Podrid's Real-World ECGs: A Master's Approach to the Art and Practice of Clinical ECG Interpretation. Volume 1: The Basics PDF
Preview Podrid's Real-World ECGs: A Master's Approach to the Art and Practice of Clinical ECG Interpretation. Volume 1: The Basics
Podrid, w w w.re alwo rldECGs .c o m Malhotra, et al. Podrid’s Real-World ECGs Volume 1 Philip Podrid, MD combine s outline s the bas ic approac he s traditional c as e -bas e d workbooks with and tools utilize d in the analys is of all ECGs , Bos ton Unive rs ity Sc hool of Me dic ine Podrid’s Rea l-World a ve rs atile We b-bas e d program to offe r inc luding the ide ntific ation of important Harvard Me dic al Sc hool s tude nts and phys ic ians an indis pe ns able wave forms and s ubtle abnormalitie s . This Bos ton, Mas s ac hus etts re s ourc e for deve loping the te c hnic al s kills introduc tory volume lays the foundation We s t Roxbury VA Hos pital and s ys te matic approac h ne e de d to for a true unde rs tanding of vital ECG We s t Roxbury, Mas s ac hus etts P inte rpre t ECGs with c onfide nc e . princ iple s , inc luding: Rajeev Malhotra, MD, MS o A Master’s Approach ECGs from real patient cases offer an • Normal ac tivation of the atria Rahul Kakkar, MD d in-depth learning experience by foc us ing and ve ntric le s Peter A. Noseworthy, MD r to the Art and Practice i on fundame ntal e le c trophys iologic prope rtie s • The s tandard le ad s ys te m Mas s ac hus etts Ge ne ral Hos pital d and c linic al c onc e pts as we ll as de taile d • Normal wave forms and inte rvals Harvard Me dic al Sc hool ’ of Clinical ECG Interpretation s dis c us s ion of important diagnos tic findings • Compone nts of a normal ECG re c ording Bos ton, Mas s ac hus e tts and re levant manage me nt de c is ions . R e Six volumes encompass more than 600 G a R individual cases—plus an online re pos itory Includes free 1-year acces s to additional V l of hundre ds more inte rac tive c as e s tudie s - - that inc lude fe e dbac k and dis c us s ion practice cases at www.realworldECGs .com W 9 ir . 9 s about the important wave forms and c linic al r & s i o h n de c is ion-making involve d. a a r t i s l r d e p . p E i Podrid’s Real-World ECGs: v Volume 1 C The Ba s ics A Master’s Approach to the Art and Practice of Clinical ECG Interpretation G s Volume 1 The Basics Dr. Philip Podrid is known worldwide as an expert in electrocardiography. Philip Podrid, Rajeev Malhotra, , md md ms Volume 2 Myocardial Abnormalities He is also a superb teacher. When you combine his input with beautiful ECGs, Volume Volume 3 Conduction Abnormalities not surprisingly, you will have a series of “Real(cid:0)World ECGs” that demonstrate 1 Volume 4 Arrhythmias the art and practice of clinical ECG interpretation as only a real master can. Rahul Kakkar, md Peter A. Noseworthy, md Volume 5 Narrow and Wide Complex Tachycardias —From the Foreword by Hein J. Wellens, MD Volume 6 Paced Rhythms, Congenital Abnormalities, Electrolyte Disturbances, and More The Basics ISBN: 978-1-935395-00-3 9 0 0 0 0 Forewords by: Hein J. Wellens , md Roman DeSanctis, md 3405 W. 44th Street Minneapolis, Minnesota 55410 9 7 8 1 9 3 5 3 9 5 0 0 3 www.cardiotextpublishing.com (888) 999-9174 tahir99-VRG & vip.persianss.ir Podrid’s Real-World ECGs A Master’s Approach to the Art and Practice of Clinical ECG Interpretation Volume 1 The Bas ics tahir99-VRG & vip.persianss.ir tahir99-VRG & vip.persianss.ir Podrid’s Real-World ECGs A Master’s Approach to the Art and Practice of Clinical ECG Interpretation Volume 1 The Bas ics Philip Podrid, MD Rahul Kakkar, MD Professor of Medicine Cardiology Fellow Professor of Pharmacology and Experimental Therapeutics Massachusetts General Hospital Boston University School of Medicine Harvard Medical School Boston, Massachusetts Lecturer in Medicine Harvard Medical School Peter A. Noseworthy, MD Boston, Massachusetts Attending Physician Cardiology Fellow West Roxbury VA Hospital Massachusetts General Hospital West Roxbury, Massachusetts Harvard Medical School Boston, Massachusetts Rajeev Malhotra, MD, MS Instructor in Medicine Cardiology Division Massachusetts General Hospital Harvard Medical School Boston, Massachusetts Minneapolis, Minnesota tahir99-VRG & vip.persianss.ir © 2013 Philip Podrid, Rajeev Malhotra, Rahul Kakkar, and Peter A. Noseworthy Due to ongoing research, discoveries, modifications to medicines, equipment and devices, and changes in government regulations, the information contained in this book Cardiotext Publishing, LLC may not reflect the latest standards, developments, guidelines, regulations, products or 3405 W. 44th Street devices in the field. Readers are responsible for keeping up to date with the latest Minneapolis, Minnesota, 55410 developments and are urged to review the latest instructions and warnings for any USA medicine, equipment or medical device. Readers should consult with a specialist or www.cardiotextpublishing.com contact the vendor of any medicine or medical device where appropriate. Any updates to this book may be found at: Except for the publisher’s website associated with this work, the publisher is not www.cardiotextpublishing.com/titles/detail/9781935395003 affiliated with and does not sponsor or endorse any websites, organizations or other Comments, inquiries, and requests for bulk sales can be directed to the publisher at: sources of information referred to herein. [email protected]. The publisher and the authors specifically disclaim any damage, liability, or loss All rights reserved. No part of this book may be reproduced in any form or by any incurred, directly or indirectly, from the use or application of any of the contents means without the prior permission of the publisher. of this book. All trademarks, service