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Appendix B

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Commonly used abbreviations

ACO acute coronary occlusion AIVR accelerated idioventricular rhythm AMI acute myocardial infarction BBB bundle branch block ER early repolarization HCM hypertrophic cardiomyopathy HLVV high left ventricular voltage LAD left anterior descending artery LAE left atrial enlargement LAFB left anterior fascicular block LBBB left bundle branch block LPFB left posterior fascicular block LVA left ventricular aneurysm LVH left ventricular hypertrophy MAT multifocal atrial tachycardia MI myocardial infarction PAC premature atrial contraction PAT paroxysmal atrial tachycardia PMI posterior myocardial infarction PRWP poor R- wave progression PVC premature ventricular contraction RBBB right bundle branch block RVH right ventricular hypertrophy SB sinus bradycardia SR sinus rhythm ST sinus tachycardia STE ST- segment elevation STEMI ST- segment elevation myocardial infarction SVT supraventricular tachycardia VT ventricular tachycardia WPW Wolff–Parkinson–White syndrome

ECGs for Acute, Critical and Emergency Care, Second Edition. Amal Mattu and William J. Brady.

161

Index

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Page numbers in bold type refer to electrocardiographs

accelerated atrioventricular (AV) junctional rhythm 5, 54, 75

hypothermia 14, 58–9 v first degree AV block 24, 66

accelerated idioventricular (or ventricular) rhythm (AIVR) 5, 54,

101, 117, 144–5, 152

acute coronary occlusion (ACO) 5, 50, 54, 55, 78

ST‐segment abnormality 130, 157

acute myocardial infarction (AMI) 6, 54

sinus arrhythmia 37, 72

sinus tachycardia 38, 72 anterior and high lateral 8, 56 anterolateral

left anterior fascicular block 46, 74

prolonged QT 51, 79 anterolateral, with sinus tachycardia 41, 74 anteroseptal, with sinus tachycardia 105, 146 inferior

AV junctional rhythm 101, 144

probable posterior extension 69

second degree AV block 126, 155

sinus bradycardia and first degree AV block 45, 76

T‐wave abnormality in aVL 119, 153 ischemia v underlying coronary artery disease 19, 63 lateral 27, 66, 110, 148 left bundle branch block 50, 78 with ongoing ischemia 65 posterior 22, 23, 61, 63, 65

left and right atrial enlargement 45, 76

probable 31, 69 prominent T‐waves 73 right bundle branch block 54 right ventricular 60, 61

with acute inferior and lateral STEMI 50, 78

with inferior AMI 118, 153

with inferolateral AMI 50, 138

possible, with inferior/inferolateral STEMI 17, 62, 120, 153 streptokinase, intravenous 101 ST‐segment elevation 56 thrombolytic therapy 117, 152

see also myocardial infarction (MI); previous myocardial infarction

(MI); ST‐segment elevation myocardial infarction (STEMI) alcoholic cardiomyopathy 102 AMI see acute myocardial infarction (AMI) aneurysm, ventricular see left ventricular aneurysm angioplasty 48, 63, 77 anterior wall myocardial infarction 56 antidepressant overdose see tricyclic antidepressant (TCA) overdose antidysrhythmic agents 5, 54 antihypertensive therapy 5, 54 antipsychotic drug overdose 106, 146 appropriate discordance, rule of 54, 55, 58 atrial bigeminy 132, 158 atrial fibrillation

with aberrant conduction 64, 69 with AV dissociation and third degree AV block 151 hyperkalemia 118, 152–3 possible, with hyperkalemia 123, 154 with rapid ventricular response 12, 21, 57, 64

left anterior fascicular block 26, 66 and occasional PVCs 30, 69

with slow ventricular response 118, 152

atrial flutter

with 2:1 AV conduction 11, 29, 36, 41, 57, 68, 71, 74–5

alcoholic cardiomyopathy 102 and apparent ST‐segment elevations 119, 153 left bundle branch block 108, 147

left ventricular hypertrophy 112, 149 sawtooth pattern 11, 29, 57, 68, 119, 153 with variable block 20, 63

bifascicular block 103, 145

lateral ischemia 27, 34, 66, 70

and occasional PVCs 44, 76

reversed V1 and V2 electrodes 131, 158

atrial tachycardia (paroxysmal atrial tachycardia, PAT) 127, 156 atrial trigeminy see under premature atrial contractions (PACs) atrioventricular (AV) block

acute inferior, lateral and right ventricular MI 50, 78 AV dissociation and third degree AV block 125, 155 first degree

acute inferolateral MI 17, 62

hyperkalemia 28, 36, 68, 72

ECGs for Acute, Critical and Emergency Care, Second Edition. Amal Mattu and William J. Brady.

