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ECG for Medical Diagnosis
SK Apu
1:
Introduction
DEFINITION
WHAT TO LOOK FOR IN THE ECG? (HOW TO REPORT AN ECG?)
CLINICAL VALUE OF THE ELECTROCARDIOGRAM
2:
Anatomy and Physiology
ANATOMY OF THE HEART (FIG. 2.1)
Layers of the Heart Wall
CORONARY CIRCULATION
Coronary Arteries
CONDUCTIVE SYSTEM OF THE HEART (JUNCTIONAL TISSUES OF THE HEART) (FIG. 2.3)
Atria Conducting System (Table 2.1)
Ventricular Conducting System
Impulse Formation and Conduction
SEQUENCE OF HEART ACTIVATION
PROPERTIES OF CARDIAC CELLS
NERVE SUPPLY OF THE HEART
Parasympathetic
Parasympathetic Stimulation
3:
Electrocardiographic Leads
DEFINITION
TYPES OF LEADS
ELECTRODE PLACEMENT OF THE STANDARD LEADS
Triaxial Reference System (Fig. 3.7)
View of the Heart
Augmented Unipolar Limb Leads (Figs 3.8A and B)
View of the Heart
Hexaxial Reference System (Fig. 3.9)
View of the Heart
REPRESENTATION OF THE SURFACE OF THE HEART BY ELECTRODE
Chest or Precordial Leads Placement (Fig. 3.10)
R-WAVE PROGRESSION
Introduction
Causes of R-wave Progression (Fig. 3.12)
4:
Essential Basic Electrocardiogram Principles
THE BASIC ACTION: DEPOLARIZATION AND REPOLARIZATION
RECORDING DEPOLARIZATION AND REPOLARIZATION
ECG Deflections
5:
Normal Electrocardiogram
BASIC SHAPE OF THE NORMAL ELECTROCARDIOGRAM (FIG. 5.1)
Junctions
Waves and Complexes (Fig. 5.2)
Atrial Activation
Ventricular Activation
Points
Intervals
Segments
J-point (RST Junction)
VARIOUS FORMS OF THE QRS COMPLEX (FIG. 5.5)
ELECTROCARDIOGRAM PAPER (FIG. 5.6)
CALIBRATION (FIG. 5.7)
NORMAL ELECTROCARDIOGRAM MEASUREMENTS
Amplitude and Duration
MAKING A RECORDING (FIG. 5.9)
When Making a Recording
HEART RATE DETERMINATION (FIGS 5.10 TO 5.12)
STANDARDIZATION OF ELECTROCARDIOGRAM
ECG Conventions and Intervals
Cause of Low Voltage ECG Tracing
Criteria of Low Voltage Tracing
Heart Rhythm
Cause of Irregular Rhythm
Characters of Sinus Rhythm
6:
Axis and Vectors
AXIS
VECTOR
QRS AXIS
RELATION OF ECG LEADS TO AXIS LEADS (FIG. 6.4)
AXIS LEADS AND CORRESPONDING DEGREES (FIG. 6.5)
DETERMINATION OF QRS VECTOR (FIGS 6.6A AND B)
DETERMINATION OF MEAN QRS AXIS (FIGS 6.7A TO C)
Method 1
Method 2 (Fig. 6.8)
Method 3
AXIS DEVIATION
Definition
Types (Figs 6.10 to 6.12)
RAPID ESTIMATION OF MEAN QRS AXIS (FIG. 6.13)
Causes of Left Axis Deviation (LAD) (Axis between −30° and 90°)
Causes of Right Axis Deviation (RAD) (Axis between +90o and +180o):
Causes of Extreme RAD (North-west Axis or Indeterminate QRS Axis or no Mans Land)
7:
Abnormalities of Wave Intervals and Segments
NORMAL P-WAVE
Criteria
ABNORMAL P-WAVE (CLINICAL SIGNIFICANCE) (FIGS 7.1A TO D)
Various Causes of Atrial Enlargement
NORMAL AND PATHOLOGICAL Q-WAVE
Normal Q-wave
Pathological Q-wave (Fig. 7.2)
Causes of Pathological Q-wave
Area of Infarction from Q-wave Location
NORMAL AND ABNORMAL R-WAVE
Normal R-wave (Fig. 7.3)
Abnormal R-wave (Fig. 7.4)
Tall R-wave
S-wave
Causes of Nonprogressing of R-wave
NORMAL AND ABNORMAL QRS COMPLEX
Normal QRS Complex (Fig. 7.5)
