Preface 6
Acknowledgements 7
1 Introduction to the ECG 8
2 Strengths and weaknesses of the ECG 10
Part 1 The normal ECG
3 Basis of the ECG 12
4 The normal P wave 16
5 The normal QRS complex 18
6 The T and U waves 20
Part 2 ECG abnormalities
7 Abnormalities in the shape of the P wave - left and right atrial enlargement 22
8 Increased QRS amplitude 24
9 Q waves and loss of R wave height 26
10 QRS axis deviation 28
11 Long PR interval and QRS broadening 30
12 Delta waves 32
13 ST elevation 34
14 ST depression 36
15 Mild T wave flattening 38
16 Deep T wave inversion 40
17 QT interval and U wave abnormalities 42
Part 3 Clinical syndromes
18 Acute chest pain 44
19 Chronic chest pain 46
20 Acute breathlessness 48
21 Chronic breathlessness 51
22 Palpitations 54
23 Syncope 57
24 Hypertension 60
25 Shock 62
26 Stroke 64
27 Emotion and the ECG 66
28 Sudden cardiac death 68
Part 4 Diseases
29 Acute coronary syndromes 70
30 Non-ST segment elevation myocardial infarction 72
31 ST segment elevation myocardial infarction 74
32 Aortic valve disease and hypertrophic cardiomyopathy 76
33 Mitral valve disease 78
34 Cardiomyopathy and myocarditis 80
35 Pulmonary hypertension 82
36 Congenital heart disease 84
37 Endocrine disease and electrolyte disruption 86
38 Psychological disease and its treatment 88
39 Genetic pro-arrhythmic conditions 90
Part 5 Tachyarrhythmias
40 Distinguishing supraventricular from ventricular tachycardia 92
41 Narrow complex tachycardia 95
42 Atrial ectopic beats 98
43 Atrial fibrillation 100
44 Atrial flutter and atrial tachycardia 102
45 Atrioventricular nodal re-entrant tachycardia 104
46 Atrioventricular re-entrant tachycardia 106
47 Ventricular ectopics 108
48 Non-sustained ventricular tachycardia 110
49 Monomorphic ventricular tachycardia 112
50 Polymorphic ventricular tachycardia 114
51 Ventricular fibrillation 116
Part 6 Bradyarrhythmias and related diseases
52 Sinus node disease 118
53 Left bundle branch block 120
54 Right bundle branch block 122
55 First degree atrioventricular block - long PR interval 124
56 Second degree atrioventricular block 126
57 Atrioventricular block - third degree (complete) heart block 128
Part 7 Pacemakers
58 Pacemakers - basic principles 130
59 Anti-bradycardic pacemakers 132
60 Anti-tachycardic and heart failure devices 134
Part 8 ECG-based investigations
61 External and internal loop recorders 136
62 Tilt-table test and carotid sinus massage 138
63 Twenty-four hour ECGs 140
64 The exercise stress test 144
65 Invasive electrophysiological studies 148
Part 9 Self-assessment case studies
Case studies and answers 150
Appendix 162
Index 163

Highly Commended in the Cardiology category at the BritishMedical Association Book Awards 2009
This brand new title in the popular at a Glanceseriescombines the science behind ECGs with how to use them toguide diagnosis and treatment. These key skills are fundamental forexamination of the cardiovascular system and all medical studentsand specialist nurses are expected to be proficient at ECGinterpretation.
The at a Glance approach provides a large number of cleardiagrams and example ECGs alongside concise text, putting the ECGsinto a clinical context, all in easy-to-absorb double-pagesections.