marks, and trade names used herein are the property of their Unless otherwise stated, all figures and tables in this book are used courtesy respective owners and are used only to identify the products or services of those owners. of the authors. This book is intended for educational purposes and to further general scientific and Cover design by Caitlin Crouchet and Elizabeth Edwards; medical knowledge, research, and understanding of the conditions and associated interior design by Elizabeth Edwards treatments discussed herein. This book is not intended to serve as and should not be relied upon as recommending or promoting any specific diagnosis or method of treatment Library of Congress Control Number: 2012947870 for a particular condition or a particular patient. It is the reader’s responsibility to ISBN: 978-1-935395-00-3 determine the proper steps for diagnosis and the proper course of treatment for any condition or patient, including suitable and appropriate tests, medications or medical Printed in the United States of America devices to be used for or in conjunction with any diagnosis or treatment. tahir99-VRG & vip.persianss.ir These workbooks are dedicated first to my wife Vivian and son Joshua, whose patience, tolerance, support, and love over the years have been limitless, exceptional, and inspirational. They are also dedicated to the many cardiology fellows, house staff, and medical students whom I have had the pleasure and honor of teaching over the past three decades and who have also taught me so very much. Philip Podrid To my wife Cindy and daughter Sapna, for all their love, support, and encouragement. Rajeev Malhotra To my darling daughters, Mia and Eila, whom I love to infinity. Rahul Kakkar For Katie and Jack Peter A. Noseworthy v tahir99-VRG & vip.persianss.ir tahir99-VRG & vip.persianss.ir Contents Foreword by Roman W. DeSanctis, M D ................................................. ix Foreword by Hein J. Wellens, M D ......................................................... xi Preface ................................................................................... xiii Introduction The Basics .............................................................................1 Core ECGs ................................................................................ 19 Index ..................................................................................... 395 vii tahir99-VRG & vip.persianss.ir tahir99-VRG & vip.persianss.ir Foreword The invention of the electrocardiogram (ECG) by Dr. Willem Einthoven, purposes, and it is a portion of his incredible collection that has been first reported in 1901, ranks as one of the all-time great discoveries in used to spawn these books. medicine. Einthoven’s landmark achievement was duly recognized in There are scores of textbooks on electrocardiography, but what 1924, when he was awarded the Nobel Prize in Medicine. sets these volumes apart is that every ECG is tied directly to an actual By the early 1940s, all of the components of the 12-lead ECG that clinical case. Each ECG is initially presented in a visually attrac- we use today were in place. When I finished my cardiology training tive and readable format accompanied by a clinical vignette. O n the 50 years ago, the ECG was one of very few cardiodiagnostic tools next page, the salient features of the ECGs are highlighted, dissected, available to us. As a result, we received an intensity of training in elec- and discussed in meticulous detail, followed by a summary of the trocardiography that is generally not encountered in many of today’s patient’s clinical problem and treatment, particularly as they relate to cardiology fellowship programs, where the emphasis has shifted toward the ECG findings. the newer high-tech diagnostic modalities. Yet the ECG remains a The first volume in this unique series covers electrocardiography major pillar in the evaluation of disorders of the heart. In a patient with basics. It is followed by five more volumes covering the entire spectrum a cardiac arrhythmia, what diagnostic information does the treating of electrocardiography: myocardial abnormalities, conduction abnor- physician want the most? Of course—the ECG. Although the medical malities, arrhythmias, narrow and wide complex tachycardias, and a world progresses rapidly and changes constantly, the body of knowl- sixth volume amalgamating a potpourri of paced rhythms, congenital edge surrounding the ECG is virtually timeless. What was true 50 years abnormalities, and electrolyte disturbances. As I perused one of the ago is largely true today, and will remain so 50 years from now. workbooks, I truly enjoyed the experience. It is fun to try to guess the This wonderful series of ECG workbooks, appropriately entitled clinical problem from the ECG. In fact, on my teaching rounds, that “ Real-World EC G s,” by Dr. Philip Podrid and three outstanding is often exactly what I do. I will ask the trainee to present first just young cardiologists from Massachusetts General Hospital—Dr. Rajeev the ECG and with other trainees try to deduce from it what might be M alhotra, Dr. Rahul Kakkar, and Dr. Peter N oseworthy—offers a going on clinically. For example, in an adult with marked left ventricu- splendid opportunity for self-education in electrocardiography (and lar hypertrophy and strain, one of three conditions is almost always a bit of fun at the same time). An esteemed academic cardiologist, present: severe aortic valve disease, hypertrophic cardiomyopathy, or Dr. Podrid has had a career-long interest in electrocardiography. Over hypertensive heart disease. many years he has collected and saved thousands of ECGs for teaching ix
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