Abnormalities of QRS Complex
QRS may be
Causes of High Voltage QRS
Causes of Low Voltage QRS (<5 mm in L1, L2, L3 and <10 mm in Chest Leads)
Causes of Wide QRS (>0.12 sec, 3 Small Squares)
Causes of Changes Shape of QRS
Causes of Variable QRS
NORMAL AND ABNORMAL T-WAVE
Normal T-wave
Abnormal T-wave
Causes
Electrocardiogram Finding of Hyperkalemia Depend Upon Serum Potassium (Fig. 7.12)
Relationship between Locations of Electrocardiogram Changes and Coronary Artery Spasm
JUVENILE T-WAVE PATTERN
Diagnostic Pearls
NORMAL AND ABNORMAL U-WAVE
Normal U-wave (Fig. 7.13)
Abnormal U-wave (Fig. 7.14)
Inverted in Lead I, Lead II, V6
Prominent U-wave in V3–V5
NORMAL AND ABNORMAL P-INTERVAL
Abnormal PR Interval
Causes of PR Segment Depression (Fig. 7.18)
QT INTERVAL: NORMAL AND ABNORMAL
Normal QT Interval
Abnormalities of QT Interval
Causes of Short QT Interval
Causes of Long QT Interval
Interpretation
NORMAL AND ABNORMAL ST SEGMENT
Normal ST Segment
Abnormal ST Segment
ST Segment Depression
ST Segment Elevation (Fig. 7.29)
Causes of ST Segment Elevation (>2 mm)
Causes of ST Depression
Electrocardiogram Features of Myocardial Infarction (Besides ST Elevation)
Specific Features of Dresslers Syndrome (Postinfarction Syndrome)
EARLY REPOLARIZATION (HIGH TAKE OFF) SYNDROME
Electrocardiogram Criteria of Early Repolarization Syndrome (Fig. 7.32)
Clinical Features
RHYTHM OF THE HEART
Causes of Irregular Rhythm
Sinus Rhythm
Characters
Arrhythmia
NORMAL VARIANTS IN ELECTROCARDIOGRAM
8:
Hypertrophy
ATRIAL HYPERTROPHY
RIGHT ATRIAL HYPERTROPHY (FIG. 8.3)
(P-pulmonale, P-congenitale)
The ECG Criteria
LEFT ATRIAL HYPERTROPHY (FIG. 8.4)
(P-Mitrale)
The ECG Criteria
Others
Cause of P-pulmonale
Causes of P-mitrale
BOTH RIGHT AND LEFT ATRIAL HYPERTROPHY (P-TRICUSPIDALE) (FIGS 8.5 AND 8.6)
ECG Criteria
Causes
Various Causes of Atrial Enlargement
VENTRICULAR HYPERTROPHY
LEFT VENTRICULAR HYPERTROPHY (FIG. 8.7)
ECG Criteria
Causes of LVH
Romhilt-Estes Scoring System for LVH
Sokolow-Lyon Criteria for LVH
Cornell Voltage Criteria for LVH
Cause of Systolic and Diastolic Overload on LVH
Right Ventricular Hypertrophy (Fig. 8.8)
ECG Criteria
ECG Criteria for RVH in Age
Causes of RVH
Butler-Leggett Formula for RVH
Sokolow-Lyon Criteria for RVH
OVERLOAD CONCEPT OF LEFT VENTRICULAR HYPERTROPHY
Types
Cause
Causes
SYSTOLIC OVERLOAD (PRESSURE OVERLOAD) OF LEFT VENTRICULAR HYPERTROPHY
ECG Criteria
DIASTOLIC OVERLOAD (VOLUME OVERLOAD) OF LEFT VENTRICULAR HYPERTROPHY
ECG Criteria
ECG Criteria in Systolic Overload of LVH
ECG Criteria in Diastolic Overload of LVH
BIVENTRICULAR HYPERTROPHY (FIG. 8.12)
(LVH and RVH)
ECG Criteria
Causes of Biventricular Hypertrophy
Common Diagnostic Criteria
9:
Arrhythmias: Disorders of the Cardiac Rhythms
ARRHYTHMIAS
Classification of Arrhythmias
Clinical Classification
Anatomy and Physiology of Conduction System (Fig. 9.1)
Discharge Rates of Potential Pacemakers of the Heart
Description of Abnormal Cardiac Rhythm
Genesis of Abnormal Cardiac Rhythm
