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Anaesthesiology
Atlas of Electrocardiography
Built from Barash Clinical Anesthesia, 9th Edition
What’s inside
11 sections · 115 slides
Overview
- Scope of this atlas
- How every tracing in this atlas is read
Lead Placement and the Normal Complex
- Standard electrode positions on the chest
- Lead systems and their electrode pairs
- Positive and negative electrodes for each lead
- Positive and negative electrodes for each lead (continued)
- Abbreviations used for electrode positions
- Waves and intervals of the normal cardiac cycle
Supraventricular Rhythms and Conduction Block
- Atrial fibrillation
- Atrial fibrillation on the rhythm strip
- Atrial flutter
- Saw-toothed flutter waves
- Classification of atrioventricular block
- First-degree atrioventricular block
- Prolonged but constant PR interval
- Second-degree AV block, Mobitz type I (Wenckebach)
- Progressive PR lengthening before a dropped beat
- Second-degree AV block, Mobitz type II
- Dropped beats without PR lengthening
- Third-degree AV block (complete heart block)
- Management of complete heart block
- Independent atrial and ventricular activity
Bundle Branch Block
- Left bundle branch block
- Anaesthetic implication of left bundle branch block
- Twelve-lead pattern of left bundle branch block
- Right bundle branch block
- Twelve-lead pattern of right bundle branch block
Coronary Artery Disease
- Transmural myocardial infarction
- Subendocardial myocardial infarction
- Localising infarction by lead group
- Inferior infarction and the right coronary artery
- Inferior infarction: leads, changes and artery
- Posterior infarction and the posterior descending artery
- Posterior infarction: leads, changes and artery
- Lateral infarction and the left circumflex artery
- Lateral infarction: leads, changes and artery
- Anterior infarction and the left anterior descending artery
- Anterior infarction: leads, changes and artery
- Anteroseptal infarction and the septal branches
- Anteroseptal infarction: leads, changes and artery
- Myocardial ischaemia
- Recognising intraoperative ischaemia
- Twelve-lead recording of ST-segment depression
- Exercise-induced ST depression in V5
- Marked ST-segment change in the lateral leads
- Digitalis effect
Electrolyte Disturbance and Temperature
- Reliability of ECG changes in electrolyte disturbance
- Rate, rhythm and interval changes with calcium and potassium
- Calcium effect on the limb leads
- Hypokalaemia on the rhythm strip
- Hyperkalaemia on the rhythm strip
- Hypothermia
- J point and Osborn waves in hypothermia
Tachyarrhythmias
- Multifocal atrial tachycardia
- Varying P wave shapes in multifocal atrial tachycardia
- Paroxysmal atrial tachycardia
- Treatment of paroxysmal atrial tachycardia under anaesthesia
- Abrupt transition from atrial tachycardia to sinus rhythm
- Sinus tachycardia
- Sinus tachycardia on the rhythm strip
- Torsades de pointes
- Management of torsades de pointes
- Twisting QRS axis in sustained torsades de pointes
- Ventricular tachycardia
- Treatment and differentiation of ventricular tachycardia
- Wide bizarre complexes of ventricular tachycardia
- Ventricular fibrillation
- Coarse ventricular fibrillation
- Fine ventricular fibrillation
- Wolff-Parkinson-White syndrome
- Why digoxin is avoided in Wolff-Parkinson-White syndrome
- Short PR interval and delta wave
Bradycardias and Ectopic Beats
- Sinus bradycardia
- Slow regular sinus rhythm
- Sinus arrhythmia
- Respiratory variation in the R-R interval
- Sinus arrest
- Escape pacemaker hierarchy
- Pause from sinus arrest
- Premature atrial contraction
- Early beat with a hidden P wave
- Premature ventricular contraction
- Wide early beats with compensatory pauses
Pericardial, Pulmonary and Neurologic Causes
- Pericarditis
- Diffuse ST and T-wave change across the twelve leads
- Pericardial tamponade
- Low-voltage complexes in pericardial tamponade
- Electrical alternans with beat-to-beat amplitude change
- Pneumothorax
- Pulmonary embolus
- Right heart strain pattern of pulmonary embolus
- Subarachnoid haemorrhage
- Deep wide T-wave inversion in subarachnoid haemorrhage
Pacemaker Tracings
- Atrial pacing
- Pacemaker spikes preceding each P wave
- Ventricular pacing
- Pacemaker spikes preceding each QRS complex
- DDD pacing
- Sequential atrial and ventricular pacing spikes
Summary and Sources
- Points to carry into theatre
- Traps that lead to misdiagnosis
- Sources of the illustrations
- Sources of the illustrations (continued)
- Contributors acknowledged in this appendix
- Barash, Cullen, and Stoelting's Clinical Anesthesia, 9th Edition