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Abstract

In patients with chest pain or suspected heart disease (IHD/CAD), the electrocardiogram (ECG) is one of the principle investigations at the time of presentation. The ECG is a graph obtained when the electrical potentials of an electrical field originating in the heart are recorded at the surface of the body [1–3]. Once the electrical activity is detected it is amplified, displayed on the screen/ monitor and finally recorded on a paper chart [1–3]. In general, the ECG records depolarisation (P wave and QRS complex) and repolarisation (ST segment, T wave and U wave) of the heart. The advantages of the ECG are (a) it is an independent marker of myocardial disease, and (b) it detect haemodynamic, anatomical, electrolyte and drug induced abnormalities [1–3]. Although the ECG is useful in the initial stages of chest pain investigation, it has severe limitations.

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References

  1. Macfarlane PW, Lawrie TDV (eds) (1989) Comprehensive Electrocardiology; Theory and Practice in Health and Disease. Pergamon Press, New York.

    Google Scholar 

  2. Task Force Report of the American College of Cardiology and the American Heart Association (1992). ACC/AHA Guidelines for Electrocardiography. Circulation 19:473–481.

    Google Scholar 

  3. Castellanos A, Interian A, Myerburg RJ (2001) The resting electrocardiogram. In Hurst’s The Heart, Fuster V, Alexander RW, O’Rourke RA (eds), pp. 281–314.

    Google Scholar 

  4. Taback L, Marden E, Mason HL et al (1959) Digital recording of electrocardiographic data for analysis by a digital computer. IRE Trans Med Electron 6:167–171.

    Article  Google Scholar 

  5. Boyle J III (2001) Cardiovascular physiology. In Physiology, 2nd edn, Bullock J et al. (eds). The National Medical Series for Independent Study, pp. 93–148.

    Google Scholar 

  6. Khan GM (2003) Rapid ECG Interpretation, 2nd edn. Saunders.

    Google Scholar 

  7. Huff J (2002) ECG Workout. Exercises in Arrhythmia Interpretation, 4th edn. Lippincott Williams & Wilkins.

    Google Scholar 

  8. Houghton AR, Gray D (2003) Making Sense of the ECG, 2nd edn. Arnold Publishers.

    Google Scholar 

  9. Goldschlager N, Goldman MJ (1984) Electrocardiography – Essentials of Interpretation. Lange Medical Publications.

    Google Scholar 

  10. Hampton JR (2003) The ECG in Practice. Churchill Livingstone.

    Google Scholar 

  11. Chung EK (2001) Pocket Guide to ECG Diagnosis, 2nd edn. Blackwell Science, Malden, MA.

    Google Scholar 

  12. Aehlert B (2002) ECGs Made Easy, 2nd edn. Mosby, Inc, St Louis, MO.

    Google Scholar 

  13. Jenkins RD, Gerred SJ (2005) ECG by Example Elsevier/Churchill Livingstone.

    Google Scholar 

  14. Swanton RH (2003) Cardiac Investigations in Cardiology, 5th edn. Blackwell Publishing

    Google Scholar 

  15. Rautaharju PM, Park L, Rautaharju FS, Crow RA (1998) Standardized procedure for locating and documenting ECG chest electrode positions: consideration of the effect of breast tissue on ECG amplitudes in women. J Electrocardiol 31:17–29.

    Article  PubMed  CAS  Google Scholar 

  16. Huszar RJ (2002) Basic Dysrhythmias: Interpretation & Management, 3rd edn. Mosby, St Louis, MO.

    Google Scholar 

  17. Atrial and Ventricular Depolarization Changes. www.americanheart.org

    Google Scholar 

  18. Brailer DJ, Kroch E, Pauly MV (1997) The impact of computer-assisted test interpretation on physician decision making: the case of electrocardiograms. Med Decision Making 17:80–86.

    Article  CAS  Google Scholar 

  19. Massel D (2003) Observer variability in ECG interpretation for thrombolysis eligibility: experience and context matter. J Thromb Thrombolysis 15:131–140.

    Article  PubMed  Google Scholar 

  20. Rodger M, Makropoulos D, Turek M et al. (2000) Diagnostic value of the electrocardiogram in suspected pulmonary embolism. Am J Cardiol 86:807–809.

    Article  PubMed  CAS  Google Scholar 

  21. Gibbons RJ, Balady GJ, Bricker JT et al. (2002) ACC/AHA (2002) guideline update for exercise testing: a report of the American College of Cardiology/American Heart Association Task force on Practice Guidelines (Committee on Exercise Testing). 2002. American College of Cardiology website. Available at: www.acc.org/clinical/guideline/exercise/dirIndex.htm

    Google Scholar 

  22. Ellestad MH (2003) Stress testing protocol. In Stress Testing Principles and Practice, 5th edn. Oxford University Press, Chapter 8.

    Google Scholar 

  23. Morise AP, Diamond GA (1995) Comparison of the sensitivity and specificity of exercise electrocardiography in biased and unbiased populations of men and women. Am Heart J 130:741–747.

    Article  PubMed  CAS  Google Scholar 

  24. Hill J, Timmis A (2002) Exercise tolerance testing. BMJ 324:1084–1087.

    Article  PubMed  Google Scholar 

  25. Michaelides AP, Psomadaki ZD, Dilaveris PE et al. (1999) Improved detection of coronary artery disease by exercise electrocardiography with the use of right precordial leads. New Eng J Med 340:340–345.

    Article  PubMed  CAS  Google Scholar 

  26. Stuart RJ, Ellestad MH (1980). National survey of exercise stress testing fascilities. Chest 77:94.

    Article  PubMed  Google Scholar 

  27. Rochimis P, Blackburn H (1971) Exercise test (1971). A survey of procedures, safety, and litigation experience in approximately 170,000 tests. JAMA 217:1061.

    Article  Google Scholar 

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Buscombe, J., Gnanasegaran, G., Bashir, H. (2009). Electrocardiography and Exercise Stress Test. In: Movahed, A., Gnanasegaran, G., Buscombe, J., Hall, M. (eds) Integrating Cardiology for Nuclear Medicine Physicians. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-78674-0_8

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  • DOI: https://doi.org/10.1007/978-3-540-78674-0_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-78673-3

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