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Critical Decisions in Emergency and Acute Care Electrocardiography
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Table of Contents

Section Editors, vii Contributors, viii Preface, xi Forewords, xii Part 1 The ECG in Clinical Practice, 1 1 What are the clinical applications of the ECG in emergency and critical care? 3 2 What are the indications for the ECG in the pediatric emergency department? 12 3 What are the limitations of the ECG in clinical practice? 19 4 Is the ECG indicated in stable, non-cardiac patients admitted to the hospital? 24 5 What is the use of the ECG in preoperative assessment and cardiovascular risk stratification? 28 6 Which patients benefit from continuous electrocardiographic monitoring during hospitalization? 33 Part 2 The ECG in Cardinal Presentations, 39 7 How should the ECG be used in the syncope patient? 41 8 How should the ECG be used in the chest pain patient? 49 9 How should the ECG be used in the dyspneic patient? 58 10 How should the ECG be used in the patient with altered mentation? 64 11 How should the ECG be used in the patient during and following cardiac arrest? 69 12 What is the impact/proper role of the ECG in the undifferentiated cardiorespiratory failure patient? 75 Part 3 The ECG in ACS, 83 13 What is the role of the ECG in ACS? 85 14 What pseudoinfarction patterns mimic ST elevation myocardial infarction? 92 15 What ECG changes might myocardial ischemia cause other than ST segment elevation or Q waves and what are the differential diagnoses of these changes? 103 16 What is a hyperacute T Wave? 115 17 What is the significance of Q waves? 122 18 What are the ECG indications for additional electrocardiographic leads (including electrocardiographic body-surface mapping) in chest pain patients? 128 19 What further diagnostic adjuncts to the standard 12-lead ECG may help to diagnose ACS? 138 20 Is serial electrocardiography (serial ECGs and ST segment monitoring) of value in the ECG diagnosis of ACS? 148 21 What QRS complex abnormalities result in ST segment elevation that may mimic or obscure AMI? 155 22 What are the electrocardiographically silent areas of the heart? 167 23 What is the value of the prehospital acquired 12-lead ECG? 176 24 What are the electrocardiographic indications for reperfusion therapy? 182 25 What are the ECG manifestations of reperfusion and reocclusion? 195 26 Does localization of the anatomic segment/identification of the infarct-related artery affect early care? 204 27 Can the ECG be used to predict cardiovascular risk and acute complications in ACS? 216 Part 4 The Dysrhythmic ECG, 231 28 Can the electrocardiogram determine the rhythm diagnosis in narrow complex tachycardia? 233 29 Can the ECG guide treatment of narrow QRS tachycardia? 244 30 How can the ECG guide the diagnosis and management of wide complex tachycardias? 251 31 Can the ECG guide management in the patient with bradydysrhythmias? 267 32 What are the electrocardiographic indications for temporary cardiac pacing? 276 33 Can the ECG accurately diagnose pacemaker malfunction and/or complication? 284 34 How can the ECG guide acute therapy in the Wolff Parkinson White (WPW) patient? 295 35 What is the role of the ECG in PEA cardiac arrest scenarios? 303 Part 5 The ECG in Critical Care, 315 36 What is the role of the ECG in the critically ill, non-coronary patient? 317 37 Can the ECG distinguish between coronary and non-coronary etiologies in the critically ill patient? 326 38 What is the role of the ECG in therapeutic considerations/medical management decisions in the critically ill patient? 335 39 Can the ECG predict risk in the critically ill, noncoronary patient? 345 40 What is the proper role of the ECG in the evaluation of patients with suspected PE? 354 41 What is the role and impact of the ECG in the patient with hyperkalemia? 362 42 What is the role and impact of the ECG in the patient with electrolyte abnormalities other than hyperkalemia? 371 43 What is the role of the ECG in the hypothermic patient? 378 44 What are the non-ACS ?deadly? ECG presentations? 384 Part 6 The Toxicologic ECG, 395 45 How useful is the ECG in the evaluation of the poisoned patient? 397 46 Can the ECG guide management in the critically ill, poisoned patient? 402 47 Do characteristics of the QRS complex in the poisoned patient correlate with outcome? 407 48 What is the treatment for wide complex dysrhythmias in the poisoned patient? 412 Part 7 Electrocardiogaphic Differential Diagnosis, 417 49 What is the ECG differential diagnosis of ST segment elevation? 419 50 What is the ECG differential diagnosis of ST segment depression? 428 51 What is the ECG differential diagnosis of the abnormal T wave? 436 52 What is the ECG differential diagnosis of narrow complex tachycardia? 444 53 What is the ECG differential diagnosis of wide complex tachycardia? 452 54 What is the ECG differential diagnosis of bradycardia? 461 55 What is the ECG differential diagnosis of the abnormally wide or large QRS complex? 469 56 What is the ECG differential diagnosis of a prolonged QT interval? 479

About the Author

William Brady, Department of Emergency Medicine, University of Virginia School of Medicine Jonathon Truwit, Pulmonary and Critical Care Medicine, University of Virginia Health Systems

Reviews

"This book is written by the emergency physician for the emergency physician and it would appeal to any avid, competitive ECG collector who will find it value for money." (Cardiology News, 1 October 2011) "I loved this book and excitedly read bits aloud as I scanned the chapters. It was the combination of a scholarly approach combined with a down-to-earth discussion of patient management that was so appealing." ( British Journal of Cardiac Nursing, September 2009)

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