Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Master Visual Diagnosis of ECG
Shahzad Khan, Ren Jiang Hua
SECTION 1::
Deep Analysis Section (DAS)
WHAT CONCEPT DO YOU NEED TO HAVE FOR BETTER UNDERSTANDING OF ECG?
What is ECG?
Current Generation in the Heart
WHAT ARE ECG LEADS?
Precordial or Chest Leads
How Chest (Precordial) Leads Attach?
Each Lead Looks Heart Differently
Standard Limb Lead
Good to Remember
Chest Leads
Get Familiar with ECG Strip
HOW TO TAKE ECG RECORDING?
WHAT CONCEPT YOU NEED TO KNOW TO GET FAMILIAR WITH PQRS COMPLEX?
What is Axis?
The PQRS Complex
Characteristics of Normal P Wave
How Abnormal P Wave can Present? (Fig. 1.12)
What is P Terminal Force?
Get Familiar with Q Wave
Introduction with R Wave
What is R Wave Progression?
R Wave Transition
Intrinsicoid Deflection and its Diagnostic Importance
Importance
How Abnormal R Wave can Present?
Poor Progression and Loss of R
Tall R Wave
Poor Transition
Get Familiar with S Wave
When S Wave Alone is Significant
T WAVE IN DEPTH
Different Presentations of Abnormal T Wave (Fig. 1.26B)
T Wave Inversion
T Wave Inversion should Always be Seen with ST Segment
AMPLITUDE OF T WAVE
WHEN YOU SAY U WAVE, WHAT DO YOU MEAN?
U Wave
SEGMENTS + INTERVALS OF ECG
PR Interval
Is there PR Segment Depression/Elevation?
Decrease in PR Interval
What Does QRS Interval Show?
Familiar with ST Segment (See Fig. 1.39)
How ST Elevation can Present?
ST Segment Elevation with Convexity Upward
Remember
ST Elevation Clues Toward Specific Coronary Artery
ST Elevation with Concavity Upward (Figs 1.57A to E)
Early Repolarization (High J Point)
Pericarditis
Saddle Shaped or Coved ST Elevation (Fig. 1.60A)
ST Segment Depression
Junctional or Upsloping ST Depression (Figs 1.60 and 1.62)
Flat or Downsloping ST Depression (Figs 1.63A and B)
Ischemic Causes
Nonischemic Causes
Normal Variant ST Depression
QT Interval
How to Diagnose
How to Deal with Long QT?
HANDSHAKE WITH “ELECTRICAL AXIS”
What Does Electric Axis Mean?
Now Jump to Simple Two-Step Method
Step I
Step II
Visual Impression Method
SECTION 2::
Quick Diagnosis Section (QDS)
QUICK DIAGNOSIS SECTION (QDS)
HOW TO READ ECG AND MAKE DIAGNOSIS?
Five-Finger Method
LEAD POSITION REVERSAL
Diagnostic Points
DETERMINE RATE/RHYTHM
Rate
Rhythm
SINUS RHYTHM
Diagnostic Points (Fig. 2.4)
SINUS BRADYCARDIA
Diagnostic Points (Fig. 2.5A)
SINUS TACHYCARDIA
DEXTROCARDIA
Diagnostic Points (See Fig. 2.2)
ATRIOVENTRICULAR BLOCK (AV BLOCK)
First Degree AV Block
Diagnostic Points (Figs 2.7 and 2.8)
Second Degree AV Block; Mobitz Type I (Wenckebach) Block
Diagnostic Points (Figs 2.9 to 2.11)
Second Degrees AV Block (Mobitz Type II) (Figs 2.12 and 2.13)
Supporting Points
Complete AV, or Third Degree Block
Diagnostic Points (Figs 2.14 and 2.15)
INTRODUCTION TO ELECTROCARIOGRAPHIC FEATURES OF MYOCARDIAL INFARCTION
Myocardial Infarction (MI)
ST Elevation Infarction v/s Non ST Elevation MI or Q Wave v/s Non Q Wave MI
Inferior Wall MI
Diagnostic Points (Figs 2.18 and 2.19)
Anterior Infarction
Anteroseptal or Anteroapical MI
Diagnostic Points
Supporting Points
Lateral Wall MI
Diagnostic Points (Figs 2.23 and 2.24)
Extensive Anterior Wall MI (Anterolateral MI)
Diagnostic Points (Figs 2.25 to 2.27)
Posterior MI
Diagnostic Points (Figs 2.28 and 2.29)
Right Ventricle MI
Diagnostic Points (Figs 2.30 and 2.31)
Ischemia
Diagnostic Points (Fig. 2.32)
RIGHT BUNDLE BRANCH BLOCK (RBBB)
Mechanism of RBBB
RBBB (Complete)
Diagnostic Features (Figs 2.34 and 2.35)
Incomplete RBBB (Fig. 2.36)
Left Bundle Branch Block (LBBB)
Mechanism of LBBB (Figs 2.37 and 2.40)
Left BBB (Complete)
Diagnostic Points (Fig. 2.38)
Incomplete LBBB (Fig. 2.39)
SOME DETAILS OF FASCICULAR BLOCKS
