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Understanding 12 Lead EKGs : A Practical Approach

by ;
Edition:
1st
ISBN13:

9780130272812

ISBN10:
0130272817
Format:
Paperback
Pub. Date:
1/1/2001
Publisher(s):
Prentice Hall

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    Understanding 12-Lead EKGs : A Practical Approach





Summary

For courses in EKGs, Professional Nursing, Physician Assistant, Paramedic Respiratory Therapy, and Cardiac Technology.This student-friendly learning resource comprehensively provides a practical approach to the skill of twelve-lead EKG interpretation. It simplifies and thoroughly explains all the vital concepts necessary for a complete understanding of this complex subject creating a useful and understandable tool for health care providers in their provision of optimum patient care.

Table of Contents

Foreword ix
Preface xiii
The Anatomy of the Heart (Structure)
1(8)
Objectives
1(1)
Introduction
1(1)
Anatomy of the Heart
1(1)
Location, Size, and Shape of the Heart
2(1)
Layers of the Heart
3(1)
Valves of the Heart
4(1)
Arteries, Veins, and Capillaries
5(2)
Review Questions
7(2)
Cardiovascular Physiology (Function)
9(7)
Objectives
9(1)
Introduction
9(1)
Blood Flow through the Heart
10(1)
Cardiac Cycle
10(1)
Stroke Volume
11(1)
Cardiac Output
11(1)
Autonomic Nervous System
12(1)
Receptors and Neurotransmitters
12(2)
Review Questions
14(2)
Basic Electrophysiology
16(8)
Objectives
16(1)
Introduction
16(1)
Basic Cell Groups
17(1)
Primary Cardiac Cell Characteristics
17(1)
Major Electrolytes That Affect Cardiac Function
18(1)
Movement of Ions
19(1)
Cardiac Depolarization
19(1)
Cardiac Repolarization
20(1)
Refractory Periods
21(1)
Review Questions
21(3)
The Electrical Conduction System
24(6)
Objectives
24(1)
Introduction
24(1)
SA Node
25(1)
Internodal Pathways
26(1)
AV Node
26(1)
AV Junction
26(1)
Bundle of His
26(1)
Bundle Branches
27(1)
Purkinje Network
27(1)
Review Questions
27(3)
The Electrocardiogram
30(17)
Objectives
30(1)
Introduction
30(1)
Electrical Basis of the EKG
31(1)
EKG Leads
31(6)
EKG Graph Paper
37(1)
EKG Waveforms
37(5)
Standard 12-Lead EKG Waveforms
42(2)
Review Questions
44(3)
Interpretation EKG Strips
47(14)
Objectives
47(1)
Introduction
47(1)
General Rules
48(1)
The Five-Step Approach
48(6)
The 5 + 3 Approach
54(1)
ST Segment Depression
55(1)
ST Segment Elevation
56(1)
Pathologic Q Waves
57(1)
Review Questions
58(3)
Acute Myocardial Infarctions
61(10)
Objectives
61(1)
Introduction
61(1)
Coronary Artery Anatomy
61(2)
The Coronary Sinus (Great Cardiac Vein)
63(1)
Angina Pectoris
64(1)
Acute Myocardial Infarctions
64(1)
Chest Pain
65(2)
Clinical Significance of Acute Myocardial Infarctions
67(1)
Patient Assessment
67(1)
Review Questions
68(3)
Myocardial Ischemia, Injury, and Necrosis
71(8)
Objectives
71(1)
Introduction
71(1)
Time Is Muscle (Myocardium)
72(1)
Infarct Regions and Definitions
72(4)
Clinical Significance of Myocardial Ischemia, Injury, and Necrosis
76(1)
Review Questions
76(3)
Interpretation of Inferior MIs
79(10)
Objectives
79(1)
Introduction
79(1)
Anatomy and Physiology Review
80(1)
Transmural versus Subendocardial Infarctions
81(1)
Lead-Specific ST Elevation
81(2)
EKG Changes Related to Inferior Infarction
83(1)
Clinical Significance of Inferior MIs
84(2)
Review Questions
86(3)
Interpretation of Anterior MIs
89(11)
Objectives
89(1)
Introduction
89(1)
Anatomy of the Coronary Arteries
90(1)
``Widowmaker''
90(1)
Lead-Specific ST Segment Elevation
91(3)
EKG Changes Commonly Associated with Anterior MIs
94(1)
Clinical Significance of Anterior MIs
94(2)
Summary
96(1)
Review Questions
97(3)
Interpretation of Septal MIs
100(8)
Objectives
100(1)
Introduction
100(1)
Anatomy of the Interventricular Septum and the Coronary Arteries
100(1)
Lead-Specific ST Segment Elevation
101(3)
EKG Changes Commonly Associated with Septal MIs
104(1)
Clinical Significance of Septal MIs
104(1)
Summary
105(1)
Review Questions
105(3)
Interpretation of Lateral MIs
108(8)
Objectives
108(1)
Introduction
108(1)
Anatomy of the Left Ventricle and the Circumflex Branch of the Left Coronary Artery
108(1)
Lead-Specific ST Segment Changes
109(2)
EKG Changes Commonly Associated with Lateral MIs
111(1)
Clinical Significance of Lateral MIs
112(1)
Summary
113(1)
Review Questions
114(2)
Interpretation of Posterior MIs
116(12)
Objectives
116(1)
Introduction
116(1)
Coronary Artery Anatomy Review
117(1)
Lead-Specific ST Segment Changes
117(1)
The Mirror Test
117(1)
Another Trick for Identifying Posterior MIs
118(1)
Posterior V Leads
118(3)
EKG Changes Related to Posterior MIs
121(1)
Clinical Significance of Posterior MIs
122(2)
Summary
124(1)
Summary of Recognition of Specific MIs
124(1)
Review Questions
125(3)
Axis Deviation and Bundle Branch Blocks
128(15)
Objectives
128(1)
Introduction
128(1)
EKG Leads
128(1)
The Hexaxial Reference System
129(1)
Axis Deviation
130(2)
Bundle Branch Blocks
132(6)
Clinical Significance of Bundle Branch Blocks
138(2)
Review Questions
140(3)
Therapeutic Modalities
143(15)
Objectives
143(1)
Introduction
143(1)
Thrombolytics
144(4)
Emergency External Cardiac Pacing
148(2)
Defibrillation
150(3)
Cardioversion
153(2)
Review Questions
155(3)
Cardiovascular Pharmacology
158(23)
Objectives
158(1)
Introduction
159(1)
Oxygen
159(1)
Sympathomimetics
160(5)
Sympatholytics
165(1)
Antidysrhythmics
166(7)
Analgesics
173(2)
Antianginals
175(1)
Alkalinizing Agents
176(1)
Anticoagulants
177(1)
Review Questions
178(3)
More Review Questions
181(24)
12-Lead EKG Review Strips
205(78)
Appendix 1: Answers to Review Questions 283(6)
Chapter 1
283(1)
Chapter 2
283(1)
Chapter 3
283(1)
Chapter 4
283(1)
Chapter 5
284(1)
Chapter 6
284(1)
Chapter 7
284(1)
Chapter 8
284(1)
Chapter 9
284(1)
Chapter 10
284(1)
Chapter 11
285(1)
Chapter 12
285(1)
Chapter 13
285(1)
Chapter 14
285(1)
Chapter 15
285(1)
Chapter 16
286(1)
Chapter 17
286(3)
Appendix 2: Answers to Review Questions: Chapter 18 (12-Lead EKG Review Strips) 289(36)
Index 325

