The Art of Ekg Interpretation

by Ehrat, Karen S.

• ISBN13: 9780787225377
• ISBN10: 0787225371
• Format: Paperback
• Copyright: 1998-06-01
• Publisher: Kendall Hunt Pub Co

Table of Contents

LEADing into Section I	1	(13)
Section I: The Conduction System and Related Matters	13	(30)
The Conduction System	14	(1)
The P Wave and P-R Interval	15	(2)
The QRS Complex	17	(3)
The ST Segment and the T Wave	20	(2)
Paper Time	22	(2)
Measuring P, P-R, and QRS Intervals	24	(3)
Calculating Heart Rate	27	(4)
Sinus Rhythm	31	(2)
Interpreting Dysrhythmias	33	(10)
Section II: Sinus and Atrial Dysrhythmias	43	(36)
Steps for Interpreting Dysrhythmias	44	(1)
Sinus Arrhythmia	45	(3)
Sinus Bradycardia	48	(3)
Sinus Tachycardia	51	(2)
Premature Atrial Contractions	53	(5)
Atrial Tachycardia	58	(3)
Wandering Atrial Pacemaker (W.A.P.)	61	(1)
Sick Sinus Syndrome (Brady-Tachy Syndrome)	62	(1)
Atrial Flutter	63	(4)
Atrial Fibrillation	67	(3)
Atrial Flutter-Fibrillation (``flutterfib'')	70	(9)
Section III: Junctional Escape and Ectopic Rhythms	79	(20)
Junctional Escape Rhythm	80	(8)
Retrograde P Wave	82	(2)
The Hidden P Wave	84	(4)
Premature Junctional Beats	88	(3)
Junctional Tachycardia	91	(8)
Section IV: Ventricular Ectopic and Escape Rhythms	99	(30)
Premature Ventricular Contractions	100	(9)
P Wave Buried in QRS Complex	101	(1)
Retrograde P Wave	101	(2)
R on T Phenomenon	103	(1)
Multifocal P.V.C.'s	104	(3)
Interpolated P.V.C.'s	107	(2)
Fusion (Dressler) Beats	109	(3)
Ventricular Tachycardia	112	(6)
Capture Beats	115	(3)
Ventricular Flutter	118	(1)
Ventricular Fibrillation	118	(3)
Ventricular Escape Beats and Rhythms	121	(8)
Atrial Kick	122	(7)
Section V: Conduction Disturbances and Heart Block	129	(40)
Sinus Arrest (Sinus Pause) and Sinus Block	130	(2)
Atrial Tachycardia with Block	132	(1)
His Bundle Electrogram Studies and Related Facts	133	(4)
Table of Heart Blocks	135	(2)
First Degree AV Block	137	(3)
Second Degree AV Block	140	(7)
Second Degree AV Block---Mobitz Type I	140	(2)
Second Degree AV Block---Mobitz Type II	142	(3)
2:1 AV Conduction	145	(2)
Complete Heart Block (CHB)	147	(6)
Bundle Branch Block	153	(16)
Right Bundle Branch Block (RBBB)	153	(3)
Rate Dependent Bundle Branch Block	156	(1)
Left Bundle Branch Block (LBBB)	156	(13)
Section VI: Artifact ... To Be, or Not To Be...	169	(22)
Deores D. Schultz
Introduction to Artifact	170	(2)
Sixty-Cycle Interference	172	(2)
Motion Artifact	174	(7)
Artifact Produced by Electrical Equipment	181	(1)
``Off the Monitor''	182	(3)
Problems Associated with Artifact	185	(6)
Clues for Identifying Artifact	186	(5)
Section VII: Cardioversion and Defibrillation	191	(8)
Refractory and Vulnerable Phases of the Cardiac Cycle	192	(7)
Synchronized Cardioversion	192	(2)
Defibrillation (non-synchronized shock)	194	(5)
Section VIII: Pacemaker Basics	199	(14)
Deanna M. Culberson
Pacemaker Anatomy and Physiology	200	(6)
Indications for Pacemakers	200	(1)
External Pacemaker Generator	200	(2)
Temporary Pacemakers	202	(1)
Permanent Pacemakers	202	(1)
Permanent Pacemaker Programming	203	(1)
Inhibited (Demand) Generator Response	203	(1)
Triggered (non-demand) Generator Response	204	(2)
The Pacemaker Rhythm	206	(3)
AV Sequential Pacing	207	(2)
Determining Pacemaker Rate	209	(1)
More about Capture	209	(4)
Section IX: Electrolyte Changes	213	(14)
Ions, Electrolytes, and Potassium	214	(6)
Anions and cation	214	(1)
Serum Potassium	215	(1)
Hypokalemia	216	(2)
Dysrhythmias Associated with Hypokalemia	217	(1)
Hyperkalemia	218	(2)
Dysrhythmias Associated with Hyperkalemia	219	(1)
Serum Calcium	220	(7)
Hypocalcemia	221	(1)
Hypercalcemia	222	(5)
Section X: Ischemia, Injury, and Infarct	227	(40)
Myocardial Ischemia	228	(8)
The Normal EKG	228	(1)
Orientation of Leads to the Left Ventricular Surfaces	229	(1)
Myocardial Blood Supply (the coronary arteries)	230	(1)
Myocardial Ischemia	231	(5)
Myocardial Injury and Infraction	236	(21)
Muscle Layers in the Heart	236	(1)
Diagnosis of Myocardial Infraction	237	(1)
Current Injury (ST Segment Elevation)	237	(1)
Reciprocal ST Depression	238	(1)
