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Title: The Ecg in Acute Mi: An Evidence-Based Manual of Reperfusion Therapy by Stephen W., MD Smith, Deborah L.,Phd Zvosec, Timothy D., MD Henry, Scott W., MD Sharkey ISBN: 0-7817-2903-3 Publisher: Lippincott Williams & Wilkins Publishers Pub. Date: April, 2002 Format: Paperback Volumes: 1 List Price(USD): $49.95

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Average Customer Rating: 5 (1 review)

Rating: 5
Summary: My media review...
Comment: The ECG in Acute MI provides a quick reference text for use in critical clinical situations in which accurate ECG interpretation will lead to more rapid recognition of appropriate candidates for reperfusion therapy, as well as a text for more detailed study of electrocardiogram interpretation. This manual is intended for all clinicians that may have to recognize and treat an acute myocardial infarction (AMI). Thus, this book is for emergency department physicians, cardiologists, critical care physicians, hospitalists, internists, family practitioners, physician assistants, cardiac care nurses, residents and medical students. The text assumes a basic clinical understanding of electrocardiograms and common terminology, and focuses on outlining the essentials of ECG interpretation and how they may be used to accurately diagnose AMI, as well as to facilitate appropriate and timely reperfusion therapy. In this manual, reperfusion therapy includes the use of thrombolytics and percutaneous coronary intervention (PCI), including angioplasty and stent placement.
The authors utilize a well-organized format of concisely written text with key points highlighted and numerous clinical and electrocardiographic demonstrations included in every chapter in order to illustrate core concepts, and allow for quick reference. The text is divided into six sections for rapid review and easy access: General Issues of ECG Morphologies and the Diagnosis of AMI; the ECG Morphologies of AMI broken down by anatomic distribution (i.e. anterior MI, Inferior MI, etc.); Conditions that can obscure the diagnosis of AMI, including ECG pseudo-infarction patterns and AMI look-alikes; Other issues including atypical presentations, biomarkers and echocardiography as used in the reperfusion decision; and the management of AMI.
The ECG in Acute MI includes more than 300 12-lead ECGs, over 200 of which have accompanying case histories to help the reader understand the ECG in a clinical context. Many of the case examples include angiographic findings that serve to cement the reader's understanding of the ECG manifestations of anatomical disease. The chapters and representative example cases are cross-referenced extraordinarily well, facilitating review and comparison in an emergency setting. In addition, each chapter contains an extensive annotated bibliography outlining the pertinent studies previously published, including interpreted methods, findings and comments. The value of including a detailed description of the evidence based literature on which assertions in the text are made, cannot be overstated. Overall, there are more than 500 cited references for the text.
The ECG in Acute MI is well organized, thorough and an easy to use manual, both for the seasoned physician and the clinician in training. Although a manual focusing only on ECG interpretation seems a bit daunting at over 300 pages, the concise format of the text makes reading or reviewing chapters either to refresh prior knowledge or verify findings of an acute ECG in the clinical setting to confirm an interpretation entirely possible. While the reviewer had been comfortable with her ability to interpret ECG's in the acute setting, she was pleasantly surprised at just how much she learned from this manual. The authors set out to review and highlight the key aspects of ECG interpretation in order to more accurately diagnose acute MI and facilitate appropriate and timely therapy. The authors focus on educating the reader on the more sophisticated interpretation of subtle, non-diagnostic and atypical electrocardiographic findings of infarction, beyond the much more easily recognized "tombstoning" pattern of AMI. Additionally, the case based discussion utilizing serial ECG's emphasizes the dynamic nature of the electrocardiogram in acute myocardial infarction. This has led the reviewer to be much more suspicious of subtle hints on an initial ECG and the value of repeated examination in the acute clinical setting. The drawback of a text focused on subtle and atypical ECG findings is that the manual is occasionally tedious in its' detail and tiresome in its' description of differentiating characteristics of subtleties.
Although there are several excellent manuals for ECG interpretation available in the medical literature, the ECG in Acute MI is superior in its utilization of clinical correlation and evidenced based theory. The ECG in acute MI would be an excellent addition to any emergency department library, and would easily lend itself to the development of an advanced ECG interpretation module for residency curriculum. The authors have added a unique and tremendously valuable resource to the reference texts available to practicing clinicians.