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TABLE OF CONTENTS
Getting Started 1
Chapter 1
The Basics 9
Electricity and the Heart 10
Time and Voltage 17
P Waves, QRS Complexes, T Waves, and Some Straight
Lines 19
Naming the Straight Lines 28
Summary: The Waves and Straight Lines of the EKG 30
Making Waves 31
The 12 Views of the Heart 36
A Word About Vectors 45
The Normal 12-Lead EKG 46
Summary: Orientation of the Waves of the Normal EKG 57
Coming Attractions 59
Chapter 2
Hypertrophy and Enlargement of the Heart 61
Definitions 62
Axis 65
Summary: Axis 72
Axis Deviation, Hypertrophy, and Enlargement 75
Atrial Enlargement 78
Summary: Atrial Enlargement 81
Ventricular Hypertrophy 82
Secondary Repolarization Abnormalities of Ventricular
Hypertrophy 88
Summary: Ventricular Hypertrophy 90
Case 1 91
Case 2 92
Chapter 3
Arrhythmias 95
The Clinical Manifestations of Arrhythmias 97
Why Arrhythmias Happen 98
Rhythm Strips 99
How To Determine the Heart Rate From the EKG 101
The Four Basic Types of Arrhythmias 105
Arrhythmias of Sinus Origin 106
Ectopic Rhythms 113
The Four Questions 116
Ectopic Supraventricular Arrhythmias 118
Summary: Supraventricular Arrhythmias 129
Ectopic Ventricular Arrhythmias 130
Summary: Ventricular Arrhythmias 137
Summary: Rules of Malignancy for PVCs 137
Supraventricular Versus Ventricular Arrhythmias 138
Summary: Ventricular Tachycardia (VT) Versus
Paroxysmal Supraventricular Tachycardia
(PSVT) With Aberrancy 144
Programmed Electrical Stimulation 145
Implantable Defibrillators 146
Case 3 148
Case 4 150
Chapter 4
Conduction Blocks 153
What Is a Conduction Block? 154
AV Blocks 155
Summary: AV Block 164
Bundle Branch Block 165
Summary: Bundle Branch Block 171
Hemiblocks 172
Summary: Criteria for Hemiblock 176
Combining Bundle Branch Blocks and Hemiblocks 177
Summary: Criteria for Bifascicular Block 177
The Ultimate in Playing With Blocks: Combining AV
Blocks, Bundle Branch Blocks, and Hemiblocks 180
Pacemakers 182
Case 5 186
Chapter 5
Preexcitation Syndromes 189
What Is Preexcitation? 190
Wolff-Parkinson-White Syndrome 192
Lown-Ganong-Levine Syndrome 193
Associated Arrhythmias 194
Summary: Preexcitation 198
Case 6 199
Chapter 6
Myocardial Infarctions 201
What Is a Myocardial Infarction? 202
How to Diagnose a Myocardial Infarction 203
Summary: The EKG Changes of an Evolving Myocardial
Infarction 215
Localizing the Infarct 216
Non-Q Wave Myocardial Infarctions 225
Angina 227
Summary: The ST Segment in Cardiac Disease 229
Limitations of the EKG in Diagnosing an Infarction 230
Stress Testing 231
Case 7 236
Chapter 7
Finishing Touches 243
Electrolyte Disturbances 245
Hypothermia 249
Drugs 250
Other Cardiac Disorders 254
Pulmonary Disorders 258
Central Nervous System Disease 260
The Athlete's Heart 261
Summary: Miscellaneous Conditions 262
Case 8 264
Chapter 8
Putting It All Together 267
The 11-Step Method for Reading EKGs 270
Review Charts 272
Subject Index 289
END
