Prelims

ECG in Medical Practice

Concerned mainly with basic concepts, abnormalities in cardiac disease and 151 tracings of ECG for practice

ECG in Medical Practice

FIFTH EDITION

ABM Abdullah MRCP (UK) FRCP (Edin) UGC Professor University Grants Commission Bangladesh Bangabandhu Sheikh Mujib Medical University Dhaka, Bangladesh

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ECG in Medical Practice / ABM Abdullah

First Edition: 2004

Fifth Edition: 2020

9789389587258

Printed at:

Dedicated to

Professor Taimur AK Mahmud MCPS FCPS

Ex-professor of Medicine

Bangabandhu Sheikh Mujib Medical University

Dhaka, Bangladesh

My beloved colleague, well-wisher and a source of inspiration

Preface to the Fifth Edition

By the good grace of Almighty Allah and encouragement of my family members and well-wishers, I am pleased to prepare the fifth edition of ECG in Medical Practice. This book was first published in 2004. Since its publication, immense popularity and wide acceptability of the previous editions among the medical students and doctors have encouraged me to prepare this new one.

Even with the development of sophisticated technology in cardiology, ECG is still a valuable and unparallel initial investigation in any cardiac disease. So, the basic concept of ECG and its diagnostic value still remain unchanged.

I am highly pleased to present the 5th edition, in which numerous new informations, latest investigations, and management have been added. Those who had the opportunity to read the previous edition, will find that in this new edition, some new ECG strips have been incorporated and new explanations have been re-written in the light of recent updates in cardiology.

Since 2004 of its first edition, this fifth edition will probably a pleasant one and hopefully will be acceptable by the respected valued readers. I also hope this edition will help the students to prepare for both undergraduate and postgraduate examination and to develop their clinical competence and confidence in cardiology.

In spite of my sincere best efforts, I believe there is still some scope of further improvement of this book and make it even more better. Any constructive comments and criticisms will be highly welcomed and appreciated, which will reinforce to understand ECG in an easy way.

For better practice, I have added 151 ECG tracings with answers which are provided in the last part. I would advise the reader to see the tracing first, then make your own interpretation and finally compare with the given diagnosis written at the end of the chapter.

ABM Abdullah

Preface to the First Edition

Despite the advent of many high-tech diagnostic procedures, ECG still remains one of the most basic, useful and easily available tools for the early diagnosis and evaluation of many cardiac problems.

In spite of a lot of books on this topic, I have written another new book, which is simple, concise, easy and a practical one that will help any physician, especially the beginners with little knowledge or experience on ECG.

The aim of this book is to guide the students and doctors about the basic concepts in ECG, its interpretation and recognition of cardiac abnormalities. It is also my intention to include common abnormalities in ECG and common cardiac problems that will help the students in any specialty of medicine, especially those who will appear in any examination.

To simplify and also to practice, I have arranged this book in three chapters:

Chapter 1—contains the basic principles of ECG along with normal ECG pattern and the abnormalities.
Chapter 2—contains the ECG abnormalities in different cardiac and extra-cardiac diseases.
Chapter 3—contains 100 ECG tracings of varying difficulty (from simple to more complex) for self-practice. Interpretation of these ECG are written in the last few pages (I would advise first to interpret the ECG by yourself, then compare the findings).

Whenever you are going through an ECG, always proceed systematically. Never leave anything to chance and never assume anything. Always describe the basic things and finally look for any abnormality.

Being an internist, I have prepared this book after going through dozens of different ECG books and have tried my best to fill up the gaps, I have noticed in those during my long teaching experience. It is my students and doctor colleagues who have constantly inspired and insisted me to prepare such a book so that they can have a complete and easy grasp over the topic in a short-time. I believe, this book will not only fulfil their demand but also be of great help for those who are willing to self-learn the basic concepts of ECG.

I was always careful not to overburden the busy clinicians and practitioners with the unnecessary details.

I would like to emphasize that efficiency, skill and fluency in interpreting ECG will only be achieved by going through the ECG tracings repeatedly and reviewing the topics frequently.

I would always appreciate and welcome constructive criticism from the valued readers about this book.

ABM Abdullah

Acknowledgments

I would like to take the opportunity to extend my sincere gratitude to Professor Kanak Kanti Barua, Vice Chancellor, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh for his encouragement and valuable suggestions in preparing this book. Also, I would like to acknowledge Professor Shohael Mahmud Arafat FCPS (Medicine) MRCP (UK) FRCPE FICP (Hon), Chairman, Department of Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh for his encouragement and valuable suggestions to enrich the book.

I am also highly grateful to Dr Mustasin Haider Sami, Dr Abhishek Bhadra, and Dr Hasanul Karim for graphical presentations and computer composing of the entire book. They have also gone through the whole manuscript and made necessary corrections and modifications. I can, without any hesitation, mention that they have worked as the co-authors.

I must acknowledge the contributions of my colleagues, doctors, and students who were kind enough to help me in writing such a book of its kind. They are always a source of my inspiration and encouragement.

Professor MU Kabir Chowdhury FRCP (Glasgow) DDV
Professor Sunil Kumar Biswas MCPS (Medicine) MD (Internal Medicine)
Professor Md Gofranul Hoque FCPS
Professor Tahmida Hassan DDV MD
Dr Shahnoor Sarmin MCPS FCPS MD (Cardiology)
Dr Ayesha Rafiq Chowdhury FCPS (Medicine) MD (Cardio) MRCP (UK)
Dr Md Abul Kalam Azad FCPS MD (Rheumatology)
Dr Md Razibul Alam MBBS MD (Gastroenterology)
Dr Samprity Islam MBBS MD (Pulmonology)
Dr Tazin Afrose Shah MBBS FCPS
Dr Ahmed-Al-Muntasir-Niloy MD internist (USA)
Dr Sadi Abdullah MBBS DTCD MRCP (UK)
Dr Imtiaz Ahmed MBBS MRCP (UK) FCPS (Medicine)
Dr Sadia Sabah MBBS MD (Resident)
Dr Md Shakhawat Hossain Rokan MBBS
Dr Abhijit Chowdhury MBBS Internist (Australia)
Dr Parvin Akhter MBBS MD (Internal Medicine)
Dr Nazma Azim Daizy MBBS MD (Resident)
Dr Nuzhat Nadia MBBS
Dr Nazia Hasin MBBS
Dr Israt Rubaiya MBBS
Dr Sumayia Sultana MBBS
Dr Nazmun Nahar MBBS
Dr Dolon Sarkar MBBS
Dr Aminul Kibria MBBS

My special thanks to Mr Jitendar P Vij for his constant support and encouragement and his associates particularly to, Mr MS Mani, Mr Shashi Kumar Shamboo, Dr Richa Saxena, Kamakshi Khanna and the team of M/s Jaypee Brothers Medical Publishers (P), Ltd, New Delhi, for their untiring endeavor and hard work, which made it possible for the “painless delivery” of this book. They have also notably enhanced the physical quality of the book making it beautiful and attractive. I must be grateful to my students who were repeatedly encouraging and demanding to write such a book.

Last, but not the least, I would like to express my gratitude to my wife, whose untiring support and sacrifice has made it possible to bring out such a nice book. I am also grateful to my daughter Dr Sadia Sabah and my son Dr Sadi Abdullah for their encouragement and inspiration in preparing such a book.

ABM Abdullah

Chapter Notes