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

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

by H. Thomas Milhorn


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Primary care providers are often the first, and sometimes the only, point of contact for many patients within the healthcare system. The standard 12-lead electrocardiogram is one of the most common tests obtained and interpreted by primary care providers, with most reading their own recordings and basing clinical decisions on their findings. Primary care providers 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 an outgrowth of a previous book, Electrocardiography for the Family Physician.

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Product Details

ISBN-13: 9781627342599
Publication date: 09/01/2018
Pages: 198
Product dimensions: 5.50(w) x 8.50(h) x 0.42(d)

About the Author

H. Thomas Milhorn, MD, PhD is the author of 12 books, 12 chapters in books, and over 150 research and medical education publications. In 1992 he retired from the University of Mississippi School of Medicine with the ranks of Professor of Family Medicine, Professor of Physiology and Biophysics, and Associate Professor of Psychiatry and Human Behavior. Moving to Meridian, Mississippi he practiced family and addiction medicine full time for nine years. He currently is on the faculty of East Central Healthnet Family Medicine Residency Program where he teaches an electrocardiography course.

Table of Contents

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

Prinzmetal’s 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

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