The Electrocardiogram in Emergency and Acute Care

Clear, practical guidance in mastering ECG interpretation in the critically ill patient

The Electrocardiogram in Emergency and Acute Care contains clear, practical guidance on mastering both single-lead and 12 lead ECGs, covering the full range of complexities and including a section on differential diagnosis of more common ECGs, with over 200 tracings from which to learn and self-test.

The editors place an emphasis on readability and accessibility, with clearly written chapters and excellent illustrations that serve as a primary source of information for students, trainees, and practicing emergency physicians in all areas.

In The Electrocardiogram in Emergency and Acute Care, readers can expect to find detailed information on topics such as:

• Clinical applications, impact, and interpretation of the electrocardiogram, plus variants of the normal, lead misplacement, and electrocardiographic artifact encountered in clinical practice
• Cardiac rhythms and cardiac dysrhythmias, covering cardiac rhythms with normal rates, narrow QRS complex tachycardia, wide QRS complex tachycardia, and bradycardia
• Anatomic and physiologic considerations of ischemic heart disease, historical development of the prehospital electrocardiogram, and electrocardiographic findings in acute coronary syndrome
• Special populations, high-risk presentation scenarios, and advanced electrocardiographic techniques, covering electrocardiograms in pediatric and poisoned patients
• The Electrocardiogram in Emergency and Acute Care is ideally suited to medical students, residents, and physicians in training, but is also a useful reference for established physicians as a review and reference text, along with all other health professionals working in this field.

Editors and Contributors x

Foreword xii

Preface xiv

Section I The ECG in Clinical Care 1

1 Clinical Applications of the Electrocardiogram 3
George Glass x

2 Clinical Impact of the Electrocardiogram (ECG) 10
Robert C. Schutt, William J. Brady, Korin B. Hudson, and Steven H. Mitchell

3 Interpretation of the Electrocardiogram – Single- , Multi- , and 12- Lead Analysis 15
Robert C. Reiser, Robert C. Schutt, Korin B. Hudson, and William J. Brady

4 Variants of the Normal, Lead Misplacement, and Electrocardiographic Artifact Encountered in Clinical Practice 21
Robert C. Reiser, Robert C. Schutt, Korin B. Hudson, and William J. Brady

Section II Cardiac Rhythms and Cardiac Dysrhythmias 27

5 Cardiac Rhythms with Normal Rates 29
Korin B. Hudson and William J. Brady

6 Narrow QRS Complex Tachycardia 33
Courtney B. Saunders and Jeffrey D. Ferguson

7 Wide QRS Complex Tachycardia 41
Michael Levy and Francis X. Nolan, Jr †

8 Bradycardia 48
Korin B. Hudson, J. Aidan Boswick, and William J. Brady

9 Atrioventricular Conduction Block 54
Steven H. Mitchell, Korin B. Hudson, and William J. Brady 

10 Intraventricular Conduction Block: Bundle Branch Block and Other Conduction Abnormalities 59
Steven H. Mitchell, Richard B. Utarnachitt, and William J. Brady

11 Atrial and Ventricular Ectopic Beats 67
Jeffrey D. Ferguson, Michael Levy, J. Aidan Boswick, and William J. Brady

Section III Acute Coronary Syndrome and the 12- Lead ECG 73

12 Ischemic Heart Disease: Anatomic and Physiologic Considerations 75
Peter Pollak, Peter Monteleone, Kelly Williamson, David Carlberg, and William J. Brady

13 Electrocardiographic Findings in Acute Coronary Syndrome 82
Peter Monteleone, Peter Pollak, David Carlberg, and William J. Brady

Section IV Special Populations, High- Risk Presentation Scenarios, and Advanced Electrocardiographic Techniques 101

14 The Electrocardiogram in the Pediatric Patient 103
Robert Rutherford, Robin Naples, and William J. Brady

15 The Electrocardiogram in the Poisoned Patient 111
Steven H. Mitchell, Christopher P. Holstege, and William J. Brady

16 The Electrocardiogram in Hyperkalemia 119
Steven H. Mitchell and William J. Brady

17 Life- Threatening Electrocardiographic Patterns 125
Steven H. Mitchell, Richard B. Utarnachitt, and William J. Brady

18 The Electrocardiogram in Patients with Implanted Devices 130
Amita Sudhir and William J. Brady

19 Electrocardiographic Tools in Clinical Care 136
Robin Naples, Alvin Wang, and William J. Brady

20 Wolff–Parkinson–White Syndrome 143
William J. Brady

21 Cardiac Arrest Rhythms 147
Amita Sudhir and William J. Brady

Section V Electrocardiographic Differential Diagnosis of Common ECG Presentations 153

22 Electrocardiographic Differential Diagnosis of Narrow Complex Tachycardia 155
Megan Starling and William J. Brady

23 Electrocardiographic Differential Diagnosis of Wide Complex Tachycardia 161
Amita Sudhir and William J. Brady

24 Electrocardiographic Differential Diagnosis of Bradyarrhythmia 170
Megan Starling and William J. Brady

25 Electrocardiographic Differential Diagnosis of ST Segment Elevation 175
Megan Starling and William J. Brady

26 Electrocardiographic Differential Diagnosis of ST Segment Depression 184
Amita Sudhir and William J. Brady

27 Electrocardiographic Differential Diagnosis of T Wave Abnormalities: The Prominent T Wave and T Wave Inversions 191
Amita Sudhir and William J. Brady

Index 200

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