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Books by H. Thomas Milhorn

Electrocardiography for the Family Physician:
The Essentials
ISBN #1581124414

The electrocardiogram can serve as an independent identifier of myocardial disease or reflect anatomic, metabolic, hemodynamic, or electrophysiological alterations in the heart. It can provide information that is often essential for the proper diagnosis and therapy of a variety of disorders and is without equal as a method for diagnosing cardiac arrhythmias. It is the procedure of choice for patients who present with chest pain, dizziness, syncope, or symptoms that may indicate risk of myocardial infarction or sudden death.

Family physicians are often the first, and sometimes the only, point of contact for many patients within the health care system. The standard 12-lead electrocardiogram is one of the most common tests obtained and interpreted by the family physician, with most of the physicians reading their own recordings and basing clinical decisions on their findings. It has been shown that family physicians can achieve proficiency in the interpretation of over 95 percent of all electrocardiogram findings seen in the primary care setting.

Although computerized interpretation is widely available, it is considered unreliable in up to 20 percent of the cases, making competency and interpretation by family physicians an essential skill. This book provides the necessary skills for family physicians to use in interpreting electrocardiograms, both in their offices and in the emergency rooms of their hospitals. It also should prove of value to other primary care physicians, as well as medical students and residents of nearly all medical specialties. As the subtitle states, this book is about the essential elements involved in electrocardiographic interpretation. It is not all inclusive; however, it does cover the abnormalities most likely to be seen by family physicians in their everyday practice of medicine.

This book is an outgrowth of a course I taught in the Department of Family Medicine at the University of Mississippi School of Medicine and five articles titled Electrocardiography for the Family Physician I subsequently published in Family Practice Recertification. In short, this book is the one I wish I had access to during the many years I actively practiced family medicine and when I was a resident in family medicine.

Chapter 1. General Principles of Electrophysiology
Electrocardiograph Interpretation
Electrocardiograph Paper
Conduction System of the Heart
Parts of the Electrocardiogram
   Deflections
   Intervals
   Segments
   ST-T Complex
   J Point
 
Chapter 2. Leads and normal
 electrocardiogram   

Leads  
   The Limb Leads
   The Chest Leads
   Lead Combinations
The Normal EKG
Mean Electrical Activity     
Criteria
 
Chapter 3. Heart Rate and Axis
Heart Rate
Axis
Right Axis Deviation
Left Axis Deviation
Northwest Axis
Determining the Axis of the Mean
        Vector   
 
Chapter 4. Atrial Enlargement and
Ventricular Hypertrophy

Atrial Enlargement
   Right Atrial Enlargement
   Left Atrial Enlargement
   Biatrial Enlargement   
Ventricular Hypertrophy
   Right Ventricular Hypertrophy
   Left Ventricular Hypertrophy
   Ventricular Overload (Strain)
   Biventricular Hypertrophy
 
Chapter 5. Intraventricular
Conduction  Disturbances

Right Bundle Branch Block
Left Bundle Branch Block
Incomplete Bundle Branch Block
   Hemiblocks
   Bifascicular Block
Nonspecific Intraventricular Conduction Defects
 
Chapter 6. Myocardial Ischemia, Myocardial Infarction, and Pseudoinfarction Syndromes
Myocardial Ischemia
   Classic Angina
   Other Causes of ST Segment Depression
   Prinzmetal’s Angina
   Other Causes of ST Segment Elevation
Myocardial Infarction  
   Transmural Myocardial Infarction
   Subendocardial Infarction
   Pseudoinfarction Syndromes
  Chapter 7. Rhythm Disturbances   
Normal Sinus Rhythm
Sinus Arrhythmias
   Sinus Tachycardia
   Sinus Bradycardia
   Sinoatrial Block
   Sick Sinus Syndrome
Non-sinus Atrial Arrhythmias
   Premature Atrial Contraction
   Paroxysmal Atrial Tachycardia
   Multifocal Atrial Tachycardia
   Atrial Flutter
   Atrial Fibrillation
Junctional Rhythms
   Premature Junctional Contraction  
   Junctional Tachycardia
   Junctional Escape Rhythm
   Junctional Escape Rhythm
Ventricular Rhythm Disturbances
   Premature Ventricular Contractions
   Ventricular Tachycardia
   Ventricular Fibrillation
   Idioventricular Rhythm  
   Supraventricular Beat with Aberrancy
Atrioventricular Heart Block
   First-degree Heart Block
   Second-degree Heart Block
   Third-degree Heart Block
Bigeminy
 
Chapter 8. Preexcitation Syndromes, Early Repolarization, Pulmonary Embolus, and Pericarditis
Preexcitation Syndromes
   Wolff-Parkinson-White Syndrome
   Lown-Ganong-Levine syndrome   
Early Repolarization
Pulmonary Embolus
Pericarditis
   Stages of Pericarditis
   Acute Pericarditis versus Myocardial Infarction
      versus Early Repolarization   
 
Chapter 9. Athletic Heart Syndrome, Ventricular Pacemaker, Drug Effects, Electrolyte Effects, EKG
Worksheet, and Practice EKG
Athletic Heart Syndrome
Ventricular Pacemaker
Drug Effects
   Digitalis
   Quinidine
Electrolyte Effects
   Potassium
   Calcium
EKG Worksheet
Practice EKG
 
Appendix: A Quick Review of Electrocardiography
 
Index
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