ECG at a Glance

Patrick Davey is Consultant Cardiologist at Northampton General Hospital & Honorary Senior Lecturer at the John Radcliffe Infirmary, Oxford. He was previously a Clinical Tutor at Oxford University.

• Preface 6Acknowledgements 71 Introduction to the ECG 82 Strengths and weaknesses of the ECG 10Part 1 The normal ECG3 Basis of the ECG 124 The normal P wave 165 The normal QRS complex 186 The T and U waves 20Part 2 ECG abnormalities7 Abnormalities in the shape of the P wave – left and right atrial enlargement 228 Increased QRS amplitude 249 Q waves and loss of R wave height 2610 QRS axis deviation 2811 Long PR interval and QRS broadening 3012 Delta waves 3213 ST elevation 3414 ST depression 3615 Mild T wave flattening 3816 Deep T wave inversion 4017 QT interval and U wave abnormalities 42Part 3 Clinical syndromes18 Acute chest pain 4419 Chronic chest pain 4620 Acute breathlessness 4821 Chronic breathlessness 5122 Palpitations 5423 Syncope 5724 Hypertension 6025 Shock 6226 Stroke 6427 Emotion and the ECG 6628 Sudden cardiac death 68Part 4 Diseases29 Acute coronary syndromes 7030 Non-ST segment elevation myocardial infarction 7231 ST segment elevation myocardial infarction 7432 Aortic valve disease and hypertrophic cardiomyopathy 7633 Mitral valve disease 7834 Cardiomyopathy and myocarditis 8035 Pulmonary hypertension 8236 Congenital heart disease 8437 Endocrine disease and electrolyte disruption 8638 Psychological disease and its treatment 8839 Genetic pro-arrhythmic conditions 90Part 5 Tachyarrhythmias40 Distinguishing supraventricular from ventricular tachycardia 9241 Narrow complex tachycardia 9542 Atrial ectopic beats 9843 Atrial fibrillation 10044 Atrial flutter and atrial tachycardia 10245 Atrioventricular nodal re-entrant tachycardia 10446 Atrioventricular re-entrant tachycardia 10647 Ventricular ectopics 10848 Non-sustained ventricular tachycardia 11049 Monomorphic ventricular tachycardia 11250 Polymorphic ventricular tachycardia 11451 Ventricular fibrillation 116Part 6 Bradyarrhythmias and related diseases52 Sinus node disease 11853 Left bundle branch block 12054 Right bundle branch block 12255 First degree atrioventricular block – long PR interval 12456 Second degree atrioventricular block 12657 Atrioventricular block – third degree (complete) heart block 128Part 7 Pacemakers58 Pacemakers – basic principles 13059 Anti-bradycardic pacemakers 13260 Anti-tachycardic and heart failure devices 134Part 8 ECG-based investigations61 External and internal loop recorders 13662 Tilt-table test and carotid sinus massage 13863 Twenty-four hour ECGs 14064 The exercise stress test 14465 Invasive electrophysiological studies 148Part 9 Self-assessment case studiesCase studies and answers 150Appendix 162Index 163

“This is a refreshing new book in the already crowded field of ECG interpretation books.” (Doody's Reviews, May 2009) Pre-publication reviews: 'Very thorough list of contents, broken down logically into sections....this is a very accessible book that is easy to read from cover to cover.' - Postgraduate Medical Student, Warwick University 'Once again I have been impressed by the level of input and comprehension into each chapter. I have no doubt that my medical students will be carrying around ECG at a Glance as much as they already carry around Medicine at a Glance! Could I be cheeky and ask for a copy or 2 when the book is finally printed! ' - Consultant Cardiologist & Electrophysiologist, James Cook University Hospital, Middlesbrough