By John R. Hampton DM MA DPhil FRCP FFPM FESC
This booklet deals a hundred and fifty 12-lead ECGs and rhythm strips, each one with a scientific case background and query. the whole ECG is reproduced and a examine of it with the case heritage could be adequate to offer a solution. at the again the case is tested, with an outline of the most good points of the ECG besides a scientific interpretation and a "what to do" part. The situations are graded in trouble.
"I could hugely suggest it, not just for my more youthful colleagues and scholars, but in addition to colleagues in numerous specialties." Reviewed by Perfusion, Apr 2015
For this Fourth variation over 30 new ECGs were integrated, in most cases to supply clearer examples, although the ebook intentionally keeps a few technically terrible files to keep up a ’real-world’ perspective.
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Extra resources for 150 ECG problems
51 ANSWER 26 The ECG shows: • Sinus rhythm, rate 83/min • Right axis deviation • Broad QRS complexes (140 ms) • RSR1 pattern in leads V1–V3 • Wide and slurred S waves in lead V6 • Normal ST segments • T wave inversion in leads III, VF and V1–V4 Clinical interpretation Right bundle branch block (RBBB). The right axis deviation suggests left posterior hemiblock. What to do RBBB is seen in a small proportion of people with otherwise perfectly normal hearts. In the presence of a heart murmur, however, the possibility of an atrial septal defect should be considered.
45, 76, 8E 20 See p. 127, 6E I VR V1 V4 II VL V2 V5 III VF V3 V6 ECG 11 ECG 11 II This ECG came from a 40-year-old woman who complained of palpitations, which were present when the recording was made. What abnormality does it show? e. a sinus beat) • The next four beats, at about 100/min, have abnormal (inverted) P waves, and this is an atrial tachycardia • After a pause the next two beats have normal P waves and are in sinus rhythm at about 60/min • After two sinus beats there is an extrasystole with an inverted P wave; this is an atrial extrasystole • Normal axis • The QRS complexes, ST segments and T waves are normal Clinical interpretation Since the patient had her symptoms at the time of the recording, we can be confident that the ECG findings explain them.
91, 8E 50 See p. 231, 6E I VR V1 V4 II VL V2 V5 III VF V3 V6 ECG 26 ECG 26 II A 15-year-old boy was referred to the outpatient department because of a heart murmur. He had no symptoms. What does this ECG show and what physical signs would you look for? 51 ANSWER 26 The ECG shows: • Sinus rhythm, rate 83/min • Right axis deviation • Broad QRS complexes (140 ms) • RSR1 pattern in leads V1–V3 • Wide and slurred S waves in lead V6 • Normal ST segments • T wave inversion in leads III, VF and V1–V4 Clinical interpretation Right bundle branch block (RBBB).