Download The ECG in Practice PDF

TitleThe ECG in Practice
PublisherChurchill Livingstone
ISBN 139780702046438
CategoryArts - Film
Author
LanguageEnglish
File Size32.4 MB
Total Pages378
Table of Contents
                            Front Cover
The ECG In Practice
Copyright
Preface
Instructions for online access
Contents
12-Lead ECGs
Chapter 1: The ECG in Healthy People
	The ‘Normal’ ECG
	What to do
Chapter 2: The ECG in Patients with Palpitations and Syncope: Between Attacks
	The Clinical History and Physical Examination
	The ECG
Chapter 3: The ECG when the Patient has a Tachycardia
	Mechanism of Tachycardias
	Tachycardias with Symptoms
	Management of Arrhythmias
	Electrophysiology and Catheter Ablation
	Cardiac Arrest
Chapter 4: The ECG when the Patient has a Bradycardia
	Mechanism of Bradycardias
	Management of Bradycardias
Chapter 5: The ECG in Patients with Chest Pain
	History and Examination
	The ECG in Patients with Myocardial Ischaemia
	The ECG in Other Causes of Chest Pain
	ECG Pitfalls in the Diagnosis of Chest Pain
	What to Do
Chapter 6: The ECG in Patients with Breathlessness
	History and Examination
	Rhythm Problems
	The ECG in Disorders Affecting the Left Side of the Heart
	The ECG in Disorders Affecting The Right Side of the Heart
	What to Do
Chapter 7: The Effects of Other Conditions on the ECG
	Artefacts in ECG recordings
	The ECG in congenital heart disease
	The ECG in systemic diseases
	The effects of serum electrolyte
abnormalities on the ECG
	The effects of medication on the ECG
	Other causes of an abnormal ECG
Chapter 8: Conclusions: Four Steps to Making the Most of the ECG
Index
	A
	B
	C
	D
	E
	F
	G
	H
	I
	J
	L
	M
	N
	O
	P
	Q
	R
	S
	T
	U
	V
	W
	X
                        
Document Text Contents
Page 2

ECG
The

In Practice

Page 189

The ECG when the patient has a bradycardia

176

ATRIAL FIBRILLATION AND FLUTTER

A slow ventricular rate can accompany atrial fl utter or
atrial fi brillation because of slow conduction through
the AV node and His bundle systems ( Figs 4.9 and
4.10 ). This may be the result of treatment with drugs

that delay AV nodal conduction, such as digoxin, beta-
blockers or verapamil, but can occur because of con-
ducting tissue disease.

Complete block associated with atrial fi brillation is
recognized from the regular and wide QRS complexes
which originate in the ventricular muscle ( Fig. 4.11 ).

I

II

Fig. 4.8

Note

• Same patient as in Figure 4.7
• Ambulatory record
• No P waves
• Narrow complex rhythm
• Rate 15/min, due to AV nodal (junctional)

escape

Sinus arrest and atrioventricular nodal escape

I VR V1 V4

II VL V2 V5

III VF V3
V6

Fig. 4.9

Page 190

Atrial fi brillation and fl utter 4

177

Familial

• Isolated
• With atrioventricular conduction disturbance
• With QT interval prolongation
• Congenital

Acquired

• Idiopathic
• Coronary disease
• Rheumatic disease
• Cardiomyopathy
• Neuromuscular disease:

– Friedreich’s ataxia
– peroneal muscular atrophy
– Charcot–Marie–Tooth disease

• Infi ltration:
– amyloidosis
– haemochromatosis

• Collagen diseases:
– rheumatoid
– scleroderma
– systemic lupus erythematosus

• Myocarditis:
– viral
– diphtheria

• Drugs:
– lithium
– aerosol propellants

Box 4.3 Causes of the sick sinus syndrome

Atrial fl utter with variable block
Note

• Irregular bradycardia
• Flutter waves at 300/min obvious in all leads
• Ventricular rate varies, range 30–55/min
• QRS complex duration slightly prolonged (128 ms),

indicating partial right bundle branch block

• There is not complete block, as shown by the irregular
QRS complexes

Flutter waves in lead II

Page 377

Index

364

verapamil 135, 154
voltage criteria, left ventricular hypertrophy

294–295, 295, 297, 299
VVI pacing see right ventricular pacemakers

(VVI)

W

‘wandering atrial pacemaker’ 49
warfarin 154
Wenckebach phenomenon 84–85
wide-area circumferential ablation (WACA)

158

Wolff–Parkinson–White (WPW) syndrome
69–72, 73, 105, 106, 148–149,
258–259

atrial fi brillation with 73, 148–149,
149

broad complex tachycardia associated
107, 147–149, 148–149

ECG diagnostic pitfalls 253
ECG features summary 73
management 155

ablation 157, 158
prevalence 72
re-entry pathway 105, 106, 147

sinus rhythm 70–71, 72–73, 108–109
tachycardias 106–107, 108, 147–149
type A 69–72, 70–71, 70–73, 108–109,

148–149, 255, 256–257
after cardioversion 108–109

type B 69–72, 74–75, 258–259, 299,
302–303

left ventricular hypertrophy vs 299,
302–303

X

X-rays, chest see chest X-rays

Page 378

Instructions for online access

Thank you for your purchase. Please note that your purchase of this Elsevier eBook also includes access to
an online version. Please click here (or go to ebooks.elsevier.com) to request an activation code and
registration instructions in order to gain access to the web version.

Similer Documents