Electrocardiografia

ABC OF CLINICAL ELECTROCARDIOGRAPHY

FRANCIS MORRIS JUNE EDHOUSE WILLIAM J BRADY JOHN CAMM
BMJ Books

ABC OF CLINICAL ELECTROCARDIOGRAPHY

ABC OF CLINICAL ELECTROCARDIOGRAPHY

Edited by FRANCIS MORRIS
Consultant in Emergency Medicine, Northern General Hospital, Sheffield

JUNE EDHOUSE
Consultant in Emergency Medicine, Stepping Hill Hospital, Stockport

WILLIAM J BRADY
AssociateProfessor, Programme Director, and Vice Chair, Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA and

JOHN CAMM
Professor of Clinical Cardiology, St George’s Hospital Medical School, London

© BMJ Publishing Group 2003

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by anymeans, electronic, mechanical, photocopying, recording and/or otherwise, without the prior written permission of the publishers. First published in 2003 by BMJ Books, BMA House, Tavistock Square, London WC1H 9JR www.bmjbooks.com British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 0 7279 1536 3 Typeset by BMJ ElectronicProduction Printed and bound in Spain by GraphyCems, Navarra Cover image depicts a chest x ray and electrocardiogram trace Composite image of an electrocardiogram trace showing termination of atrioventricular nodal re-entrant tachycardia, overlaid onto a false-coloured chest x ray With permission from Sheila Terry/Science Photo Library

Contents
Contributors Preface 1 2 3 4 5 6 7 8 9 10 11 12 13 14 1516 17 18 Introduction. I—Leads, rate, rhythm, and cardiac axis Steve Meek, Francis Morris Introduction. II—Basic terminology Steve Meek, Francis Morris Bradycardias and atrioventricular conduction block David Da Costa, William J Brady, June Edhouse Atrial arrhythmias Steve Goodacre, Richard Irons Junctional tachycardias Demas Esberger, Sallyann Jones, Francis Morris Broad complex tachycardia—PartI June Edhouse, Francis Morris Broad complex tachycardia—Part II June Edhouse, Francis Morris Acute myocardial infarction—Part I Francis Morris, William J Brady Acute myocardial infarction—Part II June Edhouse, William J Brady, Francis Morris Myocardial ischaemia Kevin Channer, Francis Morris Exercise tolerance testing Jonathan Hill, Adam Timmis Conditions affecting the right side of the heartRichard A Harrigan, Kevin Jones Conditions affecting the left side of the heart June Edhouse, R K Thakur, Jihad M Khalil Conditions not primarily affecting the heart Corey Slovis, Richard Jenkins Paediatric electrocardiography Steve Goodacre, Karen McLeod Cardiac arrest rhythms Robert French, Daniel DeBehnke, Stephen Hawes Pacemakers and electrocardiography Richard Harper, Francis MorrisPericarditis, myocarditis, drug effects, and congenital heart disease Chris A Ghammaghami, Jennifer H Lindsey Index vi vii 1 5 9 13 17 21 25 29 33 37 41 45 49 53 57 61 66 70

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Contributors
William J Brady Associate Professor, Programme Director, and Vice Chair, Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA Kevin Channer Consultant Cardiologist, RoyalHallamshire Hospital, Sheffield David Da Costa Consultant Physician, Northern General Hospital, Sheffield Daniel De Behnke Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA June Edhouse Consultant in Emergency Medicine, Stepping Hill Hospital, Stockport Demas Esberger Consultant in Accident and Emergency Medicine, Queen’s Medical Centre, Nottingham Robert French Departmentof Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA Chris A Ghammaghami Assistant Professor of Emergency and Internal Medicine, Director, Chest Pain Centre, Department of Emergency Medicine, University of Virginia Health System, Charlottesville, VA, USA Steve Goodacre Health Services Research Fellow, Accident and Emergency Department, Northern General Hospital, Sheffield...