دانلود کتاب الکتروکاردیوگرافی بالینی گلدبرگر

This book is an introduction to electrocardiography written especially for medical students, house officers, and nurses. The text, which assumes no previous instruction in reading electrocardiograms (ECGs), has been widely used in entry-level courses. Frontline clinicians, including emergency medicine physicians, hospitalists, emergency medical technicians, physician assistants, and cardiology trainees wishing to review the essentials have consulted previous editions. A high degree of ECG “literacy” is increasingly important for those involved in acute clinical care at all levels, requiring knowledge that far exceeds simple pattern recognition and mnemonic aids. ECG interpretation is important not only as a focal point of clinical medicine but as an exemplar of critical thinking. The rigor demanded by competency in ECG analysis requires attention both to the subtlest of details and to the subtending arcs of integrative reasoning: of “seeing the trees and the forest.” Furthermore, ECG analysis is one of those unique areas in clinical medicine where you literally observe physiologic and pathophysiologic dynamics “play out” over seconds down to milliseconds. Not infrequently, bedside rapid-fire decisions are based on real-time ECG data. The alphabetic P-QRS-T-U sequence, much more than a flat graph, represents a dynamic mapping of multidimensional electrical signals literally exploding into existence (automaticity) and spreading throughout the heart (conduction) as part of the fundamental processes of activation and recovery. The ECG provides some of the most compelling and fascinating connections between basic “preclinical” sciences and the recognition and treatment of potentially life-threatening problems in outpatient and inpatient settings. This new, tenth edition follows the general format of the previous one. The material is divided into three sections. Part I covers the basic principles of 12-lead electrocardiography, normal ECG patterns, and the major abnormal depolarization (QRS) and repolarization (ST-T-U) patterns. Part II describes the mechanism of sinus rhythms, followed by a discussion of the major arrhythmias and conduction abnormalities associated with tachycardias and bradycardias. Part III presents more specialized material, including sudden cardiac death, pacemakers, and implantable cardioverter-defibrillators (ICDs), and it also reviews selected “marquee” topics presented from different perspectives (e.g., digitalis toxicity, sudden cardiac arrest) to add dimensionality to the earlier presentations. We make additional materials for review and further exploration available in online supplements (ExpertConsult.com).