162

INDEX

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lateral and right ventricular STEMI 50, 78 left bundle branch block 6, 54–5 previous inferior MI 24, 66 sinus bradycardia 45, 76 sinus rhythm 4, 44, 54 sinus tachycardia 43, 75

second degree

with 2:1 AV conduction 38, 72 acute inferior STEMI 126, 155–6 type 2 (Mobitz II) (Wenckebach) AV block 23, 38, 65, 72

variable, atrial tachycardia with 127, 156

atrioventricular (AV) dissociation 54, 56

and AV junctional rhythm 107, 111, 112, 147–9 with third degree AV block 102, 107, 108, 112, 145–7, 149

atrial fibrillation with 115, 151

without third degree AV block 117, 125, 152, 155 atrioventricular (AV) junctional escape rhythm 115, 151 atrioventricular (AV) junctional rhythm 5, 54, 118, 152–3

acute inferior and anterolateral ischemia 20, 63

acute inferior STEMI 101, 144

antipsychotic drug overdose 106, 146

and atrioventricular (AV) dissociation 107, 111, 112, 146–7,

148, 149 AV dissociation and third degree AV block 117, 152 non‐specific T‐wave flattening 131, 157–8 with premature junctional complexes 129, 157 third degree AV block 102, 145

atrioventricular (AV) junctional tachycardia 54

with right bundle branch block 13, 58

AV see atrioventricular

beta‐blockers 6, 55

atrial flutter 131, 158 sinus bradycardia 29, 69 toxicity 20, 63

biatrial enlargement 102, 145 bifascicular block 7, 55–6, 72

atrial flutter 103, 145 AV dissociation without third degree AV block 125, 155

breast cancer, metastatic 116, 152 Brugada syndrome 123, 154–5

calcium channel blockers (CCB) 5, 29, 54, 69, 131, 158 “camel‐hump” appearance 31, 69

buried P‐waves 103, 145

capture beats 111, 117, 125, 148, 152, 155 cardiac auscultation, acute pericarditis 54 cardiac ischemia see myocardial ischemia cardiomyopathy

alcoholic 102 atrioventricular (AV) junctional rhythm 111, 148

carpopedal spasm 24, 66

chest pain

acute pericarditis 3, 54 acute septal STEMI 89, 137 cocaine use 17 inferior and anteroseptal ischemia 39, 73

chronic obstructive pulmonary disease (COPD) 13, 39, 57, 58, 72,

94, 140

see also emphysema clonidine overdose 29, 69 cocaine 17, 136 complete heart block see atrioventricular (AV) block, third degree coronary angiography 19, 63 cyclic antidepressant overdose see tricyclic antidepressant (TCA)

overdose

deep vein thrombosis (DVT) 73 digoxin effect 15, 29, 59, 115, 151, 151 digoxin toxicity 15, 29, 59

atrial tachycardia with variable AV block 127, 156

probable 115, 151, 151 dysrhythmia 5, 54

early inferior myocardial injury 119, 153 early repolarization (ER) 17, 53

ectopic atrial rhythm 52, 79

left ventricular hypertrophy 17, 61

prominent T‐waves 59

sinus arrhythmia 3, 17, 53–4, 61

v acute pericarditis 3, 54 echocardiography 76 ectopic atrial bradycardia 8, 56 ectopic atrial rhythm 4, 54

early repolarization 52, 79 ectopic pregnancy, ruptured 109, 148 electrical alternans (EA)