ECG Pattern in LAF Block
ECG Pattern in Posterior Fascicular Block
Left Anterior Fascicular Block
Diagnostic Points (Fig. 2.43)
Left Posterior Fascicular Block
Diagnostic Points (Fig. 2.44)
Bifascicular Block
Diagnostic Points (Figs 2.45 to 2.47)
Left Ventricular Hypertrophy (LVH)
Diagnostic Criteria (Figs 2.48 and 2.49)
Right Ventricular Hypertrophy
Diagnostic Points (Figs 2.50 to 2.52)
Right and Left Atrial Abnormality
Left Atrial Hypertrophy (Figs 2.53 to 2.56)
Diagnostic Points
Right Atrial Hypertrophy (Figs 2.53 and 2.57
Diagnostic Points
Biatrial Hypertrophy (Fig. 2.58)
ARRHYTHMIAS
Atrial Premature Beats or Contractions (APB) or (APC) (Figs 2.59 to 2.62)
Aberrantly Conducted APC
Features of Aberrantly Conducted APC
Junctional Premature Contractions (JPC)
Diagnostic Points (Figs 2.67 to 2.70)
Ventricular Premature Contractions (VPC)
Diagnostic Points (Figs 2.71 to 2.75)
Wandering Atrial Pacemaker (Figs 2.76 and 2.77)
GET FAMILIAR WITH TACHYCARDIA
Narrow Complex Tachycardia
Sinus Tachycardia
Atrioventricular Nodal Re-entrant Tachycardia (AVNRT) (Nearly 90% of SVT You See in Emergency Room—ER)
How it Initiates
AVNRT Common Type (Slow Fast)
ECG Features
AVNRT Uncommon Type (Fast Slow)
Features (Figs 2.83 to 2.85)
Paroxysmal Atrial Tachycardia (PAT)
Diagnostic Features (Figs 2.86A and B)
PAT with AV Blocks
Diagnostic Features (Figs 2.87 and 2.88)
Multifocal Atrial Tachycardia (MAT)
Diagnostic Points (Figs 2.89 and 2.90)
Atrial Flutter (AF)
Diagnostic Points
Supporting Points (Figs 2.91 to 2.95)
PAT and Atrial Flutter (Figs 2.96A and B)
PAT with Bundle Branch Block
Atrial Fibrillation
Diagnostic Points
Supporting Points (Figs 2.99 and 2.100)
ATRIOVENTRICULAR RECIPROCATING TACHYCARDIA (AVRT) OR AV PRE-EXCITATION TACHYCARDIA
What is Pre-excitation Syndrome?
IMPORTANT PRE-EXCITATION SYNDROMES
Wolff-Parkinson-White Syndrome (WPW)
WPW A (Figs 2.103A and B)
WPW B (Figs 2.103A and B)
How to Identify WPW Syndrome? (Figs 2.104 to 2.108)
WPW Syndrome as Pre-excitation Tachycardia
Orthodromic Circus Movement Tachycardia
Diagnostic Points (Fig. 2.109)
WPW with Atrial Fibrillations
Antidromic Circus Movement Tachycardia
Diagnostic Points (Figs 2.112 to 2.114)
Lown-Ganong-Levine (LGL) Pre-excitation
Diagnostic Points (Figs 2.115 and 2.116)
Accelerated Idioventricular Rhythm (AIVR)
Diagnostic Points (Figs 2.117 to 2.119)
Ventricular Tachycardia (VT)
Diagnostic Points (Table 2.5 and Figs 2.120 to 2.125)
How to Differentiate from Aberrancy?
Torsade de Pointes
Diagnostic Points (Figs 2.126 and 2.127)
Ventricular Fibrillation (VF) (Fig. 2.128)
Diagnostic Points
MISCELLANEOUS CONDITIONS
Cardiac Pathologies
Drugs Electrolytes
Physical
Atrial Septal Defects (ASD) (Fig. 2.129)
Pericarditis (Figs 2.130 to 2.133)
Early Stage
Later Stage
Pulmonary Embolism (PE)
Diagnostic Points (Figs 2.134 and 2.135)
Electrical Alternans (Figs 2.136 to 2.138)
Identification Points
Digitalis and ECG
Identification Points of Digieffect (Figs 2.139 and 2.140)
Digitalis Toxicity (Figs 2.141 to 2.143)
Type I Antiarrhythmic Drugs, Quinidine, etc.
Diagnostic Points; Therapeutic Effects (Fig. 2.144)
Diagnostic Points; Toxic Effects
Hypokalemia (Figs 2.145 to 2.147)
Hyperkalemia (Figs 2.148 to 2.150)
Hypo and Hypercalcemia
Physical Changes
Hypothermia (Fig. 2.151)
Electric Pacing
Pacemaker Abnormality
Loss of Capture
Loss of Sensing
Pacemaker Failure
ECG Changes during Exercise (Stress Test)
Normal ECG Responses
Abnormal Responses Indicating CHD (Coronary Heart Diseases)
Horizontal Down Sloping
Artifacts
AC-Interference
Feature
Muscle Tremor
Wandering Baseline
SELF-ASSESSMENT
Answers
INDEX
TOC
Index
×
Chapter Notes
Save
Clear
