By John R. Hampton DM MA DPhil FRCP FFPM FESC
This ebook bargains a hundred and fifty 12-lead ECGs and rhythm strips, each one with a scientific case background and query. the complete ECG is reproduced and a examine of it with the case heritage will be sufficient to offer a solution. at the again the case is tested, with an outline of the most positive factors of the ECG in addition to a medical interpretation and a "what to do" part. The instances are graded in trouble.
"I could hugely suggest it, not just for my more youthful colleagues and scholars, but additionally to colleagues in numerous specialties." Reviewed by Perfusion, Apr 2015
For this Fourth version over 30 new ECGs were incorporated, in general to supply clearer examples, notwithstanding the e-book intentionally keeps a few technically negative files to keep up a ’real-world’ perspective.
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Extra resources for 150 ECG problems
What does it show and what would you do? 43 ANSWER 22 The ECG shows: • Sinus rhythm, rate 75/min • Left axis deviation (left anterior hemiblock) • Normal QRS complexes, with a small Q wave (probably septal) in lead VL • Inverted T waves in leads V1–V5 Clinical interpretation This is a classic acute anterior non-ST segment elevation myocardial infarction (NSTEMI). What to do This ECG does not meet the conventional criteria for immediate percutaneous coronary intervention (PCI) or thrombolysis, which are raised ST segments or new left bundle branch block.
295, 6E 36 The combination of dizziness on exercise, a systolic murmur, and evidence of left ventricular hypertrophy suggests significant aortic stenosis. The next step is an echocardiogram: in this patient it showed a gradient across the aortic valve of 140 mmHg, indicating severe stenosis. He needed an urgent aortic valve replacement. Summary Left ventricular hypertrophy. I VR V1 V4 II VL V2 V5 III VF V3 V6 ECG 19 ECG 19 II A 75-year-old woman complained of central chest discomfort on climbing hills, together with dizziness; on one occasion she had ‘fainted’ while climbing stairs.
297, 6E I VR V1 V4 II VL V2 V5 III VF V3 V6 ECG 20 ECG 20 II A 70-year-old man is admitted to hospital following the onset of severe central chest pain. This is his ECG. What does it show and what treatment is needed? 39 ANSWER 20 The ECG shows: • Sinus rhythm, rate of sinus beats 75/min • Second degree (Wenckebach) heart block (most obvious in the rhythm strip, recorded from lead II) • Ventricular rate 70/min • Normal axis • Small Q waves in leads II, III, VF • Raised ST segments in leads II, III, VF • Depressed ST segments in leads V5–V6 Clinical interpretation This patient has second degree block of the Wenckebach type (progressive lengthening of the PR interval followed by a nonconducted P wave, and then a return to a short PR interval and repeat of the sequence).
150 ECG problems by John R. Hampton DM MA DPhil FRCP FFPM FESC