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ECG
Atul Luthra
CHAPTER 1:
Nomenclature of ECG Deflections
ELECTROCARDIOGRAM
Direction
Magnitude
Activation
ELECTROPHYSIOLOGY
DEFLECTIONS
Significance of ECG Deflections
INTERVALS
PR Interval
QT Interval
SEGMENTS
PR Segment
ST Segment
CHAPTER 2:
Electrocardiographic Leads
ELECTROCARDIOGRAPHIC LEADS
LIMB LEADS
Standard Limb Leads
Augmented Limb Leads
CHEST LEADS
LEAD ORIENTATION
EINTHOVEN TRIANGLE
CHAPTER 3:
Electrocardiography Grid and Normal Values
ELECTROCARDIOGRAPHY GRID
NORMAL ECG VALUES
Normal P Wave
Normal QRS Complex
Normal T Wave
Normal U Wave
Normal PR Interval
Normal QT Interval
Normal PR Segment
Normal ST Segment
CHAPTER 4:
Determination of Electrical Axis
ELECTRICAL AXIS
HEXAXIAL SYSTEM
QRS AXIS
DETERMINATION OF QRS AXIS
Method 1
Example A
Example B
Method 2
Example A
Example B
Example C
Method 3
ABNORMALITIES OF QRS AXIS
CHAPTER 5:
Determination of Heart Rate
HEART RATE
Method 1
Examples
Method 2
Examples
HEART RHYTHM
Heart Rate
Focus of Origin
Pattern of Regularity
Atrioventricular Relationship
CHAPTER 6:
Abnormalities of the P Wave
NORMAL P WAVE
ABSENT P WAVE
INVERTED P WAVE
CHANGING P WAVE MORPHOLOGY
TALL P WAVE
BROAD P WAVE
CHAPTER 7:
Abnormalities of QRS Complex
NORMAL QRS COMPLEX
LOW VOLTAGE QRS COMPLEX
ALTERNATING QRS VOLTAGE
ABNORMAL QRS AXIS
FASCICULAR BLOCK OR HEMIBLOCK
NONPROGRESSION OF R WAVE
ABNORMAL Q WAVES
ABNORMALLY TALL R WAVES
Right Ventricular Hypertrophy (RVH)
Persistent Juvenile Pattern
Right Bundle Branch Block (RBBB)
Posterior Wall Infarction
Mirror-image Dextrocardia
The WPW Syndrome
Left Ventricular Hypertrophy (LVH)
ABNORMALLY DEEP S WAVES
ABNORMALLY WIDE QRS COMPLEXES
Bundle Branch Block
Brugada Syndrome
Arrhythmogenic RV Dysplasia
Acute Pulmonary Embolism
Chronic Pulmonary Disease
Intraventricular Conduction Defect
Ventricular Preexcitation (WPW Syndrome)
CHAPTER 8:
Abnormalities of the T Wave
NORMAL T WAVE
INVERTED T WAVE
Nonspecific Causes
Specific Causes
TALL T WAVE
CHAPTER 9:
Abnormalities of the U Wave
NORMAL U WAVE
PROMINENT U WAVE
INVERTED U WAVE
CHAPTER 10:
Abnormalities of PR Segment
PR SEGMENT DEPRESSION
CHAPTER 11:
Abnormalities of ST Segment
ST SEGMENT DEPRESSION
ST SEGMENT ELEVATION
CHAPTER 12:
Abnormalities of PR Interval
NORMAL PR INTERVAL
PROLONGED PR INTERVAL
SHORTENED PR INTERVAL
VARIABLE PR INTERVAL
CHAPTER 13:
Abnormalities of QT Interval
NORMAL QT INTERVAL
SHORTENED QT INTERVAL
PROLONGED QT INTERVAL
CHAPTER 14:
Premature Beats in Regular Rhythm
PREMATURE BEATS
ATRIAL PREMATURE COMPLEX
JUNCTIONAL PREMATURE COMPLEX
VENTRICULAR PREMATURE COMPLEX
Clinical Relevance of Premature Complexes
Supraventricular Premature Complexes
Ventricular Premature Complexes
CHAPTER 15:
Pauses During Regular Rhythm
PAUSES DURING RHYTHM
Pause After Premature Beat
Pause After Blocked Premature Beat
Pause Due to Sinoatrial Block
Pause Due to Atrioventricular Block
Clinical Relevance of Pauses in Rhythm
Pause After Premature Beat
Pause After Blocked Premature Beat
Pause Due to Second-Degree SA Block
Pause Due to Second-Degree AV Block
Pauses Causing Bigeminal Rhythm
CHAPTER 16:
Fast Regular Rhythm with Narrow QRS
REGULAR FAST RHYTHM
SINUS TACHYCARDIA
ATRIAL TACHYCARDIA
ATRIAL FLUTTER
