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Offers a guide for a complete understanding of the disease and conditions most frequently revealed in ECGs recorded in the acute, critical, and emergency care settings
Electrocardiogram in Clinical Medicine offers an authoritative guide to ECG interpretation that contains a focus and perspective from each of the three primary areas of medical care: acute care, critical care and emergency care. It can be used as a companion with the book ECGs for the Emergency Physician I & II (by Mattu and Brady) or as a stand-alone text. These three books can be described as a cumulative EGG reference for the medical provider who uses the electrocardiogram on a regular basis.
Electrocardiogram in Clinical Medicine includes sections on all primary areas of ECG interpretation and application as well as sections that highlight use, devices and strategies. The medical content covers acute coronary syndromes and all related issues, other diseases of the myocardium, morphologic syndromes, toxicology and paediatrics; dysrhythmias will also be covered in detail. This important resource:
* Goes beyond pattern recognition in ECGs to offer a real understanding of the clinical syndromes evidenced in ECGs and implications for treatment
* Covers the indications, advantages and pitfalls of the use of ECGs for diagnosis in all acute care settings, from EMS to ED to Critical Care
* Examines the ECG in toxic, metabolic and environmental presentations; critical information for acute care clinicians who need to be able to differentiate ODs, poisoning and other environmental causes from MI or other cardiac events
* Facilitates clinical decision-making
Written for practicing ER, general medicine, family practice, hospitalist and ICU physicians and medical students, Electrocardiogram in Clinical Medicine is an important book for the accurate interpretation of EGG results.
Sommario
List of Contributors xxi
Section I The ECG in Clinical Practice 1
1 The ECG in Clinical Medicine 3
Brian Kessen and Kelly Williamson
Introduction 3
The ECG as a Clinical Tool 3
Clinical Presentations and the ECG 4
Chest Pain 4
Dyspnea 5
Syncope 6
Toxicology 7
Electrolyte Abnormalities 7
Pacemakers 10
Conclusion 10
References 10
2 History of the Electrocardiogram 13
Trale Permar and Kelly Williamson
References 17
Section II ECG Changes in Myocardial Ischemia 19
1 The Cardiac Action Potential and Changes in the Setting of Acute Coronary Syndrome: How Ischemia and Infarction Impacts the ECG 21
Kirsti A. Campbell and Michael J. Lipinski
Introduction 21
Basic Electrophysiology 21
Action Potentials in Sodium-Dependent Depolarizers 21
Action Potential in Calcium-Dependent Depolarizers 24
Anatomy of the Electrical Conduction System 24
Biochemical Impact of Ischemia 25
ST-Segment Deviation 25
QRS Complex 30
T Waves 31
P Waves 31
U Waves 34
Myocardial Ischemia: Causes Other than Acute Coronary Syndrome 34
Conclusion 34
References 36
2 Ischemic Electrocardiographic Changes and Correlation with Regions of the Myocardium 37
Thibault Lhermusier and Michael J. Lipinski
Introduction 37
Coronary Anatomy 37
Definitions of STEMI and Non-ST Elevation ACS 38
Left Main Coronary Ischemia 39
Anterior STEMI 40
Wellens Syndrome 40
Inferior STEMI 41
Right Ventricular Infarction 41
Lateral STEMI 44
Posterior STEMI 44
Conduction Abnormalities in the Setting of Ischemia 46
Aneurysm of the Left Ventricle 49
ECG in Pharmacological and Mechanical Reperfusion 49
Conclusion 50
References 50
3 STEMI Mimics 53
Peter M. Pollak
Introduction 53
Myocarditis and Myopericarditis 53
Early Repolarization 55
Left Ventricular Hypertrophy 57
Prior Infarction and Ventricular Aneurysm 58
Vasospasm (Prinzmetal or Variant Angina) 58
Apical Ballooning Syndrome (Takotsubo Cardiomyopathy) 61
Brugada Pattern and Idiopathic Ventricular Fibrillation 62
Hyperkalemia 62
Post-Cardioversion/Shock 62
Hypothermia and Osborn Waves 62
Pulmonary Embolism 63
Other Causes of ST Elevation 63
Conclusion 65
References 65
4 Confounders of ST-Elevation Myocardial Infarction 69
Amy West Pollak
Introduction 69
Left Bundle Branch Block 69
LBBB and Ischemic Heart Disease 69
Left Ventricular Hypertrophy 71
Ventricular Paced Rhythm 71
Right Bundle Branch Block (RBBB) 73
References 73
5 The Prognostic Value of the Electrocardiogram in Acute Coronary Syndromes 75
Benjamin Shepple and Robert Gibson
Introduction 75
The ECG in Acute Coronary Syndromes 75
ST Elevation Myocardial Infarction (STEMI) 75
The ECG during Myocardial Injury 76
The ECG in Response to Therapy 80
ECG after Completion of Infarction 81
UA/NSTEMI 83
ST-Segment Depression 83
T-Wave Inversions 84
Initial Normal ECG 86
Arrhythmia and Conduction Disease 86
Ventricular Arrhythmias 86
Premature Ventricular Contractions 87
Ventricu
Info autore
William J. Brady, MD, is Professor of Emergency Medicine and Medicine, University of Virginia, Charlottesville, VA, USA.
Michael J. Lipinski, MD, PhD, is Cardiovascular Associates of Charlottesville, Charlottesville, VA, USA.
Andrew E. Darby, MD, FHRS, is Associate Professor of Cardiovascular Medicine, University of Virginia Health System, Charlottesville, VA, USA.
Michael C. Bond, MD, FACEP, FAAEM, is Associate Professor of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Nathan P. Charlton, MD, is Associate Professor of Emergency Medicine, Division of Medical Toxicology, University of Virginia, Charlottesville, VA, USA.
Korin Hudson, MD, is Associate Professor of Emergency Medicine, MedStar Georgetown University Hospital, Georgetown University School of Medicine, Washington, DC, USA.
Kelly Williamson, MD, is Assistant Residency Program Director, Advocate Christ Medical Center Emergency Medicine Residency; and is Clinical Associate Professor of Emergency Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Riassunto
Offers a guide for a complete understanding of the disease and conditions most frequently revealed in ECGs recorded in the acute, critical, and emergency care settings
Electrocardiogram in Clinical Medicine offers an authoritative guide to ECG interpretation that contains a focus and perspective from each of the three primary areas of medical care: acute care, critical care and emergency care. It can be used as a companion with the book ECGs for the Emergency Physician I & II (by Mattu and Brady) or as a stand-alone text. These three books can be described as a cumulative EGG reference for the medical provider who uses the electrocardiogram on a regular basis.
Electrocardiogram in Clinical Medicine includes sections on all primary areas of ECG interpretation and application as well as sections that highlight use, devices and strategies. The medical content covers acute coronary syndromes and all related issues, other diseases of the myocardium, morphologic syndromes, toxicology and paediatrics; dysrhythmias will also be covered in detail. This important resource:
* Goes beyond pattern recognition in ECGs to offer a real understanding of the clinical syndromes evidenced in ECGs and implications for treatment
* Covers the indications, advantages and pitfalls of the use of ECGs for diagnosis in all acute care settings, from EMS to ED to Critical Care
* Examines the ECG in toxic, metabolic and environmental presentations; critical information for acute care clinicians who need to be able to differentiate ODs, poisoning and other environmental causes from MI or other cardiac events
* Facilitates clinical decision-making
Written for practicing ER, general medicine, family practice, hospitalist and ICU physicians and medical students, Electrocardiogram in Clinical Medicine is an important book for the accurate interpretation of EGG results.
