150 Practice ECGs: Interpretation and Review - Part 1 pps

... George Jesse. 15 0 practice ECGs : interpretation and review / George J. Taylor.—3rd ed. p. ; cm. Includes index. ISBN -1 3 : 97 8 -1 -4 05 1- 0 48 3-8 (pbk. : alk. paper) ISBN -1 0 : 1- 4 05 1- 0 483-X (pbk. : ... 616 .1 207547—dc22 2005 017 378ISBN -1 3 : 97 8 -1 -4 05 1- 0 48 3-8 ISBN -1 0 : 1- 4 05 1- 0 483-XA catalogue record for this title is available from the British LibrarySet in 10 on 13 pt Meridien by SNP Best-set ... Threepatientswithcompleteheartblock.Theatriaarebeingdischargedataregularrate(Pwaves) and theventriclesataregularrate(QRScomplexes).Thetworhythmsappearunrelated;thereisAVdissociation.YoumaybetemptedtosaythatPwavescomingbeforeQRScomplexescouldbeconducted,butthesedonotaltertheregularityoftheventricularescaperhythm.Patients and havewideQRScomplexes and slowventricularrates;theyprobablyhaveblockbelowtheAVnode,withatakeoverpace - makerinthebodyoftheventricle.Patienthasamorerapidescaperate(55beats/min), and theQRScomplexisnarrow;thelevelofblockistheAVnode. 15 0 Practice ECGs: Interpretation and Review Third Edition Part I: How to Interpret ECGs Chapter 1: Baseline...

... A72-year-oldmanwithchestpainof6hoursduration.Isthereanteriorischemia?200 15 0 Practice ECGs: Interpretation and Review  A54-year-oldwomanwithalonghistoryofpalpitations;yearlyexamination. 19 8 15 0 Practice ECGs: Interpretation and Review  ...  15 0 Practice ECGs 205 A72-year-oldwomanwithfever and exacerbationofchronicbronchitis. 19 4 15 0 Practice ECGs: Interpretation and Review  A73-year-oldmanwithchestpain.Shouldhehavethrombolytictherapy?Whatothertestswouldyourecommend? ...  15 0 Practice ECGs 19 9 A78-year-oldmanintheemergencyroomwithpulmonaryedema and chestpain(duringthisECGrecording). 19 2 15 0 Practice ECGs: Interpretation and Review ...

... 2432-hour duration 13 7, 17 3, 18 7, 19 8, 244, 246, 2493-hour duration 14 4, 15 9, 237, 2 41 5-hour duration 17 1, 17 8, 243, 2456-hour duration 18 4, 206, 246, 2509-hour duration 11 1, 229 14 -hour ... and 14 1, 236left bundle branch block and 15 0, 239long QT and 11 3, 229T wave inversion and 11 0, 228sinus rhythm 11 , 64, 216 sinus tachycardia (ST) 11 anterior ischemia or infarction and ... (IRBBB) 41 isolated 10 4, 16 2, 227, 2 41 left anterior fascicular block with 72, 10 5, 218 19 , 227indigestion 89, 11 1, 15 2inferior leads 5infranodal heart block 12 , 13 , 15 , 17 18 intervals 7 10 intracranial...

... 42 15 0 Practice ECGs: Interpretation and Review FIGURE 2.4 Leftbundlebranchblock(LBBB).Followthesequenceofventricularactivation. (1) Thenor-malleft-to-rightdepolarizationoftheseptumisinterruptedbytheblockedleftbundlebranch.Theseptumisactivatedfromrighttoleft.(2)Activationofthethin-walledrightventricleproduceslittlecurrent.(3)Theleftventricleisdepolarizedlatebycurrentworkingitswayoverfromtherightside, and terminalQRSforcesareorientedtowardtheleft.Patternrecognition:broadpositivecomplex—oftennotched—inleft-sideleads(I,aVL).SmallQwavesintheseleadswouldexcludeLBBBbecausetheywouldindicatenormal,left-to-rightactivationofthesep - tum.ThispatientalsohadmarkedLAD.Twavechanges and prolongationoftheQTintervalmayaccom - panyLBBB.ItisnotpossibletodiagnoseeitherleftventricularhypertrophyorMIinthepresenceofLBBB.2 ... duration ≥ 0 .12 second plus a broad, positive complex in left-side leads (I, aVL, and V6).2 50 Practice ECGs: Interpretation and Review three different patterns within a 12 -lead ECG. The ... the left-side leads, such as I, aVL, and V6, would be negative (an S wave).RBBB diagnosis: RSR’ pattern in V 1 , and QRS ≥ 0 .12 second.0 50 Practice ECGs: Interpretation and Review There...

... FourpatientswithacuteinferiorMI.ThesizeofinferiorMIisproportionaltothesumofSTelevationinthethreeinferiorleads.Inaddition,thosewithreciprocalSTdepressioninanteriororlateralleadstendtohavelargerinfarctions.Usingthesecriteria,patientwashavingthelargestMI,patients and moderate-sizedMIs, and patientasmallinfarct.PatientalsohadSTelevationinV5 and V6;thismaybecalledaninferolateralMI.Inthiscase,thedistalrightcoronaryarteryintheAVgroovewaslarge, and itterminatedinabranchtothelateralwall(seeFig2.8).Patientisanarguablecaseofinfarction,astheSTsegmentelevationisminimal.IamtemptedtosaythatthemildJpointdepressioninV2throughV4representsreciprocalSTdepression;typicalchestpain and asubsequentriseincardiacenzymeswouldbeneededtomakethediagnosisofMIwithcertaintyinthiscase.TheECGchangesofSTsegmentelevationinfarctionareusuallyobvious,butthereareborderlinecaseslikethisone.Asarule,suchborderlinecasesinvolvesmallMIs;withbigonesthereislittledoubt.64 15 0 Practice ECGs: Interpretation and Review  A57-year-oldman,preoperativeECG.66 15 0 Practice ECGs: Interpretation and Review  A54-year-oldwoman,admittedwithcholecystitis. ... 15 0 Practice ECGs: Interpretation and Review  Anactive82-year-oldwomanwithhypertension.Shouldweworryaboutpossiblesyncope?76 15 0 Practice ECGs: Interpretation and Review  ... groove);itsendsperforatingbranchesintotheseptum, and diagonalbranchestotheanteriorLVsurface.ThespatialorientationoftheECGleadsallowsgroupsofleadstoreflecteventsinagivenregionoftheheart(seeFig 1. 2aswell).70 15 0 Practice ECGs: Interpretation and Review  A79-year-oldmanbroughtfromthenursinghomewitharapidpulse.52 15 0 Practice ECGs: Interpretation and Review ...

...  15 0 Practice ECGs 10 1 An82-year-oldmanwithfatigue and ankleedemafor2weeks.80 15 0 Practice ECGs: Interpretation and Review  A46-year-oldman;routineexam.Normalorabnormal? ... A46-year-oldman;routineexam.Normalorabnormal?  15 0 Practice ECGs 81  An89-year-oldwomanwithdizzinesswhenshestands.82 15 0 Practice ECGs: Interpretation and Review  A74-year-oldman;noclinicaldataprovided. ... A62-year-oldmanintheemergencyroomofacommunityhospital.Beforearrival,hehadchestpainfor2hours,thenrelief.Painhasnowrecurred.Isittoolateforreperfusiontherapy?  15 0 Practice ECGs 91  A79-year-oldwomanwithmildhypertension.94 15 0 Practice ECGs: Interpretation and Review  A 6 1- year-oldwomanwithpoorlycontrolledhypertension....