The Pathologic Q Wave	238	(1)
Loss of R Wave	239	(1)
Normal Depolarization of the Ventricles	239	(7)
Infarct Resolution	246	(1)
Lateral Wall Myocardial Infraction	247	(1)
Inferior Wall Myocardial Infraction	247	(1)
Anteroseptal Wall Myocardial Infraction	247	(1)
Apical Area Myocardial Infarction	247	(5)
Ventricular Dysrhythmias	252	(5)
Posterior Wall Myocardial Infraction	257	(3)
Cardiac Enzymes and Isoenzymes	260	(7)
Section XI: An Introduction to Hemodynamic Monitoring	267	(30)
Deanna M. Culberson
Transducer System	268	(1)
Measuring Pressure Waves	268	(1)
Indications for Invasive Hemodynamic Monitoring	269	(6)
The Fundamentals	269	(1)
Functions of the Cardiovascular System	269	(3)
Systole; Diastole	272	(1)
Beyond Fundamentals	273	(1)
Starling's Law	273	(1)
Filling Pressure (Preload)	273	(2)
The Pulmonary Artery Catheter	275	(2)
Cardiac Output	276	(1)
Pressures and Waveformations	277	(20)
Pressures and Waveformations: The Right Atrium	277	(2)
Pressures and Waveformations: The Right Ventricle	279	(2)
Pressures and Waveformations: The Pulmonary Artery	281	(2)
Pressures and Waveformations: The Left Atrium	283	(2)
Pressures and Waveformations: Pulmonary Capillary Wedge Pressure (PCWP) vs. Left Atrial Pressure	285	(3)
Pressures and Waveformations: Pulmonary Capillary Wedge Pressure (PCWP) vs. Left Ventricular End Diastolic Pressure (LVEDP)	286	(2)
Managing Hemodynamic Imbalances	288	(6)
Glossary of Terms	294	(3)
Section XII: Antiarrhythmic and Thrombolytic Medications	297	(26)
Mike Lucey
Control of Heart Rate by Autonomic Nerves	298	(2)
Antiarrhythmic Drugs: Actions at Receptor Sites	300	(5)
The Body's Four Processes for Drug Handling	301	(1)
Absorption	301	(1)
Distribution	302	(1)
Metabolism	302	(1)
Excretion	302	(1)
Serum Drug Concentrations and the ``Therapeutic Range''	303	(2)
The Classification of Antiarrhythmic Drugs	305	(9)
Class I Drugs and Actions	306	(2)
Class II Drugs and Actions	308	(1)
Class III Drugs and Actions	309	(1)
Class IV Drugs and Actions	310	(1)
Important Antiarrhythmics without ``Class''	310	(4)
Digoxin	310	(4)
Treatment of Specific Rhythm Disorders	314	(9)
Atrial Fibrillation and Atrial Flutter	314	(1)
Ventricular Ectopy: PVC's	315	(1)
Sustained Ventricular Tachycardia	315	(1)
Ventricular Fibrillation	316	(1)
Thrombolytic Drug Treatment for Acute Myocardial Infraction	316	(7)
Mechanism of Action	317	(1)
Reperfusion Arrhythmias	317	(6)
Section XIII: Kidstuff	323	(46)
Jane D. Werth
You Have to Know the Rules to Win the Game	326	(5)
Heart Rate Norms	326	(1)
The P Wave	327	(1)
The P-R Interval	327	(1)
QRS Duration	328	(1)
QT Interval	328	(1)
The ST Segment	329	(1)
The T Wave	329	(2)
Sinus Anomalies	331	(5)
Sinus Arrhythmia	331	(1)
Sinus Bradycardia	332	(1)
Sinus Tachycardia	333	(1)
Sinus Arrest	334	(1)
Sick Sinus Syndrome	335	(1)
Atrial Dysrhythmias	336	(7)
Atrial Tachycardia	337	(1)
Premature Atrial Contraction (P.A.C.)	338	(1)
Atrial Flutter	339	(1)
Atrial Fibrillation	340	(1)
Wandering Atrial Pacemaker (W.A.P.)	341	(2)
Junctional Dysrhythmias and Rhythms	343	(5)
Junctional Escape Rhythm	343	(1)
Junctional Escape Beats	344	(1)
Premature Junctional Contractions (P.J.C.'s)	344	(1)
Junctional Tachycardia	345	(1)
Paroxysmal Supraventricular Tachycardia (P.S.V.T.)	346	(2)
Ventricular Dysrhythmias	348	(4)
Premature Ventricular Contractions (P.V.C.'s)	348	(1)
Ventricular Tachycardia	349	(1)
Ventricular Flutter	350	(1)
Ventricular Fibrillation	350	(2)
Conduction Disturbances	352	(7)
First Degree Heart Block	352	(1)
Mobitz Type I Second Degree Heart Block	353	(1)
2:1 AV Conduction	354	(1)
Mobitz Type II Second Degree Heart Block	354	(1)
Third Degree Heart Block (Complete Heart Block)	355	(1)
Bundle Branch Block	356	(1)
Right Bundle Branch Block	357	(1)
Left Bundle Branch Block	357	(2)
Drug and Electrolyte Induced Dysrhythmias	359	(3)
Hypokalemia	359	(1)
Hyperkalemia	360	(1)
Digitalis Toxicity	361	(1)
Kids' Artifact	362	(7)
Section XIV: Test Your Skill	369	(20)
Section XV: The Final Analysis: Advanced Arrhythmia Interpretation Practice	389	(22)
Index	411