Clinical Electrocardiography: A Simplified Approach

Description

Clinical Electrocardiography: A Simplified Approach, 7th Edition goes beyond the simple waveform analysis to present ECGs as they are used in hospital wards, outpatient clinics, emergency departments, and intensive care units-where the recognition of normal and abnormal patterns is only the starting point in patient care. With Dr. Goldberger's renowned ability to make complex material easy to understand, you'll quickly grasp the fundamentals of ECG interpretation and analysis.Diagnose the key rhythm disorders that are relevant to today's clinical practice through expert pearls and advice.Easily navigate the full text online at www.expertconsult.com, and broaden your mastery of the material with online-only self-assessment ECGs and review questions. View clinical findings clearly with new illustrations and updated images throughout.Expand your clinical insights via a wealth of clinical highlights and review questions online, including diagnosis and management tips, as well as extended coverage of difficult-to-classify rhythms. front matter Goldberger’s Clinical Electrocardiography: A Simplified Approach preface Preface chapter 1 1 - Key Concepts Essential Cardiac Electrophysiology Electrical Activation of the Heart Cardiac Automaticity and Conductivity: “Clocks and Cables” Preview: Looking Ahead Concluding Notes: Why is the ECG So Clinically Useful chapter 2 2 - ECG Basics: Waves, Intervals, and Segments Depolarization and Repolarization Basic ECG Waveforms: P, QRS, ST-T, and U Waves ECG Graph Paper Basic ECG Measurements and Some Normal Values Standardization (Calibration) Marker P Wave PR Interval QRS Complex QRS Width (Interval) ST Segment T Wave QT Interval U Wave Calculation of Heart Rate Box Counting Methods QRS Counting Methods Heart Rate and RR Interval: How are they Related ECG Terms are Confusing The ECG as a Combination of Atrial and Ventricular Waveforms The ECG in Perspective chapter 3 3 - ECG Leads Limb (Extremity) Leads Standard Limb Leads: I, II, and III Augmented Limb Leads: aVR, aVL, and aVF Relationship of Extremity Leads Chest (Precordial) Leads The 12-Lead ECG: Frontal and Horizontal Plane Leads Cardiac Monitors and Monitor Leads Bedside Cardiac Monitors Ambulatory ECG Technology: Holter Monitors and Event Recorders chapter 4 4 - Understanding the Normal ECG Three Basic “Laws” of Electrocardiography Normal Sinus P Wave Normal QRS Complex: General Principles The Normal QRS: Chest Leads Normal ST Segment Normal T Wave chapter 5 5 - Electrical Axis and Axis Deviation Mean QRS Axis: Definition Mean QRS Axis: Calculation Axis Deviation Axis Deviation: Instant Recognition Clinical Significance Mean Electrical Axis of the P Wave and T Wave chapter 6 6 - Atrial and Ventricular Enlargement Right Atrial Abnormality Left Atrial Abnormality Right Ventricular Hypertrophy Left Ventricular Hypertrophy The Ecg in Cardiac Enlargement: A Clinical Perspective chapter 7 7 - Ventricular Conduction Disturbances: Bundle Branch Blocks and Related Abnormalities ECG in Ventricular Conduction Disturbances: General Principles Right Bundle Branch Block Complete and Incomplete RBBB Clinical Significance Left Bundle Branch Block Complete and Incomplete LBBB Clinical Significance Differential Diagnosis of Bundle Branch Blocks Fascicular Blocks (Hemiblocks) Bifascicular and Trifascicular Blocks Diagnosis of Hypertrophy in the Presence of Bundle Branch Blocks Diagnosis of Myocardial Infarction in the Presence of Bundle Branch Blocks chapter 8 8 - Myocardial Infarction and Ischemia, I: ST Segment Elevation and Q Wave Syndromes Myocardial Ischemia Transmural and Subendocardial Ischemia Myocardial Blood Supply St Segment Elevation, Transmural Ischemia, and Acute Myocardial Infarction QRS Changes: Q Waves of Infarction ECG Localization of Infarctions Anterior Wall Q Wave Infarctions “Anteroseptal” Q Wave