By David Kerr, Annie Young, Richard Hobbs
(BMJ Books) Univ. of Birmingham, united kingdom. Covers key components of sufferer care and offers debate round the quite a few uncertanties concerning the sickness. colour illustrations. Softcover.
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Additional resources for ABC of Clinical Electrocardiography
However, an arrhythmia arising from the atria or the atrioventricular junction will produce a broad complex if associated with ventricular pre-excitation or bundle branch block. The causes of ventricular and supraventricular tachycardias are generally quite different, with widely differing prognoses. Most importantly, the treatment of a broad complex tachycardia depends on the origin of the tachycardia. This article describes monomorphic ventricular tachycardias; other ventricular tachycardias and supraventricular tachycardias will be described in the next article.
The left bundle branch usually receives blood from the left anterior descending branch of the left coronary artery and from the right coronary artery. When new left bundle branch block occurs in the context of an acute myocardial infarction the infarct is usually anterior and mortality is extremely high. The electrocardiographic changes of acute myocardial infarction can be difficult to recognise when left bundle branch block is present, and many of the conventional diagnostic criteria are not applicable.
About 20% of patients with ST segment depression and 15% with T wave inversion will experience severe angina, myocardial infarction, or death within 12 months of their initial presentation, compared with 10% of patients with a normal trace. Changes in the ST segment and T waves are not specific for ischaemia; they also occur in association with several other disease processes, such as left ventricular hypertrophy, hypokalaemia, and digoxin therapy. Electrocardiography is not sufficiently specific or sensitive to be used without a patient’s clinical history Normal Tall T wave Biphasic T wave Inverted T wave Flat T wave T wave changes associated with ischaemia T wave changes Myocardial ischaemia can affect T wave morphology in a variety of ways: T waves may become tall, flattened, inverted, or biphasic.
ABC of Clinical Electrocardiography by David Kerr, Annie Young, Richard Hobbs