Foreword |
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xii | |
Preface |
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xiv | |
Acknowledgments |
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xvi | |
About The Authors |
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xvi | |
Contributors |
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xix | |
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Chapter 1 Heart Structure and Function |
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1 | (8) |
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2 | (1) |
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Heart Location and Structure |
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2 | (2) |
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2 | (1) |
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Pericardium and the Layers of the Heart |
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2 | (1) |
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2 | (1) |
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3 | (1) |
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Internal Heart Structures |
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3 | (1) |
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4 | (1) |
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Neural Factors Influencing the Heart |
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4 | (1) |
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Properties of Myocardial Cells |
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5 | (1) |
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5 | (1) |
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Electrical Conduction System |
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5 | (1) |
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6 | (1) |
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Internodal Conduction Tracts |
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6 | (1) |
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6 | (1) |
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6 | (1) |
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6 | (1) |
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6 | (1) |
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6 | (1) |
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7 | (1) |
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7 | (1) |
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7 | (1) |
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7 | (1) |
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7 | (2) |
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7 | (1) |
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8 | (1) |
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Chapter 2 Cardiovascular Pathophysiology |
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9 | (18) |
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10 | (1) |
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Congenital Structural Abnormalities |
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10 | (6) |
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10 | (1) |
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Ventricular Septal Defect |
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11 | (1) |
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Transposition of the Great Vessels |
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12 | (1) |
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13 | (1) |
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13 | (1) |
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14 | (1) |
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15 | (1) |
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Acquired Structural Abnormalities |
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16 | (7) |
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16 | (1) |
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17 | (2) |
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19 | (1) |
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20 | (1) |
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21 | (2) |
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23 | (1) |
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24 | (3) |
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Chapter 3 Cardiovascular Testing and Procedures |
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27 | (16) |
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28 | (1) |
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Pretest Probability of Coronary Artery Disease |
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28 | (2) |
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28 | (1) |
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How to Decide Which Test to Order |
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29 | (1) |
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30 | (2) |
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Other Names Used to Describe the Exercise Test |
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30 | (1) |
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General Reasons for an Exercise Test |
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30 | (1) |
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30 | (1) |
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31 | (1) |
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31 | (1) |
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31 | (1) |
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Cardiopulmonary Assessment |
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31 | (1) |
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32 | (3) |
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32 | (3) |
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Myocardial Perfusion Imaging |
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35 | (1) |
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35 | (6) |
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Percutaneous Coronary Intervention |
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37 | (1) |
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Coronary Artery Bypass Graft |
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38 | (1) |
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Positron Emission Tomography |
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38 | (1) |
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Cardiac Magnetic Resonance Imaging |
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38 | (1) |
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38 | (3) |
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41 | (1) |
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41 | (1) |
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41 | (1) |
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42 | (1) |
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Chapter 4 Basic ECG Concepts and the Normal ECG |
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43 | (20) |
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44 | (1) |
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44 | (2) |
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44 | (1) |
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45 | (1) |
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45 | (1) |
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Standard 12-Lead Printouts |
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45 | (1) |
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Calculation of Heart Rate |
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46 | (2) |
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46 | (1) |
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46 | (2) |
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48 | (1) |
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Development of the 12 Leads |
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48 | (4) |
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Bipolar Limb Lead Development (Einthoven's Triangle) |
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48 | (2) |
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Unipolar Limb Lead Development |
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50 | (1) |
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Hexaxial Reference System |
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50 | (1) |
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51 | (1) |
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Precordial Leads in the Horizontal Plane |
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51 | (1) |
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52 | (4) |
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52 | (1) |
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53 | (1) |
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53 | (2) |
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55 | (1) |
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55 | (1) |
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56 | (1) |
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56 | (1) |
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56 | (5) |
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Calculation of the Mean QRS Axis |
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57 | (1) |
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Two-Lead Method of Axis Determination |
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57 | (1) |
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57 | (4) |
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61 | (1) |
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61 | (1) |
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61 | (1) |
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61 | (2) |
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Chapter 5 Systematic Interpretation Techniques |
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63 | (4) |
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64 | (1) |
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64 | (1) |
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Step 1 Determine the Regularity of the R Wave or Ventricular Rate/Rhythm |
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64 | (1) |
