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| The Basics | |
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| Anatomy | |
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| Gross Anatomy | |
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| Anterior View | |
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| The Heart in Cross Section | |
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| The Heart as a Pump | |
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| Pump Function Simplified | |
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| The Electrical Conduction System | |
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| Pacemaker Function | |
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| Pacemaker Settings | |
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| The Sinoatrial (SA) Node | |
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| The Internodal Pathways | |
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| The Atrioventricular (AV) Node | |
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| The Bundle of His | |
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| The Left Bundle Branch (LBB) | |
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| The Right Bundle Branch (RBB) | |
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| The Left Anterior Fascicle (LAF) | |
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| The Left Posterior Fascicle (LPF) | |
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| The Purkinje System | |
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| Chapter in Review | |
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| Electrophysiology | |
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| Mechanics of Contraction | |
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| Ion Movement and Polarity | |
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| Membrane Channels and Action Potential Phases | |
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| Chapter in Review | |
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| Individual Vectors | |
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| Adding and Subtracting Vectors | |
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| The Electrical Axis of the Heart | |
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| Electrodes and Waves | |
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| Leads Are Like Pictures of the Heart | |
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| Lead Placement (Where to Put the "Cameras") | |
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| How the Machine Manipulates the Leads | |
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| The Two Lead Systems | |
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| The Hexaxial System | |
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| The Precordial System | |
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| The Heart in Three Dimensions | |
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| Localizing an Area: Inferior Wall | |
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| Localizing Other Areas | |
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| Chapter in Review | |
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| The Actual EGG: Paper and Ink | |
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| Boxes and Sizes | |
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| Calibration | |
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| Where Is Each Lead Represented? | |
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| Temporal Relationship of the ECG | |
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| Why Is Temporal Spacing Important? | |
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| Chapter in Review | |
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| ECG Tools | |
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| Calipers: The ECG Interpreter's Best Friend | |
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| How to Use Your Calipers | |
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| Comparing Wave Heights | |
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| Adding Wave Heights | |
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| Comparing Widths | |
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| Axis-Wheel Ruler | |
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| ECG Rulers | |
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| Straight Edge | |
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| The Basic Beat | |
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| Introduction to Basic Components | |
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| Wave Nomenclature | |
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| Individual Components of the ECG Complex | |
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| The P Wave | |
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| The Tp Wave | |
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| The PR Segment | |
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| The PR Interval | |
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| The QRS Complex | |
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| The ST Segment | |
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| The T Wave | |
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| The QT Interval | |
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| The U Wave | |
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| Additional Intervals | |
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| Looking Ahead | |
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| Chapter in Review | |
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| The Rate | |
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| Establishing the Rate | |
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| Normal and Fast Rates | |
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| Bradycardic Rates | |
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| Chapter in Review | |
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| Rhythms | |
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| Major Concepts | |
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| General | |
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| P Waves | |
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| QRS Complexes | |
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| Individual Rhythms | |
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| Supraventricular Rhythms | |
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| Ventricular Rhythms | |
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| Heart Blocks | |
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| Chapter in Review | |
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| ECG Interpretation | |
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| The P Wave | |
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| Overview | |
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| ECG Case Study: P Wave Basics | |
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| P Wave Morphology | |
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| ECG Case Studies: P Wave Morphology | |
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| Abnormal P Waves | |
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| P-mitrale | |
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| ECG Case Studies: P-mitrale | |
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| P-pulmonale | |
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| ECG Case Studies: P-pulmonale | |
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| Intraatrial Conduction Delay (IACD) | |
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| ECG Case Studies: Biphasic P Waves | |
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| Biatrial Enlargement | |
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| ECG Case Studies: Biatrial Enlargement | |
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| Chapter in Review | |
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| The PR Interval | |
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| Conduction Overview | |
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| PR Depression | |
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| ECG Case Study: PR Interval Depression | |
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| Measuring the Interval | |
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| Short PR Interval | |
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| ECG Case Study: Short PR Interval | |
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| Wolff-Parkinson-White Syndrome (WPW) | |
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| ECG Case Studies: WPW | |
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| WPW Syndrome--Advanced Information | |
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| Prolonged PR Interval | |
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| ECG Case Studies: Prolonged PR Interval | |
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| Chapter in Review | |
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| The QRS Complex | |
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| How Are the Waves Made? | |
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| What to Look for in the QRS Complex | |
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| QRS Height (Amplitude) | |
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| Abnormal Amplitude | |
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| ECG Case Studies: Pericardial Effusion | |
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| ECG Case Study: Large QRS Complexes | |
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| Left Ventricular Hypertrophy (LVH) | |
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| Electrocardiogram Criteria for LVH | |
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| Identifying LVH, Step by Step | |
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| ECG Case Studies: Left Ventricular Hypertrophy | |
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| Right Ventricular Hypertrophy (RVH) | |
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| RVH and the ECG | |
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| ECG Case Studies: RVH | |
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| QRS Duration | |
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| ECG Case Studies: QRS Duration | |
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| The Wide-QRS Differential, Simplified | |
