ECG in 10 Days

2016·31.76 MB·english

by  David Ferry

SECOND EDITION
LEARN TO EFFECTIVELY INTERPRET VIRTUALLY EVERY ECG
FERRY
YOU’RE LIKELY TO ENCOUNTER IN CLINICAL PRACTICE –
ECG
IN TEN BRIEF LESSONS
E
C
T
he only review book to offer full-sized ECGs G
throughout (simulating how they appear on
NEW TO THE SECOND EDITION
I
tests and in actual practice), this sourcebook
N
• Inclusion of the latest American College of
is the most sought-after ECG review anywhere,
Cardiology (ACC) guidelines
trusted by cardiology fellows, internal medicine
• Selection of randomECGs after Day 10 for 1
residents, medical students, and health-related
additional review
0
professionals alike. ECG IN TEN DAYSis based on the
• A brand-new glossary with key terms, which
author’s popular ten-day review course, and
are also bolded within the text
D
features a unique step-by-step approach, crystal-
• Short appendix that includes formal criteria 10.875
clear vector images, plus practice EDB strips to for various ECG diagnoses A
build confidence and fine-tune clinical skills. • Consolidated chapters 2 and 3 for a more Y
cohesive look at super ventricular arrhythmias
In these pages, you’ll find essential information S
• Reorganized chapters that streamline the
on everything from SA & AV nodal conduction
content on Day 6, and help ensure a more
abnormalities, to mechanisms of arrhythmias and efficient, manageable review of the material In 10 Days
electronic pacemakers. Also included is an answer
sheet similar to the one encountered on board
exams.
• Learn how to interpret ECGs in the shortest possible time
SECOND
EDITION • 120+ full-sized ECGs with interpretations
• Based on the author’s popular ECG review course
• Logically organized outline format facilitates retention
ISBN-13: 978-0-07-146562-5 • Now includes ACC guides
ISBN-10: 0-07-146562-6
David R. Ferry
27/32 8.5
Softcover trim: 8-1/2 x 10-7/8 Color: 4 color process
final bulk: .842 (27/32 spine)
Lam: GBC Layflat glossy
Ferry_FM.qxd 10/10/06 12:31 PM Page i
ECG
in 10 Days
David R. Ferry, MD, FACC
Chief, Cardiology Section
Loma Linda VA Healthcare System
Associate Professor of Medicine
Loma Linda University School of Medicine
Loma Linda, California
NEW YORK CHICAGO SAN FRANCISCO
LISBON LONDON MADRID MEXICO CITY
MILAN NEW DELHI SAN JUAN
SEOUL SINGAPORE SYDNEY TORONTO
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ISBN: 978-0-07-181198-9
MHID: 0-07-181198-2
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This book is dedicated to my good friend, mentor,
and role model, Dr. Glenn L. Foster, cardiologist
and former Chief of Medicine at the
Loma Linda VA Healthcare System.
He taught me that patience, humanity, dignity,
precision, integrity, and spirituality were essential
to the practice of medicine and the living of life.
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Table of Contents
Preface vii
Acknowledgments ix
Suggestions for Using This Book xi
Day 1 The Basics 1
Day 2 Chamber Abnormalities and Intraventricular Conduction Defects 37
Day 3 SA and AV Nodal Conduction Abnormalities 94
Day 4 Ischemia and Infarction 151
Day 5 Reentrant Arrhythmias 194
Day 6 Ectopic Arrhythmias and Triggered Activity 246
Day 7 Extrasystoles and Preexcitation Syndromes 287
Day 8 The Differential Diagnosis of Wide-QRS Tachycardias 333
Day 9 Medication and Electrolyte Effects; Miscellaneous Conditions 379
Day 10 Electronic Pacemakers 444
v
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Preface
This book originally arose from our commitment to teach senior medical
students how to interpret electrocardiograms in two weeks, or ten work-
ing days. The School of Medicine, in its wisdom, had chosen that interval
for us, and we were forced to adapt to its mandate. We had 10 to 15 stu-
dents in our class every four weeks for the entire academic year. We
quickly realized that we needed to establish specific topics for each day
so that, regardless of which faculty members were available, there was a
consistent method used. We also decided on a set of sample ECGs to use
each day.
I found myself repeatedly drawing the same illustrations, charts, and dia-
grams, so I eventually put together the rudiments of this text into a handout.
This effort was well received by medical students, residents from Internal
Medicine, Family Practice, and Preventive Medicine, and nurses and techni-
cians. I was subsequently encouraged to publish this material, and the editors
at McGraw-Hill were gracious enough to accommodate me.
Since publication of the first edition, several things have become obvi-
ous, particularly that I needed to provide many more sample ECGs for prac-
tice, both at the end of the chapters and a random sample at the end of the
text. Therefore, there are now 20 ECGs at the ends of Chapters 2–9 and 100
at the end, bringing the total practice tracings to 280, far more than any other
book. I needed to update several figures and add many more to accommo-
date advances in electrocardiography and make some concepts easier to
understand. It was obvious that I needed to divide the contents of Day 5 into
two chapters, therefore necessitating compression of Days 2 and 3 into one
chapter. I also decided to use full 12 lead ECGs instead of rhythm strips to
illustrate the majority of concepts, since it would be in this format that prac-
titioners would encounter these tracings. Finally, I decided to use a system I
call “call-outs” on the sample ECGs, in which key portions of the tracing are
identified by circles and are then enlarged and commented on in the top
margin.
There have also been major advances in computer imaging, processing,
and storage since the first text. In this edition, all of the illustrations were
drawn on an Apple Macintosh G5 computer using Adobe PhotoShop CS2
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viii Preface
and a Wacom graphics tablet. The ECGs were scanned at 600 dpi for clarity
even when magnified in the call-outs.
It is my hope that my readers will enjoy this text as much as I did in
preparing it and in teaching the concepts.
David R. Ferry, MD
Ferry_FM.qxd 10/10/06 12:31 PM Page ix
Acknowledgments
I would like to thank my colleagues at the Loma Linda VA Healthcare
Center, Drs. Geir P. Frivold, Gary P. Foster, Alan K. Jacobson, Helme
Silvet, Patricia M. Applegate, and Paul A. Levine, for their constant
encouragement, suggestions, and corrections. Many of the features of
this text are the result of quiet, continuous gentle pressure applied by my
friend Geir Frivold. The medical students made countless suggestions
about ways to improve the first edition and told me what worked and
what did not. My wife, Dr. Linda H. Ferry, was her usual source of wis-
dom and inspiration. My editor at McGraw-Hill, Quincy McDonald and
project manager at ITC, Gita Raman, patiently worked with me to keep
the book on schedule and the quality high. Finally, I will never forget my
teachers and mentors from my fellowship days, Drs. Michael H. Crawford
and Robert A. O’Rourke.
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