram– Mechanism 68
– Ventricular Fibrillation 70
– Pacemakers (Artificial) 70
– Sinoatrial Disease (The Sick Sinus Syndrome) 72
– Heart Block 73
– Sinus Node Arrest 73
– Atrioventricular Block (AV Block) 74
– Complete Heart Block (Third Degree
Heart Block) 76
– Bundle Branch Block 78
– Fascicular Block 80
– Stokes Adams Syndrome 81
Section 6 Pericarditis 83
□ Acute Pericarditis 83
– Chronic Pericarditis/Pericardial Effusion 84
– Chronic Constrictive Pericarditis 84
– Acute Myocarditis 84
□ Systemic Hypertension 85
□ ECG in Valvular Heart Disease 86
– Acute Rheumatic Carditis 86
– Mitral Stenosis 86
– Mitral Incompetence 86
– Aortic Stenosis 86
– Aortic Incompetence 86
– Atrial Septal Defect 86
– Ventricular Septal Defect 87
– Dextrocardia 87
– Mechanical Dextrocardia 87
– Hypertrophic Cardiomyopathy 87
– Acute Pulmonary Embolism 88
– Emphysema (COPD) 89
– ECG Evaluation of Pulmonary
Function in COPD 90
– Digitalis Effect 90
– Digitalis Toxicity 90
– Hyperkalemia 91
– Hypokalemia 92
– Hypocalcemia 93
– Hypercalcemia 93
– Hypothermia 93
– Uremia 94
Index 95
Contents xiii
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