ECGs Made Easy 6th Edition Textbook

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1 ANATOMY AND PHYSIOLOGY, 1
Location. SJu, and Shape of the Heart. 2
Surfaca of the Heart. 2
Coverinp of the Heart, 2
Structure of the Heart, 5
Layers of the Heart WalL 5
Heart Chambers, 6
Heart Valves, 8
The Heart's Blood Supply, 11
The Heart's Nerve Supply, 16
The Heart aa a Pump, 19
Cardiac Cycle, 19
Blood PreS3Ul't, 20
R£ferenca, '1.7
2 BASIC ELECTROPHYSIOLOGY, 28
Cardiac Cella, 30
Types of Cardiac Cells, 30
Propertia of Cardiac Cells, 30
Cardiac Action Potmtial, 30
Polarization, 31
Depolarization, 31
Repolarization, 32
Phases of the Cardiac Action Potential, 32
Refractory Periods, 34
Conduction Syatem, 35
Sinoatrial Node, 35
Atrioventricular Node and Bundle, 37
Right and Left Bundle Branches, 38
Purkinje Fibers, 38
Cauaea of Dyarhythmiaa, 39
Disorders of Impulse Formation, 39
Disorders of Impulse Conduction, 39
3 SINUS MECHANISMS, 78
Introdudlon. 76
Sinua Rhythm, 77
How Do I Recognize It? 77
Sinua Bradycardia. 78
What Causes m 78
What Do I Do About It? 79
Sinua Tadlyardia, 80
What Causes It? 80
Sinua Arrbytbmia, 81
What Causes It! 81
Sinoatrial Block. 82
What Causes It? 82
Sinua Arrest, 83
What Causes It? 83
Referencea,IOI
4 ATRIAL RHYTHMS, 102
The Ela:trocardiogr, 41
Electrodes, 41
Leads, 42
Ambulatory Cardiac Monitoring, 46
Blectrocanliopaphy Paper, 47
Waveforms, 48
Segments, 53
Intervals, 55
Artifact. 56
Symmatic Rhythm J:nterpretation. 57
Asseas Regularity, 57
Asseas Rate, 58
Identify and Examine Waveforms, 60
Asseaslntervals and Examine Segments, 60
Interpret the Rhythm, 60
Re&renca, 74
Introduction, 103
Atrial Dyar.bythmiaa: Mech.aDi~ms, 103
Abnormal Automaticity, 103

Tnggered Activity, 103
Reentry, 104
Premature Atrial Compleea, 104
Noncompensatory versus Compensatory Pause, 105
Aberrantly Conducted Premature Atrial
Complexes, 106
Nonconducted Premature Atrial Complexes, 106
What Do I Do About Them? 107
Wuuleriq Atrial Pacemaker, 107
What Causes It? 107
Mal.tifoc:al Atrial Tachycanlia, 108
What Causes It? 108

Supraventricular 'Thchycardia, 108
Atrial Tachycardias, 109
Atrioventricular Nodal Reentrant Tachycardia, 113
Atrioventricular Reentrant Thchycardia, 114
Atrial Flutter, 117
What Causes It? 118
Atrial Fibrillation, 119
What Causes It? 121
References, 140
5 ~UNCTIONAL RHYTHMS, 141
Introduction, 141
Premature Juncticmal Compleus, 142
How Do I Recognize 1hem~ 142
What Causes 1hem? 143
Junctional Escape Beau or Rhythm, 144
What Causes It? 145
Accelerated Junctional Rhythm, 146
What Causes It? 146
Junctional Tachyardia. 146
What Causes It? 147

References, 164
6 VENTRICULAR RHYTHMS, 165
What Causes It? 177
~(CanUa~S~).177
What Causes It? 178
References, 193
7 ATRIOVENTRICULAR BLOCKS, 194
Introduction, 194
First-Degree Atrioventricalar Block, 195
What Causes It? 196
Second-Degree Atrioventricular Blocks, 197

