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ECG Interpretation
Simon James, Katharine Nelson
CHAPTER 1:
First principles
1.1 Anatomy
Systemic and pulmonary circulations
Coronary circulation
The anatomy of the conducting system
1.2 Physiology
Cardiac action potential
Cardiac electrical network
1.3 Cell physiology
1.4 Electrical activity and the ECG
CHAPTER 2:
Understanding the normal ECG
2.1 Introduction
2.2 The limb leads
Standard (limb) leads
Augmented limb leads
2.3 The chest leads
2.4 The lead orientation
The Einthoven triangle
2.5 ECG nomenclature
ECG deflections
Intervals and segments
PR interval
PR segment
QT interval
ST segment
CHAPTER 3:
Interpreting the ECG: a six-step approach
3.1 Step 1: is there electrical activity?
3.2 Step 2: what is the QRS (ventricular) rate?
Method 1
Method 2
3.3 Step 3: is the rhythm regular?
3.4 Step 4: is the QRS narrow (normal) or broad?
3.5 Step 5: is there atrial electrical activity?
3.6 Step 6: how are atrial and ventricular activity related?
3.7 Glossary of distinct ECG signs
CHAPTER 4:
Bradyarrhythmias I: sinoatrial node dysfunction
4.1 Sinus bradycardia (Figure 4.1)
Key features
Pathophysiology
Clinical relevance
Management
4.2 Sinus pause with junctional escape beat (Figure 4.2)
Key features
Pathophysiology
Clinical relevance
Management
CHAPTER 5:
Bradyarrhythmias II: conduction abnormalities
5.1 First-degree atrioventricular block (Figure 5.1)
Key features
Pathophysiology
Clinical relevance
Management
5.2 Second-degree atrioventricular block: Mobitz type 1 or Wenckebach (Figure 5.2)
Key features
Pathophysiology
Clinical relevance
Management
5.3 Second-degree atrioventricular block: Mobitz type 2 (Figure 5.3)
Key features
Pathophysiology
Clinical relevance
Management
5.4 Second-degree heart block: 2:1 atrioventricular block (Figure 5.4)
Key features
Pathophysiology
Clinical relevance
Management
5.5 Third-degree (complete) atrioventricular block: narrow QRS (Figure 5.5)
Key features
Pathophysiology
Clinical relevance
Management
5.6 Third-degree (complete) atrioventricular block: broad QRS (Figure 5.6)
Key features
Pathophysiology
Clinical relevance
Management
5.7 Right bundle branch block (Figure 5.7)
Key features
Pathophysiology
Clinical relevance
Management
5.8 Left bundle branch block (Figure 5.8)
Key features
Pathophysiology
Clinical relevance
Management
CHAPTER 6:
Ectopic beats
6.1 Atrial ectopic beats (Figure 6.1)
Key features
Pathophysiology
Clinical relevance
Management
6.2 Ventricular ectopic beats (Figure 6.2)
Key features
Pathophysiology
Clinical relevance
Management
6.3 Junctional ectopic beats (Figure 6.3)
Key features
Pathophysiology
Clinical relevance
Management
CHAPTER 7:
Atrial arrhythmias
7.1 Atrial tachycardia (Figure 7.1)
Key features
Pathophysiology
Clinical relevance
Management
7.2 Multifocal atrial tachycardia (Figure 7.2)
Key features
Pathophysiology
Clinical relevance
Management
7.3 Atrial flutter (Figure 7.3)
Key features
Pathophysiology
Clinical relevance
Management
7.4 Atrial fibrillation (Figure 7.4)
Key features
Pathophysiology
Clinical relevance
Management
7.5 Atrial fibrillation with left bundle branch block (Figure 7.5)
Key features
Pathophysiology
Clinical relevance
Management
CHAPTER 8:
Narrow-complex tachyarrhythmias (supraventricular tachycardias)
8.1 Atrioventricular nodal re-entrant tachycardia (Figure 8.1)
Key features
Pathophysiology
Clinical relevance
Management
