Making sense of the ECG : a hands-on guide / Andrew R Houghton.

Format:

Book

Author/Creator:

Houghton, Andrew R., author.

Contributor:

Clarence J. Marshall Memorial Library Fund.

Series:

Making sense (Boca Raton, Fla.)

Making sense

Language:

English

Subjects (All):

Electrocardiography--Handbooks, manuals, etc.

Electrocardiography.

Heart--Diseases--Diagnosis.

Heart--Diseases--Diagnosis--Handbooks, manuals, etc.

Heart.

Genre:

Handbooks and manuals.

Physical Description:

xi, 244 pages : illustrations (some color) ; 26 cm.

Edition:

Fifth edition.

Other Title:

Making sense of the electrocardiogram

Place of Publication:

Boca Raton, FL : CRC Press, [2020]

Contents:

1 Anatomy and physiology p. 1

Cardiac activation p. 2

The cardiac conduction system p. 3

The cardiac cycle p. 4

2 PQRST: Where the waves come from p. 7

What does the ECG actually record? p. 7

How does the ECG 'look' at the heart? p. 8

Where do each of the waves come from? p. 11

3 Performing an ECG recording p. 19

Initial preparations p. 19

Placement of the limb electrodes p. 20

Placement of the chest (precordial) electrodes p. 21

Einthoven's triangle p. 22

Recording the 12-lead ECG p. 25

4 Reporting an ECG recording p. 29

Patient data p. 29

Technical data p. 29

ECG fundamentals p. 30

ECG details p. 30

Report summary p. 30

5 Heart rate p. 33

Is the heart rate below 60/min? p. 35

Is the heart rate above 100/min? p. 36

6 An approach to heart rhythms p. 41

Identifying the cardiac rhythm p. 42

How is the patient? p. 43

Is ventricular activity present? p. 44

What is the ventricular rate? p. 44

Is the ventricular rhythm regular or irregular? p. 44

Is the QRS complex width normal or broad? p. 45

Is atrial activity present? p. 47

How are atrial activity and ventricular activity related? p. 47

Determining the cardiac rhythm p. 47

7 Supraventricular rhythms p. 49

Sinus rhythm p. 49

Sinus arrhythmia p. 50

Sinus bradycardia p. 50

Sinus tachycardia p. 51

Sick sinus syndrome p. 52

Atrial ectopic beats p. 53

Atrial fibrillation p. 54

Atrial flutter p. 59

Atrial tachycardia p. 61

AV re-entry tachycardia p. 62

AV nodal re-entry tachycardia p. 67

8 Ventricular rhythms p. 71

Ventricular ectopic beats p. 71

Accelerated idioventricular rhythm p. 74

Monomorphic ventricular tachycardia p. 75

How do I distinguish between VT and S VT? p. 78

Polymorphic ventricular tachycardia p. 80

Fascicular ventricular tachycardia p. 81

Ventricular fibrillation p. 81

9 Conduction problems p. 85

Conduction block at the SA node p. 85

Conduction block at the AV node or bundle of His p. 85

Conduction block at the bundle branches p. 88

Conduction block at the fascicles p. 93

Escape rhythms p. 93

Accelerated conduction and accessory pathways p. 94

10 The axis p. 97

Understanding and measuring the QRS axis p. 97

Is there left axis deviation? p. 106

Is there right axis deviation? p. 108

Is there extreme right axis deviation? p. 110

11 The P wave p. 111

Are any P waves absent? p. 111

Are any P waves inverted? p. 114

Are any P waves too tall? p. 115

Are any P waves too wide? p. 116

12 The PR interval p. 119

Is the PR interval less than 0.12 s long? p. 120

Is the PR interval more than 0.2 s long? p. 122

Does the PR interval vary or can it not be measured? p. 123

Is the PR segment elevated or depressed? p. 127

13 The Q wave p. 131

Are there any 'pathological' Q waves? p. 131

14 The QRS complex p. 137

Are any R or S waves too big? p. 137

Are the QRS complexes too small? p. 142

Are any QRS complexes too wide? p. 145

Are any QRS complexes an abnormal shape? p. 148

Are epsilon waves present? p. 150

15 The ST segment p. 153

Are the ST segments elevated? p. 153

Are the ST segments depressed? p. 166

Are J waves present? p. 170

16 The T wave p. 173

Are the T waves too tall? p. 174

Are the T waves too small? p. 176

Are any of the T waves inverted? p. 177

17 The QT interval p. 183

Correcting the QT interval p. 184

Is the QTc interval long? p. 185

Is the QTc interval short? p. 188

18 The U wave p. 193

Do the U waves appear too prominent? p. 194

Are any of the U waves inverted? p. 195

19 Artefacts on the ECG p. 197

Electrode misplacement p. 197

External electrical interference p. 197

Incorrect calibration p. 198

Incorrect paper speed p. 199

Patient movement p. 199

20 ECG interpretation in athletes p. 203

Normal ECG findings p. 203

Abnormal ECG findings p. 206

'Borderline' ECG findings p. 206

21 Pacemakers and implantable cardioverter-defibrillators p. 209

What do pacemakers do? p. 209

Indications for temporary pacing p. 210

Temporary pacemaker insertion and care p. 210

Indications for permanent pacing p. 210

Selection of a permanent pacemaker p. 211

Pacing and the ECG p. 212

Pacemakers and surgery p. 214

Implantable cardioverter-defibrillators p. 214

Cardiac resynchronization therapy (biventricular pacing) p. 215

22 Ambulatory ECG recording p. 217

24-h ambulatory ECG recording p. 218

Event recorder p. 218

ECG 'on demand' p. 219

Bedside monitoring/telemetry (inpatient) p. 219

Insertable cardiac monitor (ICM) p. 220

External loop recorder (ELR) p. 220

Smartphone/smartwatch applications p. 220

23 Exercise ECG testing p. 223

What are the indications for an exercise ECG? p. 223

What are the risks of an exercise ECG? p. 224

How do I perform an exercise ECG? p. 225

When do I stop an exercise ECG? p. 226

How do I interpret an exercise ECG? p. 226.

Notes:

Actually published in 2019.

Includes bibliographical references and index.

Local Notes:

Acquired for the Penn Libraries with assistance from the Clarence J. Marshall Memorial Library Fund.

ISBN:

9780367189013

0367189011

9780367188955

0367188953

OCLC:

1132245846