The Electrocardiogram in Emergency and Acute Care

Description:

The Electrocardiogram in Emergency and Acute Care

Clear, practical guidance in mastering ECG interpretation in the critically ill patient

The Electrocardiogram in Emergency and Acute Care contains clear, practical guidance on mastering both single-lead and 12 lead ECGs, covering the full range of complexities and including a section on differential diagnosis of more common ECGs, with over 200 tracings from which to learn and self-test.

The editors place an emphasis on readability and accessibility, with clearly written chapters and excellent illustrations that serve as a primary source of information for students, trainees, and practicing emergency physicians in all areas.

In The Electrocardiogram in Emergency and Acute Care, readers can expect to find detailed information on topics such as:

• Clinical applications, impact, and interpretation of the electrocardiogram, plus variants of the normal, lead misplacement, and electrocardiographic artifact encountered in clinical practice
• Cardiac rhythms and cardiac dysrhythmias, covering cardiac rhythms with normal rates, narrow QRS complex tachycardia, wide QRS complex tachycardia, and bradycardia
• Anatomic and physiologic considerations of ischemic heart disease, historical development of the prehospital electrocardiogram, and electrocardiographic findings in acute coronary syndrome
• Special populations, high-risk presentation scenarios, and advanced electrocardiographic techniques, covering electrocardiograms in pediatric and poisoned patients

The Electrocardiogram in Emergency and Acute Care is ideally suited to medical students, residents, and physicians in training, but is also a useful reference for established physicians as a review and reference text, along with all other health professionals working in this field.

Preface

Electrocardiographic monitoring is one of the most widely applied diagnostic tests in clinical medicine today; its first application to the patient occurs in the prehospital setting, in the clinician’s office or by emergency medical services (EMS) . . . its use continues on into the hospital. The electrocardiogram, whether in monitor mode using single or multichannel rhythm monitoring or in diagnostic mode using the 12‑lead ECG, is an amazing tool; it assists in establishing a diagosis, ruling‑out various ailments, guiding the diagnosis and management strategies in the evaluation, providing indication for certain therapies, offering risk assessment, and assessing end‑organ impact of a syn‑ drome. As noted in this impressive list of applications, the ECG provides significant insight regarding the patient’s condition in a range of presentations, whether it be the chest pain patient with ST segment elevation myocardial infarction (STEMI), the patient in cardiac arrest with ventricular tachycardia, the poisoned patient with bradycardia, or the renal failure patient with rhythm and morphologic findings consistent with hyperkalemia, among many, many other presentations. This extremely useful tool is non‑invasive, portable, inexpensive, quickly obtained, and easily performed. Yet, ECG interpretation is not easily performed and, in fact, requires considerable skill and experience as well as an awareness of the limitation surrounding its use.

This textbook has been prepared to assist clinicians who wish to learn, review, and refine the skills required to interpret the electrocardiogram and develop a deeper understanding of its use across the range of presentations and applications. This textbook is arranged into five sections. Section 1 is a brief introduction and review of the ECG in the clinical setting. Section 2 focuses on

the electrocardiographic rhythm diagnosis, considering the electrocardiographic findings from an in-depth dif‑ differential diagnostic perspective – in other words, rhythms with normal rates as well as bradycardia and tachycardia, allowing for the QRS complex width and regularity. Section 3 reviews the 12-lead ECG in patients suspected of acute coronary syndrome, including ST segment elevation myocardial infarction. Section 4 discusses the range of special presentations, patient populations, and uses of the electrocardiogram. Section 5 is a listing of various electrocardiographic findings, again from the differential diagnostic perspective; in this section, various rhythm and morphologic presentations are discussed, such as the narrow and wide complex tachycardias and ST segment elevation syndromes.

This textbook addresses the use of the ECG in its many forms by clinicians in a wide range of clinical settings. The novice electrocardiographer can use this text as his or her primary ECG reference; additionally, the experienced interpreter can use this textbook to expand his or her knowledge base. This work stresses the value of the ECG in the range of clinical situations encountered daily by health care providers it illustrates the appropriate applications of the electrocardiogram in emergency and acute care scenarios.

Most importantly, this textbook is written by clinicians for clinicians, with an emphasis on the reality of the patient care. I and my co-editors and authors have enjoyed its creation  we hope that you, the clinician, will not only enjoy its content but also find it of value in the care of your patients. We thank you for what you do every day.

Table of contents :

Cover
Title Page
Copyright Page
Contents
Editors and Contributors
Foreword
Preface
Section I The ECG in Clinical Care
Chapter 1 Clinical Applications of the Electrocardiogram
Standard ECG Formatting and the Normal Electrocardiogram
Common Indications and Clinical Applications
Chapter 2 Clinical Impact of the Electrocardiogram (ECG)
Chapter 3 Interpretation of the Electrocardiogram – Single-, Multi-, and 12-Lead Analysis
Chapter 4 Variants of the Normal, Lead Misplacement, and Electrocardiographic Artifact Encountered in Clinical Practice
Section II Cardiac Rhythms and Cardiac Dysrhythmias
Chapter 5 Cardiac Rhythms with Normal Rates
Chapter 6 Narrow QRS Complex Tachycardia
Chapter 7 Wide QRS Complex Tachycardia
Chapter 8 Bradycardia
Chapter 9 Atrioventricular Conduction Block
Chapter 10 Intraventricular Conduction Block: Bundle Branch Block and Other Conduction Abnormalities
Chapter 11 Atrial and Ventricular Ectopic Beats
Section III Acute Coronary Syndrome and the 12-Lead ECG
Chapter 12 Ischemic Heart Disease: Anatomic and Physiologic Considerations
Chapter 13 Electrocardiographic Findings in Acute Coronary Syndrome
Section IV Special Populations, High-Risk Presentation Scenarios, and Advanced Electrocardiographic Techniques
Chapter 14 The Electrocardiogram in the Pediatric Patient
Chapter 15 The Electrocardiogram in the Poisoned Patient
Chapter 16 The Electrocardiogram in Hyperkalemia
Chapter 17 Life-Threatening Electrocardiographic Patterns
Chapter 18 The Electrocardiogram in Patients with Implanted Devices
Chapter 19 Electrocardiographic Tools in Clinical Care
Chapter 20 Wolff–Parkinson–White Syndrome
Chapter 21 Cardiac Arrest Rhythms
Section V Electrocardiographic Differential Diagnosis of Common ECG Presentations
Chapter 22 Electrocardiographic Differential Diagnosis of Narrow Complex Tachycardia
Chapter 23 Electrocardiographic Differential Diagnosis of Wide Complex Tachycardia
Chapter 24 Electrocardiographic Differential Diagnosis of Bradyarrhythmia
Chapter 25 Electrocardiographic Differential Diagnosis of ST Segment Elevation
Chapter 26 Electrocardiographic Differential Diagnosis of ST Segment Depression
Chapter 27 Electrocardiographic Differential Diagnosis of T Wave Abnormalities: The Prominent T Wave and T Wave Inversions
Index
EULA