8.2 Atrioventricular reciprocating tachycardia (Figure 8.2)
Key features
Pathophysiology
Clinical relevance
Management
8.3 Wolff–Parkinson–White syndrome: right-sided pathway (Figure 8.3)
Key features
Pathophysiology
Clinical relevance
Management
8.4 Wolff–Parkinson–White syndrome: left lateral pathway (Figure 8.4)
Key features
Pathophysiology
Clinical relevance
Management
8.5 Wolff–Parkinson–White syndrome: posterior pathway (Figure 8.5)
Key features
Pathophysiology
Clinical relevance
Management
8.6 Wolff–Parkinson–White syndrome plus atrial fibrillation (Figure 8.6)
Key features
Pathophysiology
Clinical relevance
Management
CHAPTER 9:
Broad complex tachyarrhythmias
9.1 Monomorphic ventricular tachycardia (Figure 9.1)
Key features
Pathophysiology
Clinical relevance
Management
9.2 Polymorphic ventricular tachycardia (Figure 9.2)
Key features
Pathophysiology
Clinical relevance
Management
9.3 Torsade de pointes (Figure 9.3)
Key features
Pathophysiology
Clinical relevance
Management
9.4 Ventricular fibrillation (Figure 9.4)
Key features
Pathophysiology
Clinical relevance
Management
9.5 Supraventricular tachycardia with bundle branch block (Figure 9.5)
Key features
Pathophysiology
Clinical relevance
Management
CHAPTER 10:
Ischaemia and infarction
10.1 ST segment depression (cardiac ischaemia) (Figure 10.1)
Key features
Pathophysiology
Clinical relevance
Management
10.2 Acute myocardial ischaemia: T wave inversion and the LAD syndrome (Figure 10.2)
Key features
Pathophysiology
Clinical relevance
Management
10.3 ST segment elevation myocardial infarction: anterior (Figure 10.3)
Key features
Pathophysiology
Clinical relevance
Management
10.4 ST segment elevation myocardial infarction: acute inferior (Figure 10.4)
Key features
Pathophysiology
Clinical relevance
Management
10.5 ST segment elevation myocardial infarction: posterior (Figure 10.5)
Key features
Pathophysiology
Clinical relevance
Management
10.6 Completed myocardial infarction (Figure 10.6)
Key features
Pathophysiology
Clinical relevance
Management
CHAPTER 11:
Inherited arrhythmia problems
11.1 Hypertrophic cardiomyopathy (Figure 11.1)
Key features
Pathophysiology
Clinical relevance
Management
11.2 Arrhythmogenic right ventricular dysplasia (Figure 11.2)
Key features
Pathophysiology
Clinical relevance
Management
11.3 Long QT syndrome (Figure 11.3)
Key features
Pathophysiology
Clinical relevance
Management
11.4 Brugada syndrome (Figure 11.4)
Key features
Pathophysiology
Clinical relevance
Management
CHAPTER 12:
Miscellaneous conditions
12.1 Pericarditis (Figure 12.1)
Key features
Pathophysiology
Clinical relevance
Management
12.2 Left ventricular hypertrophy (Figure 12.2)
Key features
Pathophysiology
Clinical relevance
Management
12.3 Right ventricular hypertrophy (Figure 12.3)
Key features
Pathophysiology
Clinical relevance
Management
12.4 Pulmonary embolus (Figure 12.4)
Key features
Pathophysiology
Clinical relevance
Management
12.5 Pacemaker (Figure 12.5)
Key features
Pathophysiology
Clinical relevance
Management
12.6 Hyperkalaemia (Figure 12.6)
Key features
Pathophysiology
Clinical relevance
Management
12.7 Hypokalaemia (Figure 12.7)
Key features
Pathophysiology
Clinical relevance
Management
12.8 Hypercalcaemia (Figure 12.8)
Key features
Pathophysiology
Clinical relevance
Management
12.9 Hypocalcaemia (Figure 12.9)
Key features
Pathophysiology
Clinical relevance
Management
INDEX
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