atrial flutter with variable block 20, 63

pericardial effusion/tamponade 116, 152

supraventricular tachycardia 47, 77 emphysema 57, 74, 94, 140, 146

left atrial enlargement (LAE) 39, 72

low voltage 39, 72

multifocal atrial tachycardia 107, 147

rightward axis 7, 56 ethanol 29, 69

grouped beating 116, 122, 152, 154

heroin overdose 35, 70 high left ventricular voltage (HLVV)

hypertrophic cardiomyopathy 111, 125, 148–9, 155

hypokalemia 115, 150 “hockey‐stick” appearance 15, 59, 92, 139

163

INDEX

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hyperkalemia 115, 150

atrial fibrillation v AV junctional bradycardia 118, 152–3 AV junctional rhythm with PJCs 129, 157 poor R‐wave progression 52, 79 possible atrial fibrillation 123, 154 sinus rhythm with first degree AV block 28, 36, 68, 72 ventricular escape rhythm 109, 147

ventricular tachycardia 42, 75 hypertension 54 hyperthyroidism 49, 78 hypertrophic cardiomyopathy (HCM) 111, 125, 139, 148–9, 155 hypocalcemia 24, 66 hypokalemia 31, 66, 69 hypomagnesemia 66, 69, 116, 152 hypotension 62 hypothermia 14, 58–9, 124, 155

idiopathic hypertrophic subaortic stenosis (IHSS) 139 idioventricular rhythm see ventricular escape rhythm

(idioventricular rhythm) intracranial hemorrhage 104, 132, 145, 158 intraventricular conduction delay

digoxin toxicity 127, 156 hyperkalemia 28, 36, 68, 72, 123, 154

ischemia see myocardial ischemia

junctional tachycardia 42, 75 junctional trigeminy pattern 116, 122, 129, 152, 154, 157 juvenile T‐wave pattern, persistent 16, 49, 60, 78 J‐waves (Osborne waves) 14, 58, 59, 124, 155

LAD see left anterior descending artery (LAD) obstruction LAFB see left anterior fascicular block (LAFB) LAE see left atrial enlargement (LAE) LBBB see left bundle branch block (LBBB) left anterior descending artery (LAD) obstruction 19, 48, 63, 77,

128, 156 left anterior fascicular block (LAFB) 7, 55

acute anterolateral STEMI 46, 76 atrial fibrillation 26, 66 right bundle branch block 103, 145

left atrial enlargement (LAE) 72

acute anterolateral STEMI 41, 51, 74, 79 acute inferior STEMI and posterior MI 45, 76 acute pericarditis 34, 70 emphysema 39, 72 hyperkalemia 36, 72 hypokalemia 31, 69

left bundle branch block (LBBB)

acute myocardial infarction 78 atrial flutter with 2:1 AV conduction 108, 147 AV dissociation and third degree AV block 107, 147

first degree AV block 6, 54–5 Mobitz II AV block 23, 65 probable sinus tachycardia (ST) 113, 149 with repolarization abnormality 50, 78 ST‐segment abnormality 130, 157 ventricular tachycardia simulating 64

left posterior fascicular block (LPFB)

acute anterolateral STEMI 105, 146 plus right bundle branch block 7, 55–6

left ventricular hypertrophy (LVH) 56

acute pericarditis 10, 57 atrial flutter with 2:1 AV conduction 112, 149 AV junctional rhythm 131, 157–8 beta‐blocker toxicity 20, 63 digoxin effect 15, 59 early repolarization 17 hyperthyroidism 49, 78 hypothermia 124, 155 intermittent Wolff‐Parkinson‐White syndrome 134 left anterior fascicular block 55 multifocal atrial tachycardia 107, 147 with repolarization abnormality 34, 70 second degree AV block 38, 72 sinus bradycardia 35, 70 sinus rhythm with Mobitz I block 8, 56 sinus tachycardia and acute MI 38, 72

supraventricular tachycardia with 37, 72 leftward axis 54, 55, 75 low voltage

emphysema 39, 72

obesity 46, 77, 113, 149

pericardial effusion/tamponade 110, 116, 130, 148, 152, 157

right ventricular MI 83, 133

sinus tachycardia 126, 130, 156, 157

v ventricular aneurysm 129, 157 LPFB see left posterior fascicular block (LPFB) LVH see left ventricular hypertrophy (LVH)