Infarctions “Strictly” Anterior Q Wave Infarctions Anterolateral or Anteroapical Q Wave Infarctions Differentiating Anterior Wall Infarctions: General Comments and Caveats Inferior Wall Infarctions Posterior Infarctions Right Ventricular Infarctions Classic Sequence of St-T Changes and Q Waves with Stemi Normal and Abnormal Q Waves: A Brief Overview Ventricular Aneurysm Multiple Infarctions “Silent” Myocardial Infarction Diagnosis of Myocardial Infarction In the Presence of Bundle Branch Block Right Bundle Branch Block with Myocardial Infarction Left Bundle Branch Block with Myocardial Infarction chapter 9 9 - Myocardial Infarction and Ischemia, II: Non–ST Segment Elevation and Non–Q Wave Syndromes Subendocardial Ischemia ECG Changes with Angina Pectoris Exercise (Stress) Testing and Coronary Artery Disease “Silent” Myocardial Ischemia Subendocardial Infarction Variety of ECG Changes Seen with Myocardial Ischemia ECG Changes Associated with Noninfarction Ischemia Takotsubo Cardiomyopathy (Stress Cardiomyopathy) St Segment Elevations: Differential Diagnosis St Segment Depressions: Differential Diagnosis Deep T Wave Inversions: Differential Diagnosis Complications of Myocardial Infarction ECG After Coronary Revascularization The ECG in Myocardial Infarction: A Clinical Perspective chapter 10 10 - Drug Effects, Electrolyte Abnormalities, and Metabolic Factors Drug Effects Drugs Used to Treat Arrhythmias Psychotropic and Related Drugs Electrolyte Disturbances Hyperkalemia Hypokalemia Hypercalcemia and Hypocalcemia Magnesium Disturbances Other Metabolic Factors Hypothermia Endocrine Abnormalities Acidosis and Alkalosis ST-T Changes: Specific and Nonspecific chapter 11 11 - Pericardial, Myocardial, and Pulmonary Syndromes Acute Pericarditis, Pericardial Effusion, and Chronic Constrictive Pericarditis Acute Pericarditis Pericardial Effusion Chronic Constrictive Pericarditis Myocarditis CHRONIC Heart Failure Pulmonary Embolism Chronic Lung Disease (Emphysema) chapter 12 12 - Wolff-Parkinson-White Preexcitation Patterns Wolff-Parkinson-White Pattern: Preexcitation and Bypass Tracts Clinical Significance Treatment Overview: Differential Diagnosis of Wide QRS Complex Patterns chapter 13 13 - Sinus and Escape Rhythms Sinus Rhythms “Normal” Sinus Rhythm Regulation of the Heart Rate Sinus Tachycardia Sinus Bradycardia Sinus Arrhythmia Sinus Pauses, Sinus Arrest, and Sinoatrial Block Secondary Pacemakers and Escape Rhythms 14 14 - Supraventricular Arrhythmias, Part I: Premature Beats and Paroxysmal Supraventricular Tachycardias General Principles: Triggers and Mechanisms of Tachyarrhythmias Atrial and Other Supraventricular Premature Beats Clinical Significance Paroxysmal Supraventricular Tachycardias Atrial Tachycardia Conduction Termination Multifocal Atrial Tachycardia Clinical Considerations AV Nodal Reentrant (Reentry) Tachycardia Termination Clinical Considerations Atrioventricular Reentrant (Bypass Tract–Mediated) Tachycardia Initiation and Conduction Termination Clinical Considerations Differential Diagnosis and Treatment of PSVT Management of an Acute PSVT Episode Long-Term Management of PSVT 15 15 - Supraventricular Arrhythmias, Part II: Atrial Flutter and Atrial Fibrillation Atrial Flutter Location of Conduction Pathways Conduction to the Ventricles Atrial Fibrillation Conduction Properties Atrial Fibrillation vs. Atrial Flutter: Differential Diagnosis Atrial Fibrillation and Flutter: Overview of Major Clinical Considerations Treatment of Atrial Fibrillation/Flutter: Acute and Long-Term Considerations Rate Control Rhythm Control 16 16 - Ventricular Arrhythmias Ventricular Premature Beats Features Frequency Morphology and Origin Coupling Interval Compensatory Pauses Uniform and Multiform VPBs R on T Phenomenon Clinical Significance Ventricular Tachycardias Monomorphic Ventricular Tachycardia Clinical Significance of Monomorphic Ventricular Tachycardia Polymorphic