Excerpts

PREFACE Our purpose in writing this book was to create a learning resource that is reader-friendly, yet comprehensive in its approach to the interpretation of the 12-lead electrocardiogram. This text serves as a companion text toUnderstanding EKGs: A Practical Approach. This book consists of 18 chapters that are designed to provide the user with a practical approach to the skill of 12-lead EKG interpretation. The goal of this text is to focus on providing a useful and understandable tool for the health care provider in his/her provision of optimum patient care. It has been our intent that the presentation of the material be accomplished in a logical order. In order to afford the student the opportunity to work in a reasonable order through the technical information, the material is presented in such a manner as to achieve understanding of each chapter prior to proceeding to the next chapter. The content is presented in short, succinct chapters in order to facilitate comprehension of each concept in a "building block" format. At the end of each chapter, we have included a section of multiple choice questions to be used as self-assessment and review. A thorough knowledge of basic EKG interpretation is an essential prerequisite to understanding 12-lead EKG interpretation. With this thought in mind, we began this book with a series of chapters reviewing basic dysrhythmia interpretation. This book includes rhythm strip examples within each applicable chapter, as well as an entire chapter devoted to 12-lead EKG review strips. In addition, there are chapters devoted to cardiovascular pharmacology and therapeutic modalities. Since the late 1980s, the use of thrombolytics in the treatment of acute myocardial infarctions has become an ever expanding, dynamic component of the health care professions. As a direct result of this, more and more health care providers are required to interpret, understand, and apply their knowledge of 12lead EKGs in the clinical setting. We sincerely hope that this logical, yet comprehensive approach to 12lead EKG interpretation will furnish the student, as well as other health care providers, with a substantial foundation for the interpretation and understanding of electrocardiology. Ultimately, it is our wish that your future patients will benefit from the knowledge that you attain from this text.


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