150 ECG problems by John R. Hampton DM MA DPhil FRCP FFPM FESC

By John R. Hampton DM MA DPhil FRCP FFPM FESC

This e-book bargains one hundred fifty 12-lead ECGs and rhythm strips, every one with a scientific case background and query. the total ECG is reproduced and a learn of it with the case background will be adequate to provide a solution. at the again the case is tested, with an outline of the most good points of the ECG in addition to a scientific interpretation and a "what to do" part. The instances are graded in hassle.

"I might hugely suggest it, not just for my more youthful colleagues and scholars, but additionally to colleagues in several specialties." Reviewed by Perfusion, Apr 2015

For this Fourth variation over 30 new ECGs were incorporated, customarily to supply clearer examples, notwithstanding the booklet intentionally keeps a few technically terrible files to keep up a ’real-world’ perspective.

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Sample text

What to do Despite the ECG evidence of ischaemia, possible diagnoses include rheumatic heart disease, thyrotoxicosis, alcoholic heart disease, and other forms of cardiomyopathy. The chest X-ray suggests severe mitral regurgitation. Echocardiography is necessary. The serum digoxin level must be checked and the digoxin dose increased if appropriate. In addition to digoxin, the patient will need an angiotensin-converting enzyme inhibitor, a diuretic and, unless contraindicated, anticoagulants. Betablockers must be considered once his cardiac failure is controlled.

Digoxin, a beta-blocker or verapamil could be given in an attempt to control the ventricular rate. After anticoagulation, cardioversion – either electrical or with flecainide – will be necessary. Summary Atrial flutter with 2 : 1 conduction. See p. 67, 8E 54  See p.

She then had an aortic valve replacement, and made a complete recovery. Summary Sinus rhythm with LBBB. See p. 43, 8E 38  See p. 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).

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