MAT see multifocal atrial tachycardia (MAT) MI see myocardial infarction (MI) Mobitz I (Wenckebach) AV block 8, 56, 72, 126, 155–6

slowly progressing 104, 146 Mobitz II AV block

atrioventricular (AV) block, second degree 23, 38, 65, 72

premature atrial contractions 126, 155–6 multifocal atrial tachycardia (MAT) 57, 66

with left ventricular hypertrophy 107, 147

with right bundle branch block 122, 154 myocardial infarction (MI)

acute interior v ventricular aneurysm, low voltage 129, 157

anterior wall 56

high lateral 56

164

INDEX

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inferior 55

and anterior 150

of uncertain age 126, 156 lateral 56 recent, with persistent ischemia 32, 69 right ventricular 133

low voltage 83, 133 see also acute myocardial infarction (AMI); previous myocardial

infarction (MI); ST‐segment elevation myocardial infarction (STEMI)

myocardial ischemia

acute, T‐wave abnormalities with 128, 157 anterior, AV dissociation and third degree AV block

112, 149

anterior and inferior 11, 57, 124, 155 anterior T‐wave abnormality 19, 63 anterior wall T‐wave inversions 67 anterolateral

heroin overdose 35, 70

nausea and vomiting with 25, 66

sinus tachycardia with 25, 66

supraventricular tachycardia with 66 anteroseptal 28, 32, 67, 69, 127, 156 inferior

and anterior 11, 57, 124, 155

T‐wave abnormality in aVL 119, 153

uncertain age 114 inferior and anterolateral

hypocalcemia 24, 66

hypokalemia 66

prolonged QT 25, 66

pulmonary embolism 48, 77

Wellens’ T‐wave inversions 48, 77 lateral

atrial flutter with 27, 34, 66, 70

AV dissociation without third degree AV block 125, 155

emphysema 39, 72 left bundle branch block 50, 78 persisting after recent inferior MI 32, 69 sinus arrhythmia

acute 17, 61

persistent juvenile T‐wave pattern 16, 60 T‐wave abnormality with 25, 66 vs. underlying coronary artery disease 19, 63 v intracranial hemorrhage 132, 145, 158

narrow‐complex tachycardias 16, 59

irregular 63, 66 regular 59, 75

normal ECG 3, 53, 54

obesity 46, 77, 113, 149

pacemaker

AV sequential 12, 57, 58 dual chamber 26, 66 electronic ventricular 15, 59

“spike” (PS) 57, 58 PACs see premature atrial contractions (PACs) pericardial effusion/tamponade

acute coronary occlusion 130, 157

with acute pericarditis 120, 153

low voltage 110, 116, 148, 152

sinus tachycardia (ST) 116, 152 pericarditis, acute

left atrial enlargement 70

left ventricular hypertrophy 10, 57

pericardial effusion/tamponade 120, 153

sinus bradycardia 10, 57

sinus rhythm 34, 70

sinus tachycardia 40, 74, 120, 153

v early polarization 3, 54 persistent juvenile T‐wave pattern 16, 49, 60, 78 PJCs see premature junctional complexes (PJCs) polymorphic ventricular tachycardia (PVT) 64

antipsychotic drug overdose 106, 146

PVCs leading to 47, 77 poor R‐wave progression (PRWP)

emphysema 39, 72

hyperkalemia 52, 79 posterior leads 60, 64 premature atrial contractions (PACs) 15, 59

acute inferior MI with posterior extension 22, 63

atrial bigeminy pattern 132, 158

atrial fibrillation with 30

atrial trigeminy pattern 19, 63

right bundle branch block 105, 146 blocked 126, 156 with low voltage 113, 149 non‐conducted 126, 156

premature junctional complexes (PJCs) 116, 122, 129, 152, 154, 157 premature ventricular contractions (PVCs)

atrial fibrillation with 69 atrial flutter with 44, 76 leading to polymorphic ventricular tachycardia 47, 77 premature atrial contractions (PACs) with 132, 158 ventricular bigeminy pattern