Tachyarrhythmias Due to Re-entry
NORMAL SINUS RHYTHM (FIG. 9.2)
ECG Criteria
Characteristics of Sinus Rhythm
SINUS TACHYCARDIA (Fig. 9.3)
ECG Criteria
Causes of Sinus Tachycardia
Physiological
Pathological
Causes of Narrow Complex Tachycardia
Causes of Broad Complex Tachycardia
Treatment
Characteristics
SINUS BRADYCARDIA (FIG. 9.4)
ECG Criteria
Causes of Sinus Bradycardia
Causes of Bradycardia
Treatment
Characteristics of Sinus Bradycardia
SINUS ARRHYTHMIA (FIG. 9.5)
Diagnostic Clues
ECG Criteria
Note:
Mechanism
Characteristics of Sinus Arrhythmia
PACEMAKER SITES OF THE HEART (FIG. 9.6)
ECTOPIC BEAT (FIG. 9.7)
Types of Ectopic (Extra Systole) (Figs 9.8A and B)
ATRIAL EXTRASYSTOLES (AES) OR ATRIAL PREMATURE CONTRACTION (APC) OR ATRIAL PREMATURE OR ECTOPIC BEATS (FIG. 9.9)
ECG Criteria
Causes of Atrial Ectopic (Fig. 9.10)
Types of Atrial Ectopic
JUNCTIONAL PREMATURE CONTRACTION (FIG. 9.11)
Types
ECG Criteria
NODAL RHYTHM (JUNCTIONAL RHYTHM)
ECG Criteria
Causes of Nodal Rhythm (Fig. 9.12)
WANDERING ATRIAL PACEMAKER (WANDERING PACEMAKER) (FIGS 9.13 AND 9.14)
ECG Criteria
Causes of Wandering Pacemaker
Characteristics of Wandering Pacemaker
MULTIFOCAL ATRIAL TACHYCARDIA (FIG. 9.15)
ECG Criteria
Causes
Treatment
Clinical Significance
ACCELERATED JUNCTIONAL RHYTHM (FIGS 9.16 AND 9.17)
(Nonparoxysmal Junctional Tachycardia)
ECG Criteria
Causes
SUPRAVENTRICULAR TACHYCARDIA (SVT) OR PAROXYSMAL ATRIAL TACHYCARDIA (PAT) (FIG. 9.18)
ECG Criteria
Management of SVT
Causes of Supraventricular Tachycardia
Differences between Sinus Tachycardia and SVT
Complication of SVT
Types of SVT
Adenosine
Classification of SVT (According to Duration)
ATRIAL TACHYCARDIA (FIG. 9.20)
Three Major Types of Paroxysmal SVT
Characteristics of AT
ECG Criteria
Causes of Atrial Tachycardia
Mechanism
Treatment
Characteristics of AV Nodal Re-entrant Tachycardia (AVNRT)
Differences between Sinus and Atrial Tachycardia
Differences between Ectopic and Re-entrant Tachycardia
Differences between AVNRT and AVRT
NORMAL RANGES AND VARIATIONS IN THE ADULT ECG
Atrial Arrhythmias
AN APPROACH TO INTERPRETATION OF ECG
The QRS Rhythm
The Atrial Thythm
Atrial Premature Contraction (APC) with Aberrant Ventricular Conduction (AVC) (Fig. 9.21)
ECG Criteria
NONCONDUCTED (BLOCKED) ATRIAL PREMATURE CONTRACTION (FIG. 9.22)
Diagnostic Criteria
ATRIAL TACHYCARDIA ASSOCIATED WITH ATRIOVENTRICULAR BLOCK (FIG. 9.23)
Criteria
ATRIAL TACHYCARDIA WITH ABERRANT VENTRICULAR CONDUCTION (AVC) (FIG. 9.24)
Criteria
ATRIAL FLUTTER (FIG. 9.25)
ECG Criteria
Causes of Atrial Flutter
Classification
Differential Diagnosis of Atrial Flutter
Characteristics of Atrial Flutter
Management of Atrial Flutter
Aims
Drugs
Difference between Atrial Flutter and Atrial Tachycardia
Atrial Flutter With 2 : 1 AV Block
ECG Criteria
Diagnostic Pearls
Atrial Flutter with A 4 : 1 AV Block
ECG Criteria
Diagnostic Pearls
ATRIAL FIBRILLATION (FIG. 9.28)
ECG Criteria
Types of AF
Causes of Atrial Fibrillation
Causes of AF in Elderly Patient
