THIS BOOK MAY BE ORDERED FROM

Barnes & Noble

Amazon.com

Books-A-Million

 
 

 

 

 


Books by H. Thomas Milhorn
h

Electrocardiography: A Guide for Physicians, Medical Students, Nurse Practitioners, and other Healthcare Providers

The electrocardiogram can serve as an independent identifier of myocardial disease or reflect anatomic, metabolic, hemodynamic, or electrophysiological alterations in the heart. It can provide information that is often essential for the proper diagnosis and treatment of a variety of disorders and is without equal as a method for diagnosing cardiac arrhythmias. It is the procedure of choice for patients who present with chest pain, dizziness, syncope, or symptoms that may indicate risk of myocardial infarction or sudden death.

Primary care providers are often the first, and sometimes the only, point of contact for many patients within the health care system. The standard 12-lead electrocardiogram is one of the most common tests obtained and interpreted by the primary care physician, with most providers reading their own recordings and basing clinical decisions on their findings. It has been shown that primary care physicians can achieve proficiency in the interpretation of over 95 percent of all electrocardiogram findings seen in the primary care setting.

Although computerized interpretation is widely available, it is considered unreliable in up to 20 percent of the cases, making interpretation by primary care providers an essential skill. This book provides the necessary skills for primary care providers to use in interpreting electrocardiograms, both in their offices and in the emergency departments of their hospitals.

     This book is the result of a course I taught in the Department of Family Medicine at the University of Mississippi School of Medicine and five articles titled Electrocardiography for the Family Physician I subsequently published in Family Practice Recertification.

In short, this book is the one I wish I had access to during the many years I actively practiced family medicine and when I was a resident in family medicine.

Although this book was written with the primary care physician in mind, it should prove useful to medical students, residents in all primary care specialties, primary care nurse practitioners, and physician assistants. It is an outgrowth of my prior book Electrocardiography for the Family Physician.

Chapter 1. The Electrocardiogram   1

Electrocardiograph Paper   2

Conduction System of the Heart   2
Parts of the Electrocardiogram   3

Electrocardiographic Interpretation   13  

Chapter 1 Quiz   15  

 

Chapter 2. Leads and the Normal Electrocardiogram   17  

Leads   17  

Normal Electrocardiogram   26

Chapter 2 Quiz   29 

 

Chapter 3. Heart Rate and Axis   31     

Heart Rate   31  

Axis   32

Chapter 3 Quiz   41  

 

Chapter 4. Atrial Enlargement, Ventricular Hypertrophy, and Hypertrophic Cardiomyopathy   44      

Atrial Enlargement   44  

Ventricular Hypertrophy   47  

Hypertrophic Cardiomyopathy   53

Chapter 4 Quiz   55  

 

Chapter 5. Intraventricular Conduction Defects   57  

Bundle Branch Blocks   57    

Incomplete Bundle Branch Block   61    

Hemiblocks   61  

Bifascicular and Trifascicular Blocks   62  

Nonspecific Intraventricular Conduction Defects   62

Chapter 5 Quiz   63  
 

Chapter 6. Coronary Artery Disease   66     

Stable Angina   66  

Prinzmetalís Angina   68  

Unstable Angina   69  

Myocardial Infarction   70  

Old STEMI   79  

Left Ventricular Aneurysm    80    

Silent Myocardial Infarction   81  

STEMI and Bundle Branch Blocks   81  

Pseudoinfarction Syndromes   82  

Athletic Heart Syndrome   83

Chapter 6 Quiz   85  

   

Chapter 7. Rhythm Disturbances   89    

Sinus Rhythms   90    

Non-sinus Atrial Arrhythmias   92         

Junctional Rhythms    96 

Atrioventricular Heart Block   98  

Ventricular Rhythm Disturbances   100     

Bigeminy   107  

Electrical Alternans   108

Differential Diagnosis of Tachycardia   108

Chapter 7 Quiz   110  

 

Chapter 8. Preexcitation Syndromes, Pulmonary Embolus, Pericarditis, Early Repolarization, and Myocarditis   116 

Preexcitation Syndromes   116  

Pulmonary Embolus    121  

Pericarditis   122  

Early Repolarization   124 

Myocarditis   126

Chapter 8 Quiz   127  

 

Chapter 9. Hypothermia, Low Voltage ECG, Neurological Insult, Dextrocardia, Pacemakers, Takotsumo Cardiomyopathy, Brugada Syndrome, and Arrhythmogenic Right Ventricular Dysplasia   130  

Hypothermia   130  

Low Voltage ECG   132  

Neurological Insult   133  

Dextrocardia   133  

Pacemakers   134 

Takotsumo Cardiomyopathy   135  

Brugada Syndrome   136

Arrhythmogenic Right Ventricular Dysplasia    137

Chapter 9 Quiz   138  

 

Chapter 10. Drug Effects, Electrolyte Effects, ECG Worksheet, and Practice Electrocardiogram   141  

Drug Effects   141  

Electrolyte Effects   144 

ECG Worksheet   146  

Practice Electrocardiogram   147

Chapter 10 Quiz   148  

 

Chapter 11. Pediatric Electrocardiography   152

Normal Pediatric ECG   151

Abnormal Pediatric ECG   155

Chapter 11 Quiz   163

 

Appendix A. ECG Findings for Specific Congenital Heart Defects   165

 

Appendix B. Practice ECGs   167  

 

Appendix C. Answers to Chapter Questions and Practice ECGs   171  

 

References   177  
 

Index   181