sinus bradycardia 121, 124, 154, 155

sinus rhythm 62

previous myocardial infarction (MI)

anteroseptal 13, 58 high‐lateral 15, 59 inferior

atrial flutter with variable block 44, 76

first degree AV block 24, 44, 66, 76

165

INDEX

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previous myocardial infarction (MI) (Cont’d)

ventricular aneurysm 129, 157 inferior and anterolateral 30, 69, 103, 145 inferior and lateral, acute anterior MI 37, 72 Q‐waves 63 septal

atrial flutter 27, 34, 66, 70

AV junctional rhythm 20, 63

hypocalcemia 24, 66

PR‐interval

changing 57 normal 3, 54 prolonged 4, 56 short 53, 54, 56

PR‐segment elevation/depression, acute pericarditis 54, 74 PRWP see poor R‐wave progression (PRWP) pulmonary disease see chronic obstructive pulmonary disease;

emphysema

pulmonary embolism 11, 39, 48, 73, 75, 77

acute right heart “strain” from 75 first degree block 43, 75 rightward axis 57 v ischemia 67, 114, 150

PVCs see premature ventricular contractions (PVCs) PVT see polymorphic ventricular tachycardia (PVT) P‐waves

“buried” 24 66, 68, 103, 145 deformed/pointy 75 hidden 54 inverted 4, 53, 54 junctional 5, 54 retrograde

accelerated idioventricular (or ventricular) rhythm (AIVR) 117,

152 AV junctional rhythm 58 supraventricular tachycardia 16, 33, 47, 59, 70, 77 ventricular tachycardia 64

sinus 63 upright 53, 54

QRS complexes

narrow 54, 57, 63 negatively oriented 54–5 normal 56 positively oriented 54–5, 58 and P‐waves 56, 57 RBBB morphology 58

unusually wide 42, 75 QRS duration, prolonged 54 QRS‐interval, increased 70 QT‐interval

actual 31, 69

prolonged

acute anterolateral STEMI 51, 79 anteroseptal ischemia 32 antipsychotic drug overdose 106, 146 cyclic antidepressant overdose 114, 149 hypocalcemia 24, 66 hypokalemia 31, 69, 115, 150 hypomagnesemia 69, 116, 152 hypothermia 14, 58–9 inferior and anterolateral ischemia 24, 25, 66 intracranial hemorrhage 132, 145, 158

Q‐waves

abnormal, hypertrophic cardiomyopathy 111, 125, 148–9, 155 in acute lateral MI 27, 66 AV junctional rhythm with PJCs 129, 157 isolated 25, 66, 67 previous myocardial infarction (MI) 63 sinus tachycardia 73 WPW syndrome 75

reperfusion

incomplete 54 reperfusion dysrhythmia 102, 144

right atrial enlargement (RAE)

acute inferior STEMI and posterior MI 45, 76 T‐wave abnormalities with 128, 156

right bundle branch block (RBBB) 6

acute inferior STEMI 101, 144 atrial fibrillation 30, 69 atrial fibrillation with rapid ventricular response 21, 64 AV dissociation and junctional rhythm 125, 155 AV junctional tachycardia 13, 58 incomplete

AV dissociation and third degree AV block 112, 149 Brugada syndrome 123, 154–5 sinus tachycardia 39, 43, 48, 73, 75, 77 Wellens’ T‐wave inversions 48, 77

WPW syndrome 75 left anterior fascicular block 103, 145 Mobitz I (Wenckebach) AV block 8, 56 multifocal atrial tachycardia 122, 154 normal QRS complex axis 56 plus left posterior fascicular block 7, 55 premature atrial contractions 105, 146 right ventricular hypertrophy 13, 58 sinus rhythm 54 supraventricular tachycardia 14 with SVT 64 ventricular tachycardia simulating 64 VT simulating 22, 64

right‐sided precordial leads 51, 62, 79 right ventricular hypertrophy (RVH) 13, 58

166

INDEX

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rightward axis 55

acute anterolateral STEMI 74 cyclic antidepressant overdose 114, 149 emphysema 7, 56 left posterior fascicular block 105, 146 pulmonary embolism 11, 57, 73