Causes of AF in Young Patient
Causes of Paroxysmal AF
Clinical Presentation of AF
Complication of AF
Lone AF
Aim of Treatment of AF
Diagnostic Pearls
Characteristics of AF
Difference between Atrial Fibrillation and Atrial Flutter
Atrial Fibrillation with Bundle Branch Block (BBB) (Fig. 9.29)
ECG Criteria
Atrial Fibrillation with Aberrant Ventricular Conduction (AVC) (Fig. 9.30)
ECG Criteria
Atrial Fibrillation with Advanced Atrioventricular Block (Fig. 9.31)
ECG Criteria
ASHMAN PHENOMENON (FIG. 9.32)
ECG Criteria
Difference between Ashman Phenomenon and PVC
Significance with Definition
VENTRICULAR EXTRASYSTOLES (VES) OR, VENTRICULAR PREMATURE CONTRACTION (VPC) OR VENTRICULAR ECTOPIC (FIGS 9.33 AND 9.34)
ECG Criteria
Types of Ventricular Ectopic: (Patterns of VES)
Lown's Grading of Ventricular Ectopic
Causes of Ventricular Ectopic
Characteristics of VES
Treatment of VES
PATTERNS OF VENTRICULAR PREMATURE COMPLEX OR VENTRICULAR EXTRASYSTOLE
Interpolated Ventricular Extrasystole (Fig. 9.35)
ECG Criteria
Diagnostic Criteria
Multiform VES: (Multifocal) (Fig. 9.36)
ECG Criteria
Diagnostic Criteria
Uniform or Unifocal VES
ECG Criteria
Bigeminy VES (Fig. 9.37)
ECG Criteria
Trigeminy VES (Fig. 9.38)
ECG Criteria
Couplet VES (Fig. 9.39)
ECG Criteria
Triplet VES (Fig. 9.40)
ECG Criteria
R-on-T Phenomenon (Fig. 9.41)
ECG Criteria
Grouped VES
ECG Criteria
Characteristics of VES
VENTRICULAR TACHYCARDIA (FIG. 9.43)
ECG Criteria
Cause of Ventricular Tachycardia
Classification of VT (According to Different Ways)
Specific Forms of VT
Differentiation between VT and SVT with Aberrant Conduction
NONSUSTAINED VENTRICULAR TACHYCARDIA (FIG. 9.44)
ECG Criteria
SUSTAINED VENTRICULAR TACHYCARDIA (FIG. 9.45)
ECG Criteria
Cause of VT
Causes of Monomorphic VT
Differences between VT and SVT with Aberrant Conduction
Bidirectional Ventricular Tachycardia (Fig. 9.46)
ECG Criteria
Monomorphic VT (Fig. 9.47)
Characteristics of Monomorphic VT
Polymorphic VT (Fig. 9.48)
Characteristic of Polymorphic VT
Classification
Polymorphic VT
Common Causes of Wide Complex Tachycardia
Treatment of VT
ACCELERATED IDIOVENTRICULAR RHYTHM (FIG. 9.49)
ECG Criteria
Diagnostic Criteria
Characteristics of AIVR
TORSADES DE POINTES (FIG. 9.50)
ECG Criteria
Causes of Torsades de Pointes
Clinical Features
Management of Torsades de Pointes
Diagnostic Criteria
VENTRICULAR FLUTTER (FIG. 9.51)
ECG Criteria
Diagnostic Criteria
VENTRICULAR FIBRILLATION (FIG. 9.52)
ECG Criteria
Causes of VF
Clinical Findings
Diagnostic Criteria
Characteristics of VT
Types
Triggering Mechanisms of Primary VF
Treatment of VF
VENTRICULAR PARASYSTOLE (FIG. 9.55)
ECG Criteria
CHAOTIC VENTRICULAR RHYTHM (FIG. 9.56)
Diagnostic Criteria
VENTRICULAR ESCAPE RHYTHM (FIG. 9.57)
Diagnostic Criteria
Characteristics of VER
VENTRICULAR STANDSTILL (ARREST) OR, CARDIAC STANDSTILL OR ASYSTOLE (FIG. 9.58)
Characteristics of Asystole
Cardiac Arrest Rhythms
10:
Heart Block
INTRODUCTION
DEFINITION
Site
CLASSIFICATION
What is Hemiblock?