Ventricular Tachycardias Classification Torsades de Pointes Acquired Long QT Syndrome Hereditary Long QT Syndromes: Accelerated Idioventricular Rhythm Ventricular Fibrillation Differential Diagnosis of Wide Complex Tachycardias 17 17 - Atrioventricular Conduction Abnormalities: Delays, Blocks, and Dissociation Syndromes What is the Degree of AV Block Prolonged PR Interval (First-Degree AV Block) Second-Degree AV Block Syndromes Third-Degree (Complete) AV Block Treatment Considerations AV Dissociation Syndromes 18 18 - Digitalis Toxicity Mechanism of Action and Indications Digitalis Toxicity Vs. Digitalis Effect Symptoms and Signs of Digitalis Toxicity Factors Predisposing to Digitalis Toxicity Electrolyte Disturbances Coexisting Illness Drug-Drug Interactions Prevention of Digitalis Toxicity Treatment of Digitalis Toxicity Serum Digoxin Concentrations (Levels) 19 19 - Sudden Cardiac Arrest and Sudden Cardiac Death Clinical Aspects of Cardiac Arrest Basic ECG Patterns in Cardiac Arrest Ventricular Tachyarrhythmia (Ventricular Fibrillation or Pulseless VT) Ventricular Asystole and Brady-Asystolic Rhythms Pulseless Electrical Activity (Electromechanical Dissociation) Clinical Causes of Cardiac Arrest Sudden Cardiac Death/Arrest 20 20 - Bradycardias and Tachycardias: Review and Differential Diagnosis Bradycardias (Bradyarrhythmias) Sinus Bradycardia and Related Rhythms Wandering Atrial Pacemaker AV Junctional (Nodal) and Ectopic Atrial Rhythms AV Heart Block (Second or Third Degree) or AV Dissociation Atrial Fibrillation or Flutter with a Slow Ventricular Rate Idioventricular Escape Rhythm Tachycardias (Tachyarrhythmias) Differential Diagnosis of Narrow Complex Tachyarrhythmias Sinus Tachycardia Paroxysmal Supraventricular Tachycardias Atrial Flutter Differential Diagnosis of Wide Complex Tachycardias Differentiation of SVT with Aberrancy from Ventricular Tachycardia SVT with Aberrancy SVT with the Wolff-Parkinson-White Preexcitation Syndrome VT vs. SVT with Aberration: ­Important Diagnostic Clues in Wide Complex ­Tachycardia Clinical Clues ECG Clues Clinical Significance: Some Important Reminders Slow and Fast: Sick Sinus Syndrome and the Brady-Tachy Syndrome 21 21 - Pacemakers and Implantable Cardioverter Defibrillators: Essentials for Clinicians Pacemakers: Definitions and Types Single- and Dual-Chamber Pacemakers ECG Morphology of Paced Beats Electronic Pacemaker Programming: Shorthand Code Single-Chamber Pacemaker Programming Dual-Chamber Pacemaker Programming Managing Adverse Effects of Right Ventricular Pacing Biventricular Pacemakers: Cardiac Resynchronization Therapy ECG Diagnosis Related to Paced Rhythms Atrial Fibrillation ST-T Wave Changes Due to Acute Myocardial Ischemia Cardiac “Memory” T Wave Inversions Implantable Cardioverter-Defibrillators Recognizing Pacemaker and ICD Malfunction Magnet Response of Pacemakers and ICDs Pacemaker and ICD Implantation: Specific Indications 22 22 - How to Interpret an ECG ECG Interpretation: Big Picture and General Approach Fourteen Specific ECG Features to Analyze Standardization and Technical Features Rhythm Heart Rate(s) PR Interval P Wave Size (Amplitude and Width) QRS Width (Interval or Duration) QT/QTc Interval QRS Voltage Mean QRS Electrical Axis R Wave Progression in Chest Leads Abnormal Q Waves ST Segments T Waves U Waves Formulating an Interpretation Caution: Computerized ECG Interpretations ECG Artifacts 60-Hertz (Cycle) Interference Muscle Tremor Wandering Baseline Poor Electrode Contact or Patient Movement Improper Standardization Limb Lead Reversal 23 23 - Limitations and Uses of the ECG Important Limitations of the ECG Utility of the ECG in Special Settings Common General Medical Applications of the ECG Syncope Coma Shock Weakness Reducing Medical Errors: Common Pitfalls in ECG Interpretation 24 24 - ECG Differential Diagnoses: Instant Reviews index Index A B C D E F G H I J K L M N O P Q R S T U V W