By David Adlam, John R. Hampton DM MA DPhil FRCP FFPM FESC, Jo Hampton
Wow, do not move go eyed but when it's a development reputation ECG booklet you would like, this can be it, you could have to learn the significant other ECG made effortless first - or purchase them jointly.
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What to do Provided the patient is not in heart failure it is always a good idea to identify the cause of an arrhythmia before treating it. The combination of an atrial arrhythmia, jaundice and splenomegaly suggests alcoholism. The patient needs anticoagulants, but his international normalized ratio (INR) may already be high. Summary Atrial flutter with 2:1 conduction. See p. 68 Ij> [ See p. 160 ECG 28 This EGG was recorded from a 39-year-old woman who complained of a sudden onset of breathlessness.
The widespread ST/T changes are clearly very abnormal, but are not specific for any particular disease. However, the fact that leads Vj-Vs are affected suggests a right ventricular problem. oo Summary ** Sinus tachycardia with widespread ST/T changes suggesting pulmonary embolism. What to do This is a case where the ECG must be considered in the light of the patient's history and physical signs (if any). Clearly something has happened; 1 1 s See p. 92 See p. 289 |££££i This ECG was recorded from a 50-year-old man who was admitted to hospital as an emergency, having had chest pain characteristic of a myocardial infarction for 3 h.
On questioning she admits to breathless and 'dizzy turns' for several months. This is her preoperative ECG. What does it show and what would you do? ANSWER 12 The ECG shows: • Second degree (2:1) heart block • Prolonged PR interval (440 ms) in the conducted beats • Ventricular rate about 40/min • Normal QRS complexes and T waves Clinical interpretation Although the slow ventricular response raises the possibility of complete heart block, the fact that the PR interval is constant (albeit prolonged) shows that this is actually second degree block.