책소개머 리 말
심전도 홀로서기는 저자가 오랫동안 일선에서 심전도를 가르치면서 의학도는 물론 간
호학, 임상병리학, 응급구조학 전공자에게 우리말 자습서의 필요성을 절감하고 선배 학
자들로부터 배우고, 스스로 터득한 심전도 원리와 판독법들을 정리한 것이다. 수록된 모
든 심전도와 그림들은 저자가 직접 모으고 그린 것들이다. 공부하면서 생기는 사소한 의
문까지도 해소하고 나아갈 수 있도록 “이뭣고”에 소개하였고, 이해하기 어려운 내용은
“유레카”를 통해 저자 나름의 방법을 소개하여 이해를 돕고자 하였다.
심전도 홀로서기가 세상에 나온 지 9년이 지났다. 그동안 심전도 홀로서기가 홀로서기
할 수 있도록 많은 관심과 사랑을 베풀어 주신 여러 선생님들께 감사드린다. 첫 출판 후
2년 만에 일부를 개정하였으나 이번에는 완전히 새로 쓴다는 생각으로 전면적으로 고치
고 보충하였다. 심전도도 늘 새롭게 발전하는 학문 가운데 하나이어서 J파증후군과 같이
그동안 새롭게 정립된 내용들을 최대한 추가하고 첫 판에서 미진한 부분을 보충하였다.
바뀌지 않는 부분도 보다 더 이해하기 쉽도록 문장을 다듬고 필요에 따라 그림도 고쳐 그
렸다. 새롭게 개정된 심전도 홀로서기 3판이 여러분의 심전도 공부와 환자 진료에 큰 도
움이 되기를 기대한다.
2015년 2월
무등산 아래 하안거에서
저자 조정관
목차차 례
1 장/심전도 기록의 원리 / 1
1. 심전도 (electrocardiogram: ECG)···················································· 1
2. 심전도 파의 생성 원리····································································· 3
3. 심전도 유도··················································································· 8
4. 심전도 기록의 표준······································································· 22
5. 심전도 기록의 오류와 잡신호·························································· 23
◈ 자율평가문제··········································································· 27
2 장/심장의 구조와 전기생리 / 29
1. 심장의 전기생리학적 구조······························································ 29
2. 심장의 자극 생성 및 전달 조직 (자극전도계)······································ 30
3. 심장세포의 전기생리학적 특성························································ 31
4. 심장세포의 활동전위····································································· 33
5. 심방과 심실의 특이한 탈분극 과정··················································· 34
◈ 자율평가문제··········································································· 36
3 장/정상 심전도 파와 간격 / 39
1. 정상 심전도 파와 간격··································································· 39
2. 특수 심전도 파············································································· 41
3. 심전도 파와 분절의 생성기전·························································· 42
4. 심전도 파와 간격의 정상 기준 (100의 법칙)······································· 51
◈ 자율평가문제··········································································· 53
4 장/심전도 파와 분절의 이상 / 55
1. P파의 이상 ················································································· 55
2. QRS파의 이상·············································································· 61
3. PR간격의 이상 ············································································ 74
4. J점의 이상·················································································· 74
5. ST절의 이상 ··············································································· 77
6. T파의 이상·················································································· 82
7. U파의 이상 ················································································· 86
8. QT간격의 이상 ············································································ 86
9. 전해질 불균형에 의한 심전도 변화··················································· 86
◈ 자율평가문제··········································································· 90
5 장/심장 율동 이상 (부정맥) / 93
I. 정상 율동 / 93
1. 정상 동율동 (normal sinus rhythm)··············································· 93
2. 비동성 정상 율동 (non-sinus normal rhythm)································· 94
II. 서맥성 부정맥 / 96
1. 동기능부전 (sinus node dysfunction)············································· 96
2. 방실전도차단 (atrioventricular block: AV block)····························· 99
III. 빈맥성 부정맥 / 105
1. 심실상성 빈맥 (supraventricular tachycardias: SVT)····················· 105
2. 심실성 빈맥··············································································· 122
차 례
IV. 조기박동 (premature beats) / 134
1. 심방 조기박동 (atrial premature beats)········································ 134
2. 방실접합부 조기박동 (junctional premature beats)························· 135
3. 심실 조기박동 (ventricular premature beats) ······························· 136
V. 부정맥의 임상적 의미 / 140
1. 치료가 필요 없는 부정맥······························································ 140
2. 치료가 필요한 병적인 부정맥························································ 142
◈ 자율평가문제········································································· 143
6 장/심전도 징후 및 현상 / 147
1. 심전도 징후 (sign)······································································ 147
2. 심전도 현상··············································································· 150
◈ 자율평가문제········································································· 162
7 장/심전도 분석의 실제 / 165
1. 기록의 기준과 질의 평가······························································ 166
2. 심장 율동의 분석········································································ 170
3. 파와 분절의 분석········································································ 205
4. 심전도 분석의 이중 선회법: 심전도 분석에 리듬아치의 적용··············· 254
5. 심전도 분석 결과 서술 방법·························································· 256
◈ 자율평가문제········································································· 260
부록 심전도 걸작 80선 / 265
참고 문헌······················································································ 308
찾아보기·····························································································
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