T‐wave abnormality with anterior and inferior ischemia 11, 57 R‐on‐T phenomenon 47, 77 rule of appropriate discordance 54, 55, 58 R‐waves

broad 54

prominent, in V1 70, 73

“Salvador Dali moustache” appearance 59, 139

see also “hockey‐stick” appearance Salvadore Dali appearance 15 sawtooth pattern, atrial flutter 11, 29, 57, 68 sino‐ventricular conduction 109, 147 sinus arrhythmia

acute MI 37, 72

antipsychotic drug overdose 106, 146

early repolarization 3, 17, 53–4, 61

persistent juvenile T‐wave pattern 16, 60

prominent T‐waves 61 sinus bradycardia (SB)

acute pericarditis 10, 57

drug‐induced 29, 69

with first degree AV block 45, 46, 77

hypothermia 124, 155

Mobitz II AV block 23, 65

with non‐conducted PACs 126, 156

with premature ventricular contractions 121, 124, 154, 155 sinus rhythm (SR) 3, 53 sinus tachycardia (ST) 10, 56

acute anterior STEMI 38, 72

acute anterolateral STEMI 41, 74, 105, 146

acute inferior and right ventricular STEMI 118, 153

acute inferior STEMI with possible RV extension 120, 153

acute pericarditis 40, 57, 74, 120, 153

acute pulmonary embolism 39, 48, 73, 77

anterolateral ischemia 25, 66

atrioventricular (AV) block, first degree 75

with AV dissociation and third degree AV block 107, 112,

146–7, 149 cyclic antidepressant overdose 114, 149, 150 drug‐induced 70 with first degree AV block 43, 75 high fever and dehydration 103, 145 hyperthyroidism 49, 78 inferior and anterior ischemia 114, 150 intracranial hemorrhage 132, 158 low voltage 126, 130, 156, 157

pericardial effusion/tamponade 116, 152 premature junctional complexes 122, 154 probable 113, 149 Q‐waves 73 right ventricular hypertrophy 13, 58 Wolff‐Parkinson‐White (WPW) syndrome 70–1

v supraventricular tachycardia 109, 148 STEMI see ST‐segment elevation myocardial infarction (STEMI) streptokinase, intravenous 101 stroke 18, 62, 121, 154 ST‐segment depression

acute anterior and high lateral MI 8, 56

acute coronary occlusion 130, 157

acute inferolateral MI 21, 63

acute lateral STEMI 27, 66

v ventricular aneurysm 110, 148 acute pericarditis 74 atrial flutter 20, 63 with AV dissociation and third degree AV block 112, 149 ectopic atrial bradycardia 56 left bundle branch block 50, 54, 78 non‐specific 57 supraventricular tachycardia 33, 40, 70, 74

ST‐segment elevation (STE)

acute anterior and high lateral MI 8, 56 acute myocardial infarction 54 acute pericarditis 74, 74 acute right ventricular MI 60, 61 anterior wall MI 56 Brugada syndrome 123, 154–5 early repolarization 3, 52, 53, 53–4, 79 left bundle branch block 50, 54–5, 78 sinus bradycardia 57 ventricular aneurysm 110, 148

ST‐segment elevation myocardial infarction (STEMI) 54, 57

acute anterior 38, 72 acute anterolateral 41, 46, 51, 74, 79 acute anteroseptal left posterior fascicular block 105, 146 acute anteroseptal MI 105, 146 acute inferior 18, 62, 64, 65, 69

atrioventricular (AV) block 126, 155–6

AV junctional rhythm 101, 144

lateral 50, 51, 78

with possible right ventricular extension 120, 153

posterior 22, 23, 45, 64, 76

probable posterior extension 31, 69

right bundle branch block 101, 144

right ventricular 83, 118, 133, 133, 153

second degree AV block 126, 155–6

sinus tachycardia (ST) 118, 153 acute inferolateral 21, 62, 63 acute lateral 27, 66