CAUSES OF HEART BLOCK
CLASSIFICATION BY DEGREE
CLASSIFICATION BY SITE/LOCATION
SINOATRIAL BLOCK
Introduction
Definition
ECG Criteria
Causes
Diagnosis
Treatment
Differential Diagnosis
Characteristics
SINUS ARREST OR SINUS PAUSE OR SINUS STANDSTILL
Introduction
Definition
ECG Criteria
Characteristics
AV BLOCK: FIRST DEGREE
Introduction
Definition
ECG Criteria
Causes
Treatment
Characteristics
ATRIOVENTRICULAR BLOCK: SECOND DEGREE [MOBITZ TYPE I (WENCKEBACH)]
Definition
ECG Criteria
Causes
Treatment
Characteristics
AV BLOCK: SECOND DEGREE (MOBITZ TYPE II ATRIOVENTRICULAR BLOCK)
Introduction
Definition
ECG Criteria
Prognosis
Treatment
Characteristics
ATRIOVENTRICULAR BLOCK: THIRD DEGREE (COMPLETE HEART BLOCK) (FIG. 10.7)
ECG Criteria
Causes
Commonest Cause
Other Causes
Escape Rhythm
Determination Site of Complete Heart Block
Symptoms
Signs
Treatment
Characteristics
A Quick Look at P-waves and AV Blocks
AV Block-Quick Summary
STOKES-ADAMS SYNDROME (ATTACK)
It also Occurs in–
Clinical Features
Treatment
ATRIOVENTRICULAR DISSOCIATION (AV DISSOCIATION)
Definition
Causes
ECG Changes
Site of Pacemakers in AV Dissociation
Treatment
Range of Therapy
COMPLETE RIGHT BUNDLE BRANCH BLOCK
Definition
ECG Criteria
Causes
INCOMPLETE RIGHT BUNDLE BRANCH BLOCK (FIG. 10.10)
ECG Criteria
Causes of Tall R in V1
COMPLETE LEFT BUNDLE BRANCH BLOCK (FIG. 10.11)
Definition
ECG Criteria
Causes
Diagnosis
Treatment
INCOMPLETE LEFT BUNDLE BRANCH BLOCK (FIG. 10.12)
ECG Criteria
LEFT ANTERIOR FASCICULAR BLOCK OR LEFT ANTERIOR HEMIBLOCK
Definition
ECG Criteria
Diagnostic Pearls
LEFT POSTERIOR FASCICULAR BLOCK OR LEFT POSTERIOR HEMIBLOCK
Definition
ECG Criteria
Treatment of Bifascicular Block
INTERMITTENT BUNDLE BRANCH BLOCK
Definition
Diagnostic Criteria
Diagnostic Pearls
11:
Myocardial Ischemia, Injury, Infarction
BASIC PRESENTATION
INSUFFICIENT MYOCARDIAL PERFUSION
Electrical Processes
ECG Changes in Response to Increased Demand and Decreased Supply
LOCATION OR SITE OF MYOCARDIAL ISCHEMIA OR INFARCTION
Localization of Myocardial Infarction/Ischemia with Affected Coronary Artery
MYOCARDIAL ISCHEMIA
ECG Criteria
Characteristics of Normal and Abnormal ST Segment
Difference between Pseudodepression and True (Ischemic) Depression of ST
Pseudodepression
True Depression
Difference between Pseudoelevation and True Elevation of ST
Pseudoelevation
True Elevation
Important Causes of ST and T Changes
ELECTROCARDIOGRAPHIC PHASE OF MYOCARDIAL INFARCTION
Four Phases (Figs 11.2A to D)
EVOLUTION OF ACUTE MI
Classic ECG Criteria for Acute MI (Fully Evolved)
ECG Criteria in Old MI
Serial ECG Changes during Evolution of MI
ST Segment Elevation Other than AMI
Correlation of MI with Side of Occlusion of a Coronary Artery
ECG Predictors of Left Anterior Descending (LAD) Occlusion in Anterior MI
ECG Findings in Culprit Vessel
ECG Criteria of AMl in the Presence of LBBB
Criteria
Sensitivity and Specificity of ECG in MI
Site of Myocardial Infarction by ECG
Subendocardial Ischemia
Definition
