The ECG: A Two-Step Approach to Diagnosis

ISBN-13: 9783540008699 / Angielski / Twarda / 2003 / 616 str.

Marc Gertsch; M. Gertsch; C. P. Cannon

Opis

Introduction by Bernhard Meier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxxiii Theoretical Basics and Practical Approach Introduction and Concept of the Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 The Value of'the ECG' Today . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Limitations of the Pattern ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Concept of the Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Theoretical Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Anatomy of the Impulse Formation and Impulse Conduction Systems . . . . . . . . . . . . . . . . . . . . . . . . 3 2 Normal Impulse Conduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 Action Potential of a Single Cell ofWorking Myocardium and its Relation to Ion Flows . . . . . . . . . . 4 4 Atrial Depolarization and Repolarization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 5 Ventricular Depolarization and Repolarization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 5. 1 Vectors and Vectorcardiogram . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 5. 2 Simplified QRS Vectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 6 Lead Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 7 'Magnifying Glass' and 'Proximity' Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Refractory Period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 9 Nomenclature of the ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Practical Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 1 The Practical Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 1. 1 Definitive ECG diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 xiii 2 Practical approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 2. 1 Analysis of rhythm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 2. 2 Detailed analysis of morphology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 References 18 Pattern ECG The Normal ECG and its (Normal) Variants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Components of the Normal ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 1. 1 Sinus Rhythm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 1. 1. 1 Atrial Vectors in Sinus Rhythm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 1. 2 PQ Interval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 1. 3 QRS complex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 1. 3. 1 QRS Axis in the Frontal Plane (AQRS ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 p 1. 3. 2 QRS Axis in the Horizontal Plane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 1. 3. 3 Two Special QRS Patterns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 1. 3. 4 Other Normal Variants of the QRS Complex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 1. 4 ST Segment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ."

Recenzje

From the foreword by Professor Christopher Cannon:

"Professor Gertsch has compiled a wonderful book that covers all aspects of electrocardiography but with a very practical and clinically useful approach...."

From the reviews:

"This single-authored book covers all aspects of electrocardiography from a clinical and practical view. ... this book very useful for all levels of physicians caring for cardiac patients and health-care professionals. The book is fully illustrated with more than one thousand high quality ECGs, figures and tables. It will offer many individuals who interpret electrocardiograms the necessary educational 'building blocks' required to increase their knowledge of the subject and to improve their interpretation skills." (Roland Stroobandt, Acta Cardiologica, April, 2005)

Spis treści

SECTION I - THEORETICAL BASICS AND PRACTICAL APPROACH 1. Theoretical Basics 2. Practical Approach SECTION II - PATTERN ECG 3. The Normal ECG and its (Normal) Variants 4. Atrial Enlargement 5. Left Ventricular Hypertrophy 6. Right Ventricular Hypertrophy 7. Biventricular Hypertrophy 8. Acute and Subacute Pulmonary Embolism 9. Fascicular Blocks 10. Bundle-Branch Blocks (Complete and Incomplete) 11. Bilateral Blocks 12. Atrioventricular Block and Dissociation 13. Myocardial Infarction 14. Differential Diagnosis of Pathologic Q Waves 15. Acute and Chronic Pericarditis 16. Electrolyte Imbalances and Disturbances 17. Alterations of Repolarization SECTION III - ARRHYTHMIAS 18. Atrial Premature Beats 19. Atrial Tachycardias 20. Atrial Flutter 21. Atrial Fibrillation 22. Sick Sinus Syndrome 23. AV Junctional Tachycardias (without WPW Syndrome) 24. The Wolff-Parkinson-White Syndrome 25. Ventricular Premature Beats 26. Ventricular Tachycardias SECTION IV - SPECIAL TOPICS 27. Exercise ECG 28. Pacemaker ECG 29. Congenital Heart Disease 30. Digitalis Intoxication 31. Special Waves, Signs and Phenomena 32. Rare ECGs

O autorze

The author is one of the most experienced cardiological experts in Switzerland. Besides considerable teaching experience in Switzerland and abroad, Professor Gertsch is the Senior Consultant at the Swiss Heart Center, Department of Cardiology, Inselspital, University of Bern

Blurb

This practical guide to all types of ECG is unique in both its comprehensiveness and its accessibility. The author, one of the world’s most experienced ECG specialists, has provided a two-step approach which will be of value to the time-strapped practitioner and the ambitious student alike. Each chapter is divided into a section "At a Glance" for quick reference and "The Full Picture" for a thorough study of the topic.

Common ECGs and rarer types are included and illustrated by more than five hundred ECG strips and over fifty case reports, or "short stories".

From the foreword by Professor Christopher Cannon:

Professor Gertsch has compiled a wonderful book that covers all aspects of electrocardiography but with a very practical and clinically useful approach. In reading this book I have been struck by its very straightforward layout and setup of each chapter … I feel this book will be a welcome addition to the medical literature and should be very useful to cardiologists, electrophysiologists, internists, primary care physicians, nurses, medical residents, exercise physiologists and technicians, and all other health-care professionals caring for cardiac patients.