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Step 2 Calculate the Heart Rate |
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64 | (1) |
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Step 3 Locate and Examine the P Wave |
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64 | (1) |
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Step 4 Measure the PR Interval |
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65 | (1) |
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Step 5 Measure the QRS Complex |
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65 | (1) |
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Step 6 Identify Abnormal Q Waves |
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65 | (1) |
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Step 7 Evaluate the ST Segment and T Wave |
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65 | (1) |
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Additional Steps for Interpreting 12-Lead ECGs |
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65 | (1) |
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65 | (1) |
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65 | (1) |
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65 | (2) |
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67 | (8) |
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68 | (1) |
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68 | (1) |
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68 | (1) |
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68 | (1) |
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69 | (1) |
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69 | (1) |
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69 | (1) |
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69 | (2) |
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69 | (1) |
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70 | (1) |
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70 | (1) |
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70 | (1) |
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71 | (1) |
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Sinus Block/Pause or Arrest |
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71 | (2) |
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71 | (1) |
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71 | (1) |
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71 | (2) |
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73 | (1) |
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73 | (2) |
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Chapter 7 Chamber Enlargement |
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75 | (10) |
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76 | (1) |
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76 | (1) |
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76 | (1) |
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76 | (1) |
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76 | (1) |
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76 | (1) |
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76 | (1) |
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77 | (1) |
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77 | (1) |
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77 | (1) |
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77 | (1) |
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77 | (1) |
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77 | (1) |
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Right Ventricular Hypertrophy |
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78 | (2) |
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78 | (1) |
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78 | (1) |
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78 | (1) |
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78 | (1) |
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78 | (2) |
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Left Ventricular Hypertrophy |
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80 | (3) |
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80 | (1) |
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80 | (2) |
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82 | (1) |
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82 | (1) |
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82 | (1) |
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83 | (1) |
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83 | (2) |
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Chapter 8 Conduction Disturbances: Atrioventricular Blocks |
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85 | (8) |
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86 | (1) |
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86 | (1) |
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86 | (1) |
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86 | (1) |
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87 | (1) |
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87 | (1) |
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87 | (1) |
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Second-Degree AV Block Type I |
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87 | (1) |
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87 | (1) |
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87 | (1) |
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87 | (1) |
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88 | (1) |
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Second-Degree AV Block Type II |
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88 | (1) |
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88 | (1) |
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88 | (1) |
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88 | (1) |
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89 | (1) |
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89 | (1) |
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89 | (1) |
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89 | (1) |
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90 | (1) |
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90 | (1) |
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90 | (1) |
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90 | (1) |
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Differential Diagnosis of AV Heart Blocks |
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90 | (1) |
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Third-Degree AV Block Versus Mobitz I |
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91 | (1) |
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Third-Degree AV Block Versus Mobitz II |
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91 | (1) |
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Mobitz I Versus Mobitz II |
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91 | (1) |
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91 | (1) |
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92 | (1) |
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Chapter 9 Conduction Disturbances: Bundle Branch Blocks |
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93 | (10) |
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94 | (1) |
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Right Bundle Branch Block |
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94 | (1) |
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94 | (1) |
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94 | (1) |
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94 | (1) |
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94 | (1) |
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94 | (2) |
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96 | (1) |
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96 | (1) |
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96 | (1) |
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96 | (1) |
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96 | (1) |
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Hemiblocks (Fascicular Blocks) |
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96 | (3) |
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99 | (2) |
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101 | (1) |
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101 | (2) |
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Chapter 10 Ventricular Arrhythmias |
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103 | (12) |
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104 | (1) |
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Premature Ventricular Contractions |
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104 | (5) |
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104 | (1) |
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104 | (1) |
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105 | (3) |
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108 | (1) |
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109 | (1) |
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Monomorphic Sustained Ventricular Tachycardia |
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109 | (2) |
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110 | (1) |
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110 | (1) |
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110 | (1) |
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111 | (1) |
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111 | (1) |
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Polymorphic Ventricular Tachycardia |
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111 | (1) |
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111 | (1) |
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111 | (1) |
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111 | (1) |
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111 | (1) |
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111 | (1) |
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Accelerated Idioventricular Rhythm |
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111 | (1) |
