By John R. Hampton DM MA DPhil FRCP FFPM FESC
This publication deals a hundred and fifty 12-lead ECGs and rhythm strips, every one with a scientific case background and query. the whole ECG is reproduced and a examine of it with the case background might be sufficient to provide a solution. at the again the case is tested, with an outline of the most beneficial properties of the ECG besides a medical interpretation and a "what to do" part. The situations are graded in hassle.
"I could 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, typically to supply clearer examples, notwithstanding the ebook intentionally keeps a few technically negative documents to keep up a ’real-world’ perspective.
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Extra resources for 150 ECG problems
Clinical interpretation The ventricular rate is not adequately controlled, though the downward-sloping ST segment depression suggests that he is taking digoxin. The horizontal ST segment depression suggests ischaemia. 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.
84, 6E I VR V1 V4 II VL V2 V5 III VF V3 V6 ECG 21 ECG 21 II This ECG was recorded from a medical student during a practical class. What does it show? 41 ANSWER 21 The ECG shows: • Sinus rhythm, rate 70/min • Sinus arrhythmia • Normal axis • Normal QRS complexes • Normal ST segments and T waves Clinical interpretation This is a perfectly normal ECG. There is a beat-to-beat variation in the interval between QRS complexes, with the heart rate speeding up and slowing down. Comparison of the rate recorded in lead VF with that recorded in lead V3 may give a false impression of a change of rhythm, but the rhythm strip (lead II) clearly shows the progressive alteration of the R–R interval.
See p. 43, 76, 8E 46 See p. 127, 6E I VR V1 V4 II VL V2 V5 III VF V3 V6 ECG 24 ECG 24 This ECG and chest X-ray are from a 60-year-old man being treated as an outpatient for severe congestive cardiac failure. What might be the diagnosis of the underlying heart condition and what would you do? 47 ANSWER 24 The ECG shows: • Atrial fibrillation • Average ventricular rate 120/min • Normal axis • Normal QRS complexes • Horizontal ST segment depression in leads V3–V4 • Downward-sloping ST segment depression in leads I, II, V5–V6 The chest X-ray shows a generally enlarged heart, but especially an enlarged left ventricle and left atrium.
150 ECG problems by John R. Hampton DM MA DPhil FRCP FFPM FESC