Download e-book for kindle: ABC of Clinical Electrocardiography by Francis Morris, William J. Brady, Visit Amazon's A. John

By Francis Morris, William J. Brady, Visit Amazon's A. John Camm Page, search results, Learn about Author Central, A. John Camm,

ISBN-10: 0727915363

ISBN-13: 9780727915368

(BMJ Books) Quick-reference textual content permits readers to get to grips with the wide variety of electrocardiogram styles noticeable in scientific perform. For these more often than not perform or in hospitals coping with sufferers with middle problems. Softcover.

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Sample text

Myocardial ischaemia causes changes in the ST-T wave, but unlike a full thickness myocardial infarction it has no direct effects on the QRS complex (although ischaemia may give rise to bundle branch blocks, which prolongs the QRS complex). When electrocardiographic abnormalities occur in association with chest pain but in the absence of frank infarction, they confer prognostic significance. About 20% of patients with ST segment depression and 15% with T wave inversion will experience severe angina, myocardial infarction, or death within 12 months of their initial presentation, compared with 10% of patients with a normal trace.

The presence of pathological Q waves, however, does not necessarily indicate a completed infarct. If ST segment elevation and Q waves are evident on the electrocardiogram and the chest pain is of recent onset, the patient may still benefit from thrombolysis or direct intervention. When there is extensive myocardial infarction, Q waves act as a permanent marker of necrosis. With more localised infarction the scar tissue may contract during the healing process, reducing the size of the electrically inert area and causing the disappearance of the Q waves.

Ischaemia of the anterior wall of the left ventricle also produces ST segment depression in leads V1 to V3, and this must be differentiated from posterior myocardial infarction. The use of posterior leads V7 to V9 will show ST segment elevation in patients with posterior infarction. These additional leads therefore provide valuable information, and they help in identfying the patients who may benefit from urgent reperfusion therapy. Scapula V7 V8 V9 Position of V7, V8, and V9 on posterior chest wall I aVR V1 V4 II aVL V2 V5 III aVF V3 V6 V8 V9 ST segment elevation in posterior chest leads V8 and V9 32 Isolated posterior infarction with no associated inferior changes (note ST segment depression in leads V1 to V3) 9 Acute myocardial infarction—Part II June Edhouse, William J Brady, Francis Morris This article describes the association of bundle branch block with acute myocardial infarction and the differential diagnosis of ST segment elevation.

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ABC of Clinical Electrocardiography by Francis Morris, William J. Brady, Visit Amazon's A. John Camm Page, search results, Learn about Author Central, A. John Camm,


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