24. Clinical Cases- ECG

Question 1

normal physiologic causes of sinus tachycardia

Answer 1

• pregnancy
• emotions (anxiety, fear)
• exertion

Question 2

pathologic causes of sinus tachycardia

Answer 2

• hypovolemia
• CHF
• drugs
• hyperthyroid
• fever
• pregnancy
• anemia

Question 3

causes of sinus bradycardia

Answer 3

• vagal response
• sleep apnea
• meds
• MI
• increased ICP
• hypothyroid

Question 4

PACs are associated with what causes

Answer 4

• stress
• EtOH
• tobacco
• coffee
• COPD
• CAD

Question 5

what do PACs look like on ECG

Answer 5

• an abnormal p’ wave sooner than expected

- possibly hidden by a t wave (look for T wave taller than normal)

Question 6

PVCs are associated with what causes

Answer 6

• hypoxia
• electrolyte disorders (hypokalemia, hypomagnesemia)
• drugs (caffeine, thyroid, aminophylline, digitalis, albuterol)
• heart failure
• AMI
• ischemic heart diease
• cardiomypathy

Question 7

what do PVCs look like on ECG

Answer 7

very wide and tall QRS

Question 8

how to tell if multiple PVCs come from one irritable focus vs multiple foci

Answer 8

unifocal: all QRS will have same morphology

Question 9

3+ consecutive PVCs can turn into ___

Answer 9

ventricular tachycardia

Question 10

what does VTACH look like on ECG

Answer 10

• 150-250 bpm
• wide QRS complex (> .14s)
• extreme RAD
• Q wave in V6

Question 11

what does SVT look like on ECG

Answer 11

• 160-180 bpm
• narrow QRS complex
• p waves tend to merge with preceding T or U wave

Question 12

what does a-fib look like on ECG

Answer 12

• 350-600 bpm
• continual, chaotic atrial spikes
• undulating baseline
• no discernable p waves
• irregular R-R interval
• irregularly irregular ventricular rhythm

Question 13

what does a 1st degree AV block look like on ECG

Answer 13

• prolonged PR interval (>1 large square)