167

INDEX

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ST‐segment elevation myocardial infarction (STEMI) (Cont’d)

v ventricular aneurysm 110, 148

anteroseptal 58 inferior/inferolateral, right ventricular 17, 62, 120, 153 inferior wall 60 inferolateral 63 see also acute myocardial infarction (AMI)

supraventricular tachycardia (SVT) 16, 30, 59

with aberrant conduction 56 with left ventricular hypertrophy 37, 72 P‐waves 69 retrograde P‐waves 47, 77 with right bundle branch block 14, 58 with ST‐segment depression 33, 40, 70, 74 v sinus bradycardia 109, 148

thrombolytic therapy, accelerated idioventricular (or ventricular)

rhythm (AIVR) 117, 152 thyrotoxicosis 49, 78 torsade de pointes (TDP) 47, 77, 106, 146 tricyclic antidepressant (TCA) overdose 14, 56, 59, 114, 149, 150 T‐U fusion, bifascicular block 103, 145 T‐waves

abnormalities

acute ischemia 128, 157 anterior and inferior ischemia 11, 57 anterolateral ischemia 25, 66 anteroseptal ischemia 28, 32, 67, 127, 156 atrial flutter 27, 66 AV dissociation and third degree AV block 107, 147 AV dissociation without third degree AV block 117, 152 diffuse cardiac ischemia v intracranial hemorrhage 145 digoxin effect 15, 59 heroin overdose 70 hypokalemia 31, 69, 115, 150 hypomagnesemia 69 inferior and anterior ischemia 114, 124, 150, 155 inferior and anterolateral ischemia 25, 66 inferior and anteroseptal ischemia 75 inferior ischemia or early infarction 119, 153 intracranial hemorrhage 132, 158 ischemia vs. underlying coronary artery disease 19, 63 lateral ischemia 34, 72 pulmonary embolism 39, 48, 73, 77

sinus tachycardia (ST) 25, 66 abnormal precordial balance 128, 156 biphasic pattern 19, 63 “camel‐hump” 31 69

buried P‐waves 103, 145

hyperkalemia 115, 150 deformed/pointy 29, 68 “hockey‐stick” appearance 15, 59

hyperacute 37, 72, 83, 133 inverted

acute pulmonary embolism 11, 57 beta‐blocker toxicity 20, 63 intracranial hemorrhage 104, 145 normal ECG 3, 53 right bundle branch block 54

non‐specific flattening 31, 69, 72

alcoholic cardiomyopathy 102 atrioventricular (AV) junctional rhythm 111, 148 AV junctional rhythm with 131, 157–8 multifocal atrial tachycardia 107, 147 obstructing LAD lesion 128, 156

pleural effusion 110, 148 persistent juvenile pattern 16, 49, 60, 78 prominent/peaked 61, 72

acute MI 37, 72

early repolarization (ER) 59

first degree AV block 68

hyperkalemia 28, 36, 52, 68, 68, 72, 79, 109, 118, 147, 152–3

junctional rhythm with PJCs 129, 157

sinus arrhythmia 17, 61 simultaneous inversions 73

U‐waves 31, 44, 69, 76, 115, 150

ventricular aneurysm 110, 129, 148, 157 ventricular capture, AV sequential electronic pacemaker 57 ventricular ectopy 55 ventricular escape rhythm (idioventricular rhythm) 54

AV dissociation and third degree AV block 108, 146–7 hyperkalemia 109, 147

ventricular tachycardia (VT) 5, 9, 23, 54, 65, 70

and AV dissociation 56 electrophysiologic studies 33, 70 hyperkalemia 42, 75 intermittent, non‐sustained 121, 154 simulating RBBB or LBBB pattern 22, 64

Wellens’ syndrome

biphasic T‐wave pattern 62, 63, 77 deeply inverted T‐wave pattern 48, 77 Wellens’ sign 19, 63, 77, 128, 157

wide‐complex tachycardias

irregular 47, 77 regular 9, 56, 58, 70

Wolff‐Parkinson‐White (WPW) syndrome 8, 9, 43, 53, 55, 57,

70–71, 71 atrial fibrillation with 64, 77 intermittent 83, 134 Q‐waves 75 short PR‐interval 56

168

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