ECG Criteria
Subepicardial Ischemia
Definition
ECG Criteria
Subepicardial Injury
Definition
ECG Criteria
Coronary Artery Spasm
Definition
ECG Criteria
Extensive Anterior Myocardial Infarction
Definition
ECG Criteria for Extensive Anterior MI
Anteroseptal Myocardial Infarction
Definition
ECG Criteria
Anterior Myocardial Infarction
Definition
ECG Criteria
Anterolateral Myocardial Infarction
Definition
ECG Criteria
High Lateral Myocardial Infarction
Definition
ECG Criteria
Inferior Infarction (Diaphragmatic MI)
Definition
ECG Criteria
Posterior Wall Myocardial Infarction
Definition
ECG Criteria Note
Lead V2 Showing
Mirror-image of Lead V2 Showing
Inferoposterolateral Myocardial Infarction
Definition
ECG Criteria
Non-Q-wave Myocardial Infarction (Subendocardial Infarction)
Definition
ECG Criteria
Clinical Importance
Transmural Myocardial Infarction (Q-wave Infarction) (Fig. 11.17)
ECG Criteria
Right Ventricular Myocardial Infarction
Definition
ECG Criteria
Left Bundle Branch Block Associated with Acute Anterior MI
Definition
ECG Criteria
TYPES OF MI: MINNESOTA CRITERIA
Significance of Pathological Q, ST Elevation and T Inversion in MI
Significance of the Hyperacute Phase
Mechanism of Tall T in Hyperacute MI
Difference between Q-wave and Non-Q-wave MI
Dresslor's Syndrome (Postmyocardial Infarction Syndrome)
Definition
Mechanism
Treatment
Enzymatic Changes with Time in AMI
ECG Changes in Myocardial Ischemia
ACUTE CORONARY SYNDROMES
Definition
Diagnosis
ECG Findings for Diagnosis
ST Elevation Myocardial Infarction (STEMI)
Non-ST Elevation Myocardial Infarction (NSTEMI) Non-Q-wave MI
Unstable Angina (UA)
Diagnosis of ACS
Assessment and Classification of ACS
Biochemical Cardiac Markers
Diagnosis of ACS
Outline of Management of ACS
Clinical and Hemodynamic Subsets in AMI and Management (Forrester Classification)
12:
Drugs and Electrolytes Effects
DIGITALIS EFFECT
ECG Criteria
DIGITALIS TOXICITY (DIGOXIN TOXICITY)
Arrhythmias of Digoxin Toxicity
Atrial Arrhythmias
AV Junctional Arrhythmias
Ventricular Arrhythmias
Extracardiac Effect of Digoxin Toxicity
Treatment of Digoxin Toxicity
QUINIDINE EFFECTS (FIG. 12.3)
ECG Criteria
Causes
POTASSIUM EFFECT
Hyperkalemia (FIGS 12.5 and 12.6)
ECG Criteria
Effect of Hyperkalemia on Heart
Treatment
Features of Hyperkalemia
Common Causes of Hyperkalemia
POTASSIUM EFFECT: HYPOKALEMIA (FIGS 12.7 AND 12.8)
ECG Criteria
Effects of Hypokalemia
Effects of Hypokalemia on Heart
Causes of Hypokalemia
Treatment
CALCIUM EFFECT
Hypercalcemia
Hypocalcemia
EGC Criteria
HYPERMAGNESEMIA
HYPOMAGNESEMIA
ECG CHANGES ASSOCIATED WITH ELECTROLYTE DISTURBANCES
13:
Miscellaneous Conditions
HYPOTHERMIA
Introduction
ECG Criteria
CEREBROVASCULAR ACCIDENT PATTERN
Introduction
ECG Criteria
PERICARDITIS
Introduction
ECG Criteria
Subsequent ECG Changes
Causes of Acute Pericarditis
Presentation of Acute Pericarditis
Clinical Findings
Pericardial Rub
How to Differentiate Acute Pericarditis from Acute Myocardial Infarction by ECG?