Second-Degree Atrioventricular Block Type I, 197
What Causes It? 198
Second-Degree Atrioventricular Block Type ll, 199
What Causes It? 200
2:1 Atriovmtricalar moa, 200
Advanced Second-Degree Atriovent:rkular Block. 201
'Ihird-Degree Atrioventricu1ar Block, 202.
What Causes It? 203
Reference8, 221
B PACEMAKER RHYTHMS, 222
Introductlon,166
Premature Ventricular Complexes, 166
How Do I Recognize 1hem~ 166
What Causes 1hem? 170
Ventricular .Escape Beats or Rhythm,170
What Causes It? 172
Accelerated Idlovmtrl<:Ular :Rhythm. 172
What Causes It? 172
Ventricnlar Tachycardia, 173

Ventricular Fibrillation, 176
Pacemaker Systema. 223
Permanent Pacemakers and hnplantable Cardioverter
Defibrillators, 223
Temporary Pacemakers, 224
Pacing Lead Symms, 225
Padng Chamben and Modes, 226
Single-Chamber Pacemakers, 226
Dual-Chamber Pacemakers, 227
Biventricular Pacemakers, 227
Fixed-Rate Pacemakers, 227
Demand Pacemakers, 227
Pacemaker Codes, 228
Pacemaker Malfunction.l28
Failure to Pace, 228
Failure to Capture, 229

Failure to Sense, 230
Analyzing Pacemaker Fund:ion on the ECG, 230
Reference., 240
9 INTRODUCTION TO THE 12-LEAD
ECG, 241
Introduction, 141
Layout of the 12-Lead Electrocardiogram, 242
Vedors,242
Axis,243
.Acute Coronary Syndromes, 244
Anatomic Location of a Myocardial Infarction, 246
Intraventricular Conduction Delays, 254
Structures of the Intraventricular Conduction
System,254
Bundle Branch Activation, 254

What Causes It? 257
Chamber Enlargement, 257
Atrial .Abnormalities, 258
Ventricular Abnormalities. 259
Electrolyte Disturbances, 260
Sodium, 261
Potassium, 261
Calcium, 262
Magnesium, 263
10 POSlTEST, 278
ADalyzing the 12-Lead EledJ:ocanUogram, 263
References, 277
INDEX, 321
Anatomy and Physiology
LEARNING OBJECTIVES After reading this chapter, you

should be able to: 1 . Describe the location of the
heart.
2. Identify the surfaces of the heart.
3. Describe the structure and function of the coverings

of the heart.
4. Identify the three cardiac muscle layers.
5. Identify and describe the chambers of the heart and

the vessels that enter or leave each.
6. Identify and describe the location of the

atrioventricular and semilunar valves.
7. Explain atrial kick.
8. Name the primary branches and areas of the heart

supplied by the right and left coronary arteries.
KEY TERMS 9. Define and explain acute coronary

syndromes.
10. Discuss myocardial ischemia, injury, and
infarction, indicating which conditions are reversible
and which are not.
11. Compare and contrast the effects of sympathetic

and parasympathetic stimulation of the heart.
12. Identify and discuss each phase of the cardiac

cycle.
13. Beginning with the right atrium, describe blood

flow through the normal heart and lungs to the
systemic circulation.
14. Identify and explain the components of blood

pressure and cardiac output.
acute coronary syndrome (ACS): A term used to refer

to distinct conditions caused by a similar sequence of
pathologic events a temporary or permanent blockage
of a coronary artery. These conditions are
characterized by an excessive demand or inadequate
supply of oxygen and nutrients to the heart muscle
associated with plaque disruption, thrombus
formation, and vasoconstriction.
ACSs consist of three major syndromes: unstable
angina, non ST-elevation myocardial infarction, and ST
elevation myocardial infarction.
afterload: The pressure or resistance against which

the ventricles must pump to eject blood.
angina pectoris: Chest discomfort or other related

symptoms of sudden onset that may occur because
the increased oxygen demand of the heart temporarily
exceeds the blood supply.
Apex of the heart: Lower portion of the heart that is