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| QRS Morphology | |
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| ECG Case Studies: QRS Morphology | |
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| Q Wave Significance | |
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| Benign Q Waves | |
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| Respiratory Variation of Q Waves | |
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| ECG Case Studies: Q Wave Significance | |
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| Significant (Pathological) Q Waves | |
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| Transition Zone | |
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| ECG Case Studies: Transition Zone | |
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| QRS Notching | |
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| Osborn (J) Waves | |
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| ECG Case Studies: QRS Notching and Osborn Waves | |
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| Chapter in Review | |
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| The Electrical Axis | |
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| How to Calculate the Electrical Axis | |
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| Isolating the Axis | |
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| Find the Quadrant | |
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| Isolate the Isoelectric Lead | |
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| Isolate the Closest Lead | |
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| Isolate the Vector | |
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| Double-Check Your Findings | |
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| Causes of Axis Deviation | |
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| Right Axis Deviation (RAD) | |
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| Left Axis Deviation (LAD) | |
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| The Z Axis | |
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| The Z Axis Precordial Lead System | |
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| More Examples: Adding the Z Axis | |
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| Z Axis: Other Approaches | |
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| Chapter in Review | |
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| Bundle Branch Blocks and Hemiblocks | |
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| Right Bundle Branch Block | |
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| ECG Findings in Right Bundle Branch Blocks | |
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| The QR' Wave | |
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| ECG Case Studies: Right Bundle Branch Block | |
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| Left Bundle Branch Block | |
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| Criteria for Diagnosing LBBB | |
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| ECG Case Studies: Left Bundle Branch Block | |
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| Intraventricular Conduction Delay (IVCD) | |
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| Summary Comments on Bundle Branch Blocks | |
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| ECG Case Studies: Intraventricular Conduction Delay | |
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| Hemiblocks | |
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| Left Anterior Hemiblock | |
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| ECG Case Studies: Left Anterior Hemiblock | |
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| Left Posterior Hemiblock | |
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| ECG Case Studies: Left Posterior Hemiblock | |
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| Bifasciular Blocks | |
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| ECG Case Studies: Bifascicular Block | |
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| Chapter in Review | |
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| ST Segment and T Waves | |
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| Basics | |
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| Where Is the J Point? | |
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| ST Elevation or Depression | |
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| ST Segment Shapes | |
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| The T Wave | |
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| ECG Case Studies: ST Segments and T Waves | |
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| Ischemia and Injury | |
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| ECG Case Studies: Ischemia and Injury | |
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| Strain Pattern | |
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| Right Ventricular Strain Pattern | |
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| ECG Case Studies: Right Ventricular Strain Pattern | |
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| Left Ventricular Strain Pattern | |
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| ECG Case Studies: Left Ventricular Strain Pattern | |
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| ECG Comparisons: Benign Changes Versus Infarct | |
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| Pericarditis Revisited | |
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| ECG Case Studies: Pericarditis | |
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| STs and T Waves in Blocks | |
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| ECG Case Studies: STs and Ts in Blocks | |
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| Chapter in Review | |
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| Acute Myocardial Infarction | |
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| Introduction | |
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| Zones of Ischemia, Injury, and Infarction | |
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| Infarct and Q Waves | |
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| Q Wave Infarct | |
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| Non-Q Wave Infarct | |
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| ECG Progression in Infarct | |
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| Reciprocal Changes | |
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| Infarct Regions on the ECG | |
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| Infarct Regions in Combination | |
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| ECG Case Studies: Anteroseptal AMI | |
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| ECG Case Studies: Anteroseptal AMI with Lateral Extension | |
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| ECG Case Study: Lateral Wall AMI | |
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| ECG Case Studies: Inferior Wall AMI | |
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| ECG Case Studies: Inferolateral AMI | |
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| ECG Case Studies: Apical AMI | |
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| ECG Case Studies: Right Ventricular Infarction | |
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| ECG Case Studies: Posterior Wall AMI | |
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| ECG Case Studies: Inferoposterior AMI | |
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| ECG Case Studies: Inferior-RV-Posterior AMI | |
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| Chapter in Review | |
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| Electrolyte and Drug Effects | |
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| Hyperkalemia and Its Effects | |
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| The Spectrum of Hyperkalemia | |
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| T Wave Abnormalities in Hyperkalemia | |
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| ECG Case Studies: T Wave Changes in Hyperkalemia | |
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| IVCD and Hyperkalemia | |
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| P Waves and Hyperkalemia | |
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| ECG Case Studies: IVCD and P Waves in Hyperkalemia | |
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| Other Electrolyte Abnormalities | |
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| Hypokalemia | |
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| Hypercalcemia | |
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| Hypocalcemia | |
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| ECG Case Studies: Other Electrolyte Abnormalities | |
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| Drug Effects | |
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| Digoxin | |
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| ECG Case Studies: Drug Effects | |
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| Chapter in Review | |
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| Putting It All Together | |
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| New Ground | |
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| The 10 Questions of the Gram | |
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| What Is My General Impression? | |
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| Is There Anything That Sticks Out? | |
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| What Is the Rate? | |
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| What Are the Intervals? | |
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| What Is the Rhythm? | |
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| What Is the Axis? | |
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| Is There Any Hypertrophy | |
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| Is There Any Ischemia or Infarction? | |
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| What Is the Differential Diagnosis of the Abnormality? | |
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| How Can I Put It All Together with the Patient? | |
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| The Big Picture | |
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| Acronyms | |
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| Additional Readings | |
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| Glossary | |
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| Index | |