Management
PERICARDIAL EFFUSION
ECG
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
ECG Criteria
THE S1, S2, S3 SYNDROME
ECG Criteria
Causes
PRE-EXCITATION SYNDROMES
Three Types
Types of Accessory Pathways
Three Types
Wolff-Parkinson-White Syndrome
Definition
ECG Criteria
Types of WPW Syndrome
Presentation of WPW Syndrome
Type A Confuses with:
Type B Confuses with:
Treatment of WPW Syndrome
Why Digoxin is Avoided?
Why PR Interval Short?
Mechanism of Delta Wave
Treatment of AF with WPW Syndrome
Lown-Ganong-Levine Syndrome or James Bypass Tract
ECG Criteria
Definition
Why QRS is Normal in Lown-Ganong-Levine Syndrome?
Mahaim Bypass Tract Syndrome
ECG Criteria
SICK SINUS SYNDROME (FIG. 13.11) (BRADYCARDIA TACHYCARDIA)
ECG Criteria
Definition
Causes of SSS
Presentation of SSS
Diagnosis of SSS
Very Common ECG Findings
PULMONARY EMBOLISM
ECG Criteria
Arrhythmias that Found in Pulmonary Embolism
Features of Acute Massive Pulmonary Embolism
Most Common ECG Findings
Investigation due to Diagnose Pulmonary Embolism
Treatment of Pulmonary Embolism
DEXTROCARDIA
Definition
ECG Criteria
Technical Dextrocardia
Investigation
Association of Dextrocardia
Clinical Importance of Situs Inversus
HYPERTHYROIDISM
ECG Criteria
HYPOTHYROIDISM
ECG Criteria
ELECTROMECHANICAL DISSOCIATION
ECG Criteria
Definition
Causes
Treatment
EARLY REPOLARIZATION PATTERN
Definition
ECG Criteria
JUVENILE T-WAVE PATTERN
Definition
ECG Criteria
CARDIOMYOPATHY
Introduction
Types
ECG Criteria
Dilated Cardiomyopathy
Hypertropic Cardiomyopathies
Restrictive Cardiomyopathies
VENTRICULAR ANEURYSM
Introduction
ECG Criteria
EMPHYSEMA (FIG. 13.18)
ECG Criteria
14:
Congenital Heart Diseases
VENTRICULAR SEPTAL DEFECT (FIG. 14.1)
Introduction
ECG Criteria
ATRIAL SEPTAL DEFECT (FIG. 14.2)
Introduction
ECG Criteria
PATENT DUCTUS ARTERIOSUS (FIG. 14.3)
Introduction
ECG Criteria
TETRALOGY OF FALLOT (FIG. 14.4)
Introduction
ECG Criteria
EBSTEIN'S ANOMALY (FIG. 14.5)
Introduction
ECG Criteria
PULMONARY STENOSIS (CONGENITAL) (FIG. 14.6)
Introduction
ECG Criteria
15:
Pacemakers and Exercise Tolerance Test
PACEMAKERS
Types
ECG Criteria
ECG Pacemaker Patterns (Fig. 15.2)
Pacemaker Terminology
Some Definitions
Indications of Temporary Pacemaker (TPM)
Indications of Permanent Pacemaker (PPM)
After MI, PPM Indications
Mode of PPM
Pacemaker Malfunction
ECG Changes
Pacemaker Syndrome
EXERCISE TOLERANCE TEST (ETT), OR EXERCISE TESTING (FIG. 15.4)
Introduction
ECG Changes during Exercise Testing
ECG Interpretation of ETT
Features of Strongly +ve ETT
16:
Echocardiogram Interpretation and Diagnosis
ECG INTERPRETATION-1
ECG INTERPRETATION-2
ECG DIAGNOSIS-1
ECG DIAGNOSIS-2
17:
Glossary
Suggested Reading
INDEX
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