11 04 2014 EKG

Question 1

P wave duration and amplitude?

What leads should you be looking in?

Answer 1

<.12 sec = less than 3 boxes

Amplitude has to be less than 2.5mm- 3.0mm (small box)

Look in lead II and V1

• usually only helpful when patient is in normal sinus rhythm.

Question 2

PR interval duration
- normal
- short
-long 
And what are the causes of abnormalities?

Answer 2

normal: .12–.20 sec (3-5 boxes)

Short: .20 sec
- First degree AV block

Question 3

QRS complex

• normal?
• elongated?

Answer 3

<.12sec ( 3 boxes)

Elongated = abnormal conduction
BBB
Ventricular  ectopic beat
Toxic drug effect
Hyperkalemia

Question 4

QT interval

• normal?
• increased interval?
• Decreased?

Answer 4

• corrected QT = < or equal to .44s
  ( QT interval/ square root of RR interval)
  QT should be about half RR
  (Bazzet correction)

Elongated –

• hypokalemia, hypocalcemia, hypomagnesium
• Long QT syndrome
• Myocardial Ischemia
• Toxic drug

Shorten interval:

• Tachycardia
• hypercalcemia

Question 5

What would cause a left axis deviation in EKG leads?

Answer 5

• LVH
• Inferior wall MI
• Left anterior Fasicular Block

Question 6

What would cause a right axis deviation in EKG leads?

Answer 6

-RVH
- Acute Right heart strain (massive PE or
chronic heart failure)
- Left posterior fasicular block

Question 7

where would you look on an EKG to confirm RVH?

Answer 7

V1: R wave is greater than 7mm

Question 8

Where do you look on EKG to confirm LVH?

Answer 8

S amplitude in V1 + R amplitude in V5 (or V6) has to be greater than 35 mm

OR

AVL R-wave has to be greater than 11 mm

Question 9

Who does the left anterior descending artery ( comes off Left coronary artery) provide blood to?

Answer 9

• LV anterior wall
• Anterior septum
• LV lateral wall

Question 10

Who does the circumflex artery ( off of left coronary artery) provide blood to?

Answer 10

• Left Atrium

- Left lateral and posterior walls

Question 11

Who does the right coronary artery provide blood to?

Answer 11

• RV
• AV node
• Septum
• LV posterior and inferior walls

( ^ usually because posterior Descending artery tends to come off of the right coronary artery)

Question 12

Who are the inferior leads?

Answer 12

II, III, AVF

Question 13

Who are the anteroseptal leads?

Answer 13

V1 and V2

Question 14

Who are the anteroapical leads?

Answer 14

V3, V4

Question 15

Who are the Anterolateral leads?

Answer 15

V5, C6, I and AVL