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112 | (1) |
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113 | (1) |
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113 | (2) |
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Chapter 11 Supraventricular Arrhythmias |
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115 | (18) |
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116 | (1) |
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Premature Atrial Contractions |
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116 | (2) |
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116 | (1) |
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116 | (1) |
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117 | (1) |
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117 | (1) |
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117 | (1) |
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Premature Junctional Contractions |
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118 | (1) |
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118 | (1) |
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118 | (1) |
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118 | (1) |
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119 | (1) |
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Supraventricular Tachycardia |
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119 | (1) |
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AV Nodal Reentrant Tachycardia |
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120 | (2) |
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120 | (1) |
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120 | (1) |
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121 | (1) |
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121 | (1) |
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AV Reciprocating Tachycardia |
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122 | (2) |
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122 | (1) |
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123 | (1) |
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123 | (1) |
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123 | (1) |
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124 | (1) |
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124 | (1) |
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125 | (1) |
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125 | (1) |
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125 | (3) |
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125 | (1) |
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125 | (1) |
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126 | (1) |
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126 | (2) |
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128 | (1) |
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128 | (1) |
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128 | (1) |
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128 | (1) |
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129 | (1) |
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129 | (1) |
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130 | (1) |
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130 | (3) |
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Chapter 12 Myocardial Ischemia and Infarction |
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133 | (26) |
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134 | (1) |
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Myocardial Ischemia on the Resting ECG |
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134 | (4) |
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Baseline ECG Patterns That Complicate Interpretation of Exercise-Induced Myocardial Ischemia |
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138 | (1) |
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Phases of Myocardial Infarction on the Resting ECG |
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138 | (1) |
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139 | (1) |
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Evolving/Resolution Phase |
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139 | (1) |
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Stable, Chronic (Old) Phase |
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139 | (1) |
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ECG Changes with Each Area of the Heart |
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139 | (9) |
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139 | (1) |
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140 | (4) |
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Reciprocal ECG Changes Seen in Each Phase of Infarction |
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144 | (1) |
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144 | (4) |
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ECG Patterns That Can Mimic Myocardial Infarctions |
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148 | (1) |
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ECG Changes Seen with Aneurysm |
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148 | (1) |
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ECG Changes Seen with Pericarditis |
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148 | (1) |
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ECG Changes Seen with Early Repolarization |
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149 | (1) |
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Myocardial Ischemia Patterns During Exercise Testing |
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149 | (8) |
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Contraindications to Exercise Testing |
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149 | (1) |
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Indications for Termination of Exercise Testing |
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150 | (2) |
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Diagnostic ECG Criteria for Exercise-Induced Myocardial Ischemia |
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152 | (5) |
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157 | (1) |
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157 | (1) |
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157 | (1) |
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157 | (2) |
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Chapter 13 Pacemakers and Internal Cardiac Defibrillators |
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159 | (14) |
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160 | (1) |
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Pacemaker Terminology, Function, and Programming |
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160 | (1) |
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161 | (1) |
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161 | (1) |
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Examples of Normal and Abnormal Pacemaker Function |
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161 | (9) |
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Examples of Normal Pacemaker Function |
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161 | (1) |
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Examples of Abnormal Pacemaker Function |
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162 | (3) |
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Patients Appropriate for Stress Testing if Coronary Disease Is Known or Suspected |
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165 | (1) |
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Pitfalls to Exercise ECG Interpretation in the Pacemaker Patient |
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165 | (1) |
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Pacemaker Driven Stress Testing |
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166 | (1) |
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Alternate Indications for Exercise Testing in Patients with Pacemakers |
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167 | (3) |
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170 | (1) |
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170 | (1) |
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170 | (3) |
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Chapter 14 Influence of Pharmacologic Agents and Electrolytes on ECGs |
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173 | (12) |
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174 | (1) |
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174 | (1) |
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Mechanism of Action of Digoxin in Heart Failure |
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174 | (1) |
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Mechanism of Action of Digoxin in Atrial Fibrillation |
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174 | (1) |
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174 | (1) |
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Effects of Digoxin on ECG at Therapeutic Levels |
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174 | (1) |
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Effects of Digoxin on ECG at Toxic Levels |
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174 | (1) |
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Additional Factors Predisposing Patients to Digoxin-Induced Arrhythmias |
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175 | (1) |
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Class II and IV Antiarrhythmics: Beta-Blockers and Calcium Channel Blockers |
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175 | (1) |
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175 | (1) |
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175 | (1) |
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Drugs That Prolong the QT Interval: Class I and III Antiarrhythmics and Nonantiarrhythmics |
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176 | (2) |
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Drug-Induced QT Interval Prolongation |
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176 | (1) |
