Electrocardiogram in Emergency and Acute Care

Korin B. Hudson, MD, FACEP, FAAEM, CAQ-SM is Professor of Clinical Emergency Medicine in the Department of Emergency Medicine, Georgetown University School of Medicine and MedStar Health, Washington, D.C. USA. Amita Sudhir, MD, FACEP is Associate Professor and Program Director of Emergency Medicine, University of Virginia Health System, Charlottesville, USA. George Glass, MD, FACEP is Assistant Professor of Emergency Medicine, University of Virginia Health System, Charlottesville, USA. William J. Brady, MD, EMT-B, FACEP, FAAEM is Professor of Emergency Medicine, Medicine (Cardiovascular), and Nursing and Vice Chair for Faculty Affairs, The David A. Harrison Distinguished Educator, University of Virginia Health System, Charlottesville, USA. He is also EMS Physician and Operational Medical Director, Albemarle County Fire Rescue, Charlottesville, USA.

• Editors and Contributors xForeword xiiPreface xivSection I The ECG in Clinical Care 11 Clinical Applications of the Electrocardiogram 3George Glass x2 Clinical Impact of the Electrocardiogram (ECG) 10Robert C. Schutt, William J. Brady, Korin B. Hudson, and Steven H. Mitchell3 Interpretation of the Electrocardiogram – Single- , Multi- , and 12- Lead Analysis 15Robert C. Reiser, Robert C. Schutt, Korin B. Hudson, and William J. Brady4 Variants of the Normal, Lead Misplacement, and Electrocardiographic Artifact Encountered in Clinical Practice 21Robert C. Reiser, Robert C. Schutt, Korin B. Hudson, and William J. BradySection II Cardiac Rhythms and Cardiac Dysrhythmias 275 Cardiac Rhythms with Normal Rates 29Korin B. Hudson and William J. Brady6 Narrow QRS Complex Tachycardia 33Courtney B. Saunders and Jeffrey D. Ferguson7 Wide QRS Complex Tachycardia 41Michael Levy and Francis X. Nolan, Jr †8 Bradycardia 48Korin B. Hudson, J. Aidan Boswick, and William J. Brady9 Atrioventricular Conduction Block 54Steven H. Mitchell, Korin B. Hudson, and William J. Brady 10 Intraventricular Conduction Block: Bundle Branch Block and Other Conduction Abnormalities 59Steven H. Mitchell, Richard B. Utarnachitt, and William J. Brady11 Atrial and Ventricular Ectopic Beats 67Jeffrey D. Ferguson, Michael Levy, J. Aidan Boswick, and William J. BradySection III Acute Coronary Syndrome and the 12- Lead ECG 7312 Ischemic Heart Disease: Anatomic and Physiologic Considerations 75Peter Pollak, Peter Monteleone, Kelly Williamson, David Carlberg, and William J. Brady13 Electrocardiographic Findings in Acute Coronary Syndrome 82Peter Monteleone, Peter Pollak, David Carlberg, and William J. BradySection IV Special Populations, High- Risk Presentation Scenarios, and Advanced Electrocardiographic Techniques 10114 The Electrocardiogram in the Pediatric Patient 103Robert Rutherford, Robin Naples, and William J. Brady15 The Electrocardiogram in the Poisoned Patient 111Steven H. Mitchell, Christopher P. Holstege, and William J. Brady16 The Electrocardiogram in Hyperkalemia 119Steven H. Mitchell and William J. Brady17 Life- Threatening Electrocardiographic Patterns 125Steven H. Mitchell, Richard B. Utarnachitt, and William J. Brady18 The Electrocardiogram in Patients with Implanted Devices 130Amita Sudhir and William J. Brady19 Electrocardiographic Tools in Clinical Care 136Robin Naples, Alvin Wang, and William J. Brady20 Wolff–Parkinson–White Syndrome 143William J. Brady21 Cardiac Arrest Rhythms 147Amita Sudhir and William J. BradySection V Electrocardiographic Differential Diagnosis of Common ECG Presentations 15322 Electrocardiographic Differential Diagnosis of Narrow Complex Tachycardia 155Megan Starling and William J. Brady23 Electrocardiographic Differential Diagnosis of Wide Complex Tachycardia 161Amita Sudhir and William J. Brady24 Electrocardiographic Differential Diagnosis of Bradyarrhythmia 170Megan Starling and William J. Brady25 Electrocardiographic Differential Diagnosis of ST Segment Elevation 175Megan Starling and William J. Brady26 Electrocardiographic Differential Diagnosis of ST Segment Depression 184Amita Sudhir and William J. Brady27 Electrocardiographic Differential Diagnosis of T Wave Abnormalities: The Prominent T Wave and T Wave Inversions 191Amita Sudhir and William J. BradyIndex 200