Clinical Relevance of Fast Regular Narrow QRS Rhythm
Sinus Tachycardia
Atrial Tachycardia
Atrial Flutter
CHAPTER 17:
Normal Regular Rhythm with Narrow QRS
REGULAR NORMAL RHYTHM
NORMAL SINUS RHYTHM
ATRIAL TACHYCARDIA WITH 2:1 AV BLOCK
ATRIAL FLUTTER WITH 4:1 AV BLOCK
JUNCTIONAL TACHYCARDIA
Clinical Relevance of Regular Narrow QRS Rhythm
Normal Sinus Rhythm
Atrial Tachycardia with AV Block
Junctional Tachycardia
CHAPTER 18:
Fast Irregular Rhythm with Narrow QRS
IRREGULAR FAST RHYTHM
ATRIAL TACHYCARDIA WITH AV BLOCK
ATRIAL FLUTTER WITH AV BLOCK
MULTIFOCAL ATRIAL TACHYCARDIA
ATRIAL FIBRILLATION
Clinical Relevance of Fast Irregular Narrow QRS Rhythm
Atrial Tachycardia with Varying AV Block
Multifocal Atrial Tachycardia
Atrial Fibrillation
CHAPTER 19:
Fast Regular Rhythm with Wide QRS
FAST WIDE QRS RHYTHM
VENTRICULAR TACHYCARDIA
SUPRAVENTRICULAR TACHYCARDIA WITH ABERRANT VENTRICULAR CONDUCTION
SUPRAVENTRICULAR TACHYCARDIA WITH PREEXISTING QRS ABNORMALITY
Clinical Relevance of Fast Regular Wide QRS Rhythm
Ventricular Tachycardia
CHAPTER 20:
Normal Regular Rhythm with Wide QRS
NORMAL WIDE QRS RHYTHM
ACCELERATED IDIOVENTRICULAR RHYTHM
Clinical Relevance of Regular Wide QRS Rhythm
Sinus Rhythm with Wide QRS Complexes
Accelerated Idioventricular Rhythm
CHAPTER 21:
Fast Irregular Rhythm with Bizarre QRS
IRREGULAR WIDE QRS RHYTHM
VENTRICULAR FLUTTER
VENTRICULAR FIBRILLATION
Clinical Relevance of Fast Irregular Bizarre QRS Rhythm
Ventricular Flutter
Ventricular Fibrillation
CHAPTER 22:
Slow Regular Rhythm with Narrow QRS
REGULAR SLOW RHYTHM
SINUS BRADYCARDIA
JUNCTIONAL ESCAPE RHYTHM
SINUS RHYTHM WITH 2:1 SA BLOCK
SINUS RHYTHM WITH 2:1 AV BLOCK
BLOCKED ATRIAL ECTOPICS IN BIGEMINY
Clinical Relevance of Slow Regular Narrow QRS Rhythm
Sinus Bradycardia
Junctional Rhythm
Sinus Rhythm with 2:1 Block
Blocked APCs in Bigeminal Rhythm
CHAPTER 23:
Slow Irregular Rhythm with Narrow QRS
IRREGULAR SLOW RHYTHM
SINUS ARRHYTHMIA
WANDERING PACEMAKER RHYTHM
SINUS RHYTHM WITH VARYING SA BLOCK
SINUS RHYTHM WITH VARYING AV BLOCK
Clinical Relevance of Slow Irregular Narrow QRS Rhythm
Sinus Arrhythmia
Wandering Pacemaker Rhythm
Sinus Rhythm with Varying Block
Slow Atrial Fibrillation
CHAPTER 24:
Slow Regular Rhythm with Wide QRS
SLOW WIDE QRS RHYTHM
COMPLETE AV BLOCK
COMPLETE SA BLOCK
EXTERNAL PACEMAKER RHYTHM
SLOW RHYTHM WITH PRE-EXISTING WIDE QRS COMPLEXES
Clinical Relevance of Slow Regular Wide QRS Rhythm
Complete AV Block
Complete SA Block
External Pacemaker Rhythm
Slow Rhythm with Existing Wide QRS
CHAPTER 25:
Interesting Cases Diagnosed by ECG
CASE 1: LEFT VENTRICULAR HYPERTROPHY
CASE 2: LEFT BUNDLE BRANCH BLOCK
CASE 3: FEATURES OF HYPOKALEMIA
CASE 4: FEATURES OF HYPERKALEMIA
CASE 5: PROLONGED QT SYNDROME
CASE 6: SICK SINUS SYNDROME
CASE 7: EARLY REPOLARIZATION SYNDROME
CASE 8: BRUGADA SYNDROME
CASE 9: WPW SYNDROME
CASE 10: SUPRAVENTRICULAR TACHYCARDIA
CASE 11: ATRIAL FIBRILLATION
CASE 12: VENTRICULAR TACHYCARDIA
CHAPTER 26:
How to Report an ECG
HOW TO REPORT AN ECG
ECG REPORT
CHAPTER 27:
ECG Findings in Specific Situations
ABSENCE OF HEART DISEASE
CONGENITAL HEART DISEASE
VALVULAR HEART DISEASE
CORONARY ARTERY DISEASE
MYOCARDIAL DISEASE
PERICARDIAL DISEASE
PULMONARY DISEASE
INDEX
TOC
Index
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