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Class I Antiarrhythmic Agents |
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177 | (1) |
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Class III Antiarrhythmic Agents |
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177 | (1) |
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178 | (1) |
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Electrolyte Abnormalities |
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178 | (2) |
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178 | (2) |
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180 | (1) |
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180 | (1) |
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180 | (1) |
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181 | (2) |
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183 | (2) |
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Chapter 15 ECGs and Women |
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185 | (6) |
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Coronary Artery Disease in Women |
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186 | (1) |
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186 | (1) |
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186 | (2) |
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Appropriate Application of Exercise ECG in Women |
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186 | (1) |
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Differences in Electrode Placement in Women Compared to Men |
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186 | (1) |
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186 | (1) |
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Sex-Related Differences in Interpretation |
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187 | (1) |
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188 | (1) |
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Diseases Specific to Women |
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188 | (1) |
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Peripartum Cardiomyopathy |
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188 | (1) |
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Idiopathic Pulmonary Hypertension |
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189 | (1) |
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189 | (1) |
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189 | (1) |
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190 | (1) |
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Chapter 16 ECGs in the Pediatric Population |
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191 | (16) |
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192 | (1) |
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General Differences Between Children and Adults |
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192 | (1) |
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Clinical Exercise Testing |
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192 | (1) |
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Rationale for Exercise Testing in the Pediatric Population |
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192 | (1) |
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192 | (1) |
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Test Termination Criteria |
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193 | (1) |
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General Test Termination Guidelines |
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193 | (1) |
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193 | (3) |
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Common ECG Findings in Pediatric Exercise Testing |
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193 | (2) |
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195 | (1) |
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Congenital Heart Disease in Pediatrics |
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196 | (6) |
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197 | (1) |
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197 | (4) |
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201 | (1) |
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Noncongenital Heart Disease in Pediatrics |
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202 | (3) |
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202 | (1) |
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202 | (1) |
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Hypertrophic Cardiomyopathy |
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203 | (1) |
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203 | (2) |
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205 | (1) |
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205 | (2) |
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Chapter 17 ECGs in Athletes |
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207 | (14) |
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208 | (1) |
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Normal ECG Findings in Athletes at Rest |
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208 | (1) |
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Age, Gender, Race, and Sporting Differences |
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208 | (1) |
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Resting Changes Typically Seen in Athletes' Hearts |
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208 | (4) |
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208 | (1) |
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208 | (1) |
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208 | (1) |
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209 | (1) |
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209 | (1) |
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Incomplete Right Bundle Branch Block |
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209 | (1) |
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Left Ventricular Hypertrophy |
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210 | (1) |
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Early Repolarization and ST Segment Elevation |
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210 | (2) |
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Changes Seen During Exercise in Athletes |
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212 | (1) |
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Pathologic ECG Findings Seen in Athletes' ECGs |
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212 | (4) |
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212 | (1) |
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Nonvoltage Criteria for Left Ventricular Hypertrophy |
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212 | (1) |
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ST Segment Depression in Two or More Leads |
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212 | (1) |
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212 | (1) |
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212 | (4) |
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216 | (1) |
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217 | (2) |
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219 | (2) |
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Chapter 18 Structural Heart Disease and Inflammatory Processes |
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221 | (14) |
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222 | (1) |
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222 | (1) |
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222 | (1) |
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222 | (1) |
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222 | (2) |
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223 | (1) |
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223 | (1) |
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Hypertrophic Cardiomyopathy |
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224 | (1) |
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224 | (1) |
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225 | (1) |
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Arrythmogenic Right Ventricular Dysplasia |
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225 | (3) |
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228 | (1) |
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228 | (1) |
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228 | (4) |
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228 | (2) |
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230 | (2) |
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232 | (1) |
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232 | (1) |
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233 | (2) |
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Chapter 19 Applied Case Studies |
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235 | (44) |
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236 | (1) |
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237 | (3) |
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240 | (1) |
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241 | (1) |
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242 | (4) |
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246 | (11) |
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257 | (3) |
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260 | (3) |
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263 | (1) |
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264 | (5) |
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269 | (10) |
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279 | (76) |
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279 | (26) |
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305 | (50) |
Appendix A Generic and Brand Name Drugs by Classification |
|
355 | (2) |
Appendix B Answers to Case Studies |
|
357 | (4) |
Appendix C Answers to Practice ECGs |
|
361 | (4) |
Glossary |
|
365 | (8) |
Index |
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373 | |