Assessing and Understanding ECGs: The ECG 10+ tool

Section One (Textbook content)

Part 1 ECGs in primary care / outside the hospital setting - Indications and quality of assessment

1.1 ECGs outside the hospital setting

1.2 Patients with cardiac symptoms

1.2.1 Irregular heartbeat

1.2.2 Palpitations and tachycardia

1.2.3 Bradycardia

1.2.4 Chest pain

1.2.5 Suspected heart failure

1.2.6 A patient in the emergency room

1.2.7 ECGs in childhood

1.3 Screening in patients without complaints

1.3.1 Increased cardiovascular risk

1.3.2 Screening for atrial fibrillation

1.3.3 Screening after syncope

1.3.4 Screening upon starting QT-elongating medication

1.3.5 Pre-operative screening

1.3.6 Screening in sportspeople

1.3.7 Screening in family members of patients with sudden cardiac death

1.4 Quality of ECG assessment by non-cardiologists

1.5 Summary: indications of ECGs by non-cardiologists

Part 2 Making and understanding ECGs - basic electrophysiology and electrocardiography

2.1 Instructions for making ECGs

2.1.1 Electrodes and leads

2.1.2 Tips and tricks for high quality ECGs

2.1.3 ECG interpretation software

2.2 Explaing the ECG-waves

2.2.1 ECG-registration of heart activity

2.2.2 ECG-leads explained

2.2.3 ECG-paper: settings and definitions

2.2.4 Explaining P-, Q-, R-, S- and T-waves

Part 3 Assessing and understanding ECGs - systematic assessment using the ECG10+ method

3.1 Introduction ECG10+ checklist

3.2 ECG10+ checklist: systematics and explanation

3.2.1 ECG10+ point 1: frequency, regularity (and rhythm)

3.2.2 ECG10+ point 2: heart axis

3.2.3 ECG10+ point 3: P-wave

3.2.4 ECG10+ point 4: PQ-interval

3.2.5 ECG10+ point 5: Q-wave

3.2.5 ECG10+ point 6: QRS-complex (R-progression, height, width)

3.2.6 ECG10+ point 7: ST-interval

3.2.7 ECG10+ point 8: T-wave

3.2.8 ECG10+ point 9: QT-interval

3.2.10 ECG10+ point 10: Rhythm

3.2.11 ECG10+ point +: Diagnosis and plan

3.3 Keep it simple!

Part 4 Reference

4.1 Summary

4.2 Main illustrations in overview

Section Two Case studies: 31 cases (to be expanded to 50)

No complaints

1 Hypertension

2 Examination

3 Safely exercising

4 Sudden cardiac death in the family

5 Routine ECG

6 'Fun' ECG

Slow

7 Woman of high age

8 Unwell while swimming

9 Progressive exercise intolerancy

10 Fatigue

Fast

11 Palpitaions

12 Dizziness upon bending over

13 Dyspnea upon exercise

14 Agoraphobia

15 Working 80 hours a week

16 Chest pain upon exercise

Fast-summary

Palpitations

17 Missing beats

18 Frightened

19 Heart in the throat

20 Brady-tachy

Pain

21 Blessing in disguise

22 Sick

23 Irradiating pain

24 Oppressive pain

25 112-call

26 Coronary artery disease?

Chronic

27 Heart failure

28 Unknown history

29 Progressive complaints

30 Shortness of breath and ankle edema

31 A psychiatric patient

Appendices

Abbreviations

Literature

Index