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…The cardiac unit is a jungle, inhabited by fierce nurses, killer intensivists, marauding attendings, various flesh-eating specialists, sick patients, and lots of arrhythmias. –from the Preface Can you recognize the call of the normal sinus rhythm? Name the natural habitat of Multifocal Atrial Tachycardia or Ventricular Fibrillation? Are you well-versed in the proper care and feeding of Asystole and Atrial Flutter? If you answered “no” to any of these questions, then you need this trusty guide to help you identify and respond to arrhythmias in the veritable wilderness of the busy hospital ward. Created by a seasoned physician educator at a major urban medical center and inspired by the “field guides” used by birders, botanists and the like to identify flora or fauna in the wild, this new book offers a unique – and uniquely humorous -- approach to mastering the ever-vexing challenge of arrhythmia identification. Each arrhythmia is covered beginning with a sample ECG strip, followed by brief text describing its significant characteristics; where and when it is likely to be encountered (its “Habitat”); comments, questions and queries likely to be heard from physicians and other colleagues on the ward (the “Call”); and finally what steps the reader needs to take upon identifying the arrhythmia in a patient (“Care and Feeding”). Dr. Lader’s approach brings the sights and sounds of a modern hospital to life, enabling you to understand arrhythmia diagnosis and clinical response in context, and his offbeat, sometimes irreverent humor makes each detail memorable. Fifty self-assessment questions are included to help you master arrhythmia essentials and test your knowledge. Table of Contents Key to the Arrhythmias, inside front/back covers Preface, vi Acknowledgments, viii Abbreviations, ix PART 1: THE RHYTHMS, 1 Normal Sinus Rhythm, 3 Preexcitation, 4 Sinus Bradycardia, 6 Sinus Tachycardia, 7 Sinus Arrhythmia, 8 Wandering Atrial Pacemaker, 9 Multifocal Atrial Tachycardia, 10 Junctional Rhythm, 12 Asystole, 14 Heart Block: First Degree, Second Degree (Mobitz I and II), and Third Degree (Complete), 16 Premature Beats (Blocked and Otherwise), 20 Atrial Fibrillation, 23 Atrial Flutter, 25 Supraventricular (Paroxysmal Atrial) Tachycardia, 28 Pacemaker Rhythms, 30 Ventricular Tachycardia, 33 Accelerated Idioventricular Rhythm, 36 Prolonged QT/Torsades de Pointes, 38 Ventricular Fibrillation, 41 PART 2: MULTIPLE CHOICE QUESTIONS, 43
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