2025 ECG Quiz 6 Flashcards
Pre-Excitation Syndromes
What is pre-excitation?
Wolf-Parkinson-White
(WPW)
A shortened PRI without
a Delta Wave
Why is pre-excitation
relevant?
Supraventricular Tachycardia
(AVRT) in WPW
Orthodromic AVRT
Antidromic AVRT
Atrial Fibrillation with
WPW
Electrolyte
Disturbances: Hyperkalemia
Progression of
Hyperkalemia (1)
Progression of
Hyperkalemia (2)
Treatment of
Hyperkalemia
Electrolyte Disturbances: Hypokalemia
Electrolyte
Disturbances: Hypercalcemia
Electrolyte Disturbances: Hypocalcemia
An intervention that many clinicians do not think about is administrating Calcium
Electrolyte Disturbances: Magnesium
Disturbances
Drug effects
on ECG: Medications That
Prolong the QT Interval
Note on Zofran is that this is from Cancer dosages… which are extremely high, not what we would push
Can change with the heart rate
Look up QTC???
Drug effects
on ECG: Digitalis & Digoxin
Digoxin Toxicity
Other Causes & Conditions effect on the EKG
Hypothermia
J wave (Osborn’s Waves)
Brugada syndrome is a genetic condition that predisposes people to cardiac arrythemias
Pericarditis
Hypertrophic Obstructive
Cardiomyopathy (HOCM)
Myocarditis
Patient has infection, sepsis with this ECG…
… need clinical adjunct to make this diagnosis
… applies to a lot of these conditions within the “Other Causes” section of lecture PP
Atrial Septal Defect
(ASD)
Chronic Obstructive
Pulmonary Disease (COPD)
Acute Pulmonary
Embolism
Can be one of scariest things you encounter intraoperatively
The Athlete’s Heart
African American athletes can see - inverted T wave in V1-V4
Sleep Disorders
CNS Events…
Central nervous system (CNS) catastrophes, such as a subarachnoid bleed or
cerebral infarction, can produce diffuse T-wave inversion and prominent U
waves. The T waves are typically very deep and very wide, and their contour is
usually symmetrical (unlike the asymmetrical inverted T waves of secondary
repolarization associated with ventricular hypertrophy). Sinus bradycardia also is
commonly seen. These changes are believed to be due to involvement of the
autonomic nervous system.
The 9-Step Method for
Reading EKGs
Know your patient & practice, practice, practice!
Before you start:
* Make sure 10 mm = 1 mV on EKG
paper.
* Make sure paper speed is correct.
- Heart rate: determine the heart rate
- Intervals: measure—
* Length of the PR (0.12-0.2 sec) and QT intervals (<.44 sec)
* Width of the QRS complexes (0.06-0.1 sec) - Axis: check for deviations in P (H: <2.5mm; D: 0.08-0.1sec) , and T (H: 1/3-2/3 of R Wave; D: 0.16sec) waves
and QRS complexes - Rhythm: always ask the four questions—
* Are normal P waves present
* Are the QRS complexes wide or narrow (0.06-0.1 sec)
* What is the relationship between P waves and QRS complexes
* Is the rhythm regular or irregular? - Conduction blocks (Ch. 4)
* Atrioventricular (AV) block
* Bundle branch block or hemiblock - Preexcitation (Ch. 5)
- Enlargement and hypertrophy
(Ch. 3) - Acute Coronary Syndromes (Ch. 6)
* Look for Q waves
* Look for ST-segment and T-wave changes. - Other conditions (Ch. 7)
* Is there anything on the EKG that suggests one of the other cardiac or noncardiac conditions discussed?
* Lost? Never hesitate to ask for assistance.
Acronym
HI ARC PECO
… professor recommends to memorizing the actual process and ideas
