By B. L. Chia
During this variation, the sections on posterior myocardial infraction, supraventricular tachycardia, ventricular tachycardia, and anti-arrhythmic drug remedy have all been up to date or revised. This booklet is the end result of approximately 30 years of expertise within the educating of electrocardiography to coronary-care-unit nurses, clinical undergraduates, interns, citizens and cardiology registrars. The method of the topic is solely from the perspective of a clinician, accordingly theoretical issues were saved to a minimal and clinical-electrocardiographic correlations were emphasised in the course of the textual content.
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Extra resources for Clinical Electrocardiography
Reddy GV, Schamroth L. The electrocardiology of right ventricular myocardial infarction. Chest 1986; 90: 756. 9. Phibb B. “Transmural” versus “subendocardial” myocardial infarction: an electrocardiographic myth. J A m Coll Cardiol 1983; 1: 561. 10. Faris J, McHenry P, Stephen N. Concepts and applications of treadmill exercise testing and exercise electrocardiogram. Am Heart J 1978; 95: 102. 11. Gerson MC, McHenry PL. Resting U wave inversion as a marker of stenosis of the left anterior descending coronary artery.
The important causes of right atrial hypertrophy or dilatation are chronic obstructive lung disease, pulmonary stenosis, tetralogy of Fallot, pulmonary hypertension, Ebstein’s anomaly and tricuspid atresia. In bi-atrial hypertrophy or dilation, the P waves are both wide and tall. vi v2 v3 v4 v5 V6 Fig. 11 ECG of a 34-year-old man with severe mitral stenosis and left atrial dilatation confirmed by two-dimensional echocardiography. 12 sec) and bifid P waves in 1,II, 111, V4 to V6 (arrowheads in 11, V4 and V,) indicating “P mitrale”, which is a reflection of left atrial enlargement 47 ACUTE PULMONARY EMBOLISM The ECG changes in acute massive pulmonary embolism are many and varied.
Fig. 37 Atrial infarction in a 70-year-old woman. Note: (1) Elevated PR segments in 11, I11 and aVF (arrowheads) reflecting atrial infarction. (2) Pathological Q waves, elevated ST segments and T wave inversion in 111 and aVF reflecting acute, transmural inferior infarction. REFERENCES 1. Deedwania PC, Carbajal EV. Silent myocardial ischaemia. Arch Intern Med 1991; 151: 2373. 2. Source: The Singapore Myocardial Infarction Registry, Ministry of Health, Singapore. 3. Schamroth L. The 12 Lead Electrocardiogram.