More than 100 years since its introduction, electrocardiography continues to provide invaluable clinical information. Even with the development of modern and more expensive technologies, its significance has not declined. To the contrary, its clinical application continues to expand, and presently, it is the most utilized diagnostic modality in the whole practice of medicine. In the hospital setting, it is routinely used to monitor both cardiac and noncardiac patients, especially in acute care units and during the performance of various cardiac and noncardiac procedures. Thus, the information provided by the electrocardiogram should be standard knowledge for every medical and paramedical professional who is involved with patient care.
This book is purposely written in a format that will assist the beginner, including medical students, nurses, and paramedical professionals, in understanding basic electrocardiography. It is also intended for interns, residents, physician assistants, fellows, anesthesiologists, and clinical cardiologists by including standard of care treatment of patients with electrocardiographic abnormalities based on the most recent practice guidelines when guidelines are available. Thus, the book is a combination of both basic and bedside electrocardiography.
The book integrates the comments and suggestions of many interns, residents, and attending physicians to whom I owe a great deal of gratitude. I would like to thank Drs. Miruais Hamed, Paul Aoun, Eileen Zingman, Olga Szalasny, Katja Vassiliades, Manish Arora, Onyi Onuoha, Brandon Togioka, Darshana Purohit, Ranjani Ramanathan, Binu Matthew, Paolo Caimi, Mulugeta Fissha, Hany Bashandy, Cindy Huang, Suzan Fattohy, Rachel Hartman, Kevin Hayes, Khawaja Farook, Jason Javillo, Jennifer Morales, Ubadullah Sharief, Ledys de Marsico, Celian Valero, Samarina Ahmad, Kweku Hayford, Haritha Pendli, Maya Morrison, and many others. I am also grateful to Kittane Vishnupriya for his very helpful comments and for the ECG that he painstakingly obtained to illustrate the significance of the posterior leads in the diagnosis of posterolateral myocardial infarction when he was a coronary care resident. I am also grateful to Drs. Gabriela Szabo, Ameena Etherington, and Soma Sengupta for reviewing chapters in the book, and Laura Baldwin, our superb cardiology technician, who has taught me how to retrieve and record electrocardiograms from our archives.
I am also grateful to Dr. Morton Mower who has been my mentor since I was a resident. His suggestions for improving the book are greatly appreciated. I would also like to express my deep appreciation to Dr. Steven Gambert, Chief of the Department of Medicine, Johns Hopkins University/Sinai Hospital Program in Internal Medicine, for his support and encouragement and for his enthusiasm in having this book published.
Finally, I am grateful to my daughter, Cristina, who is instrumental in teaching me how to use the computer in the preparation of this book and my son Romulo, Jr who decided on Radiology as his specialty, for his comments and suggestions for simplifying some of the chapters, especially those dealing with Basic Electrocardiography.