formed by the tip of the left ventricle.
atria: Two upper chambers of the heart (singular,

atrium).
atrial kick: Blood pushed into the ventricles because

of atrial contraction.
atrioventricular (AV) valve: The valve located between

each atrium and ventricle; The tricuspid separates the
right atrium from the right ventricle, and the mitral
(bicuspid) separates the left atrium from the left
ventricle.
atypical presentation: Uncharacteristic signs and
symptoms perceived by some patients experiencing a
medical condition, such as an ACS.
base of the heart: Posterior surface of the heart.
blood pressure: Force exerted by the blood against the

walls of the arteries as the ventricles of the heart
contract and relax.
cardiac output (CO): The amount of blood pumped

into the aorta each minute by the heart; defined as the
stroke volume multiplied by the heart rate.
chordae tendineae (tendinous cords): Thin strands of

fibrous connective tissue that extend from the AV
valves to the papillary muscles that prevent the AV
valves from bulging back into the atria during
ventricular systole (contraction).
chronotropy: A change in (heart) rate.
diastole: Phase of the cardiac cycle in which the atria

and ventricles relax between contractions and blood
enters these chambers. When the term is used
without reference to a specific chamber of the heart,
ventricular diastole is implied.
dromotropy: Refers to the speed of conduction

through the AV junction.
dysrhythmia: Any disturbance or abnormality in a

normal rhythmic pattern; any cardiac rhythm other
than a sinus rhythm.
ejection fraction: The percentage of blood pumped out

of a heart chamber with each contraction.
endocardium: Innermost layer of the heart that lines

the inside of the myocardium and covers the heart
valves.
epicardium: Also known as the visceral pericardium;

the external layer of the heart wall that covers the
heart muscle.
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Find the Full Original Textbook (PDF) in the link

1 ANATOMY AND PHYSIOLOGY, 1

Location. SJu, and Shape of the Heart. 2

Surfaca of the Heart. 2

Coverinp of the Heart, 2

Structure of the Heart, 5

Layers of the Heart WalL 5

The Heart's Blood Supply, 11

The Heart's Nerve Supply, 16

The Heart aa a Pump, 19

Types of Cardiac Cells, 30

Propertia of Cardiac Cells, 30

Cardiac Action Potmtial, 30

Phases of the Cardiac Action Potential, 32

Atrioventricular Node and Bundle, 37

Right and Left Bundle Branches, 38

Disorders of Impulse Formation, 39

Disorders of Impulse Conduction, 39

How Do I Recognize It? 77

How Do I Recognize It? 78

What Do I Do About It? 79

How Do I Recognize It? 80

What Causes It? 80

What Do I Do About It? 81

What Causes It! 81

What Do I Do About It? 82

How Do I Recognize It? 82

What Causes It? 82

What Do I Do About It? 83

How Do I Recognize It? 83

What Causes It? 83

What Do I Do About It? 84

4 ATRIAL RHYTHMS, 102

Symmatic Rhythm J:nterpretation. 57

Identify and Examine Waveforms, 60

Asseaslntervals and Examine Segments, 60

Interpret the Rhythm, 60

Atrial Dyar.bythmiaa: Mech.aDi~ms, 103

Abnormal Automaticity, 103

Premature Atrial Compleea, 104

How Do I Recognize It? 104

Noncompensatory versus Compensatory Pause, 105

Aberrantly Conducted Premature Atrial

Nonconducted Premature Atrial Complexes, 106

What Do I Do About Them? 107

Wuuleriq Atrial Pacemaker, 107

How Do I Recognize It? 107

What Causes It? 107

What Do I Do About It? 107

Mal.tifoc:al Atrial Tachycanlia, 108

How Do I Recognize It? 108

What Causes It? 108

Supraventricular 'Thchycardia, 108

Atrial Tachycardias, 109

Atrioventricular Nodal Reentrant Tachycardia, 113

Atrioventricular Reentrant Thchycardia, 114

Atrial Flutter, 117

How Do I Recognize It? 117

What Causes It? 118