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EKG > 4 > Flashcards

4 Flashcards

1
Q

B. PR Interval - SHORT (<0.12 sec)

A

Pre-Excitation Syndromes

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2
Q

for which AV block do you have NSR

A

1st degree AV

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3
Q

why would you see an . AV block type 1

4

A

enhanced vagal tone
or congenital
acute MI or
electrolyte imabalances

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4
Q

what PRI do we see with 1st degree AV block

A

greater than .2 seconds

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5
Q

second degree AV block type I is usually due to

A

result of myocardial damage or atrial hypertrophy

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6
Q

sxs of av block 2 type 1

A

irregular heartbeat

Light-headedness, dizziness, or syncope (more common in type II)

Chest pain, if the heart block is related to myocarditis or ischemia

A regularly irregular heartbeat

Bradycardia may be present

Symptomatic patients may have signs of hypoperfusion, including hypotension

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7
Q

sxs of seocnd degree av block type 2

A

Light-headedness, dizziness, or syncope (more common than in type I)

Chest pain, if the heart block is related to myocarditis or ischemia

A regularly irregular heartbeat

Bradycardia may be present

Symptomatic patients may have signs of hypoperfusion, including hypotension

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8
Q

3 degree AV block is seen as what measurement

A

if the P to P interval is regular

R to R IS can also regular

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9
Q

for 3rd degree AV blocks the tx is a

A

pacemaker

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10
Q

when do you need a pacemaker for a block

A

second degree type two and third degree block

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11
Q

CCB and BB in AV blocks

A

use with caution because they can block further

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12
Q

Pre-Excitation Syndromes two major ones

A

wolf . parkinsons white and

lown ganong levine

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13
Q

In Pre-Excitation Syndromes two major ones we see Early activation of the ventricles due to

A

” Early activation of the ventricles due to impulses bypassing the AV node via an accessory pathway.

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14
Q

bundle of kent

A

pathophysiolog of WPW

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15
Q

James fibers

A

exist in the AV node and the issue with Lown Ganong Levine

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16
Q

Accessory pathways are formed during cardiac development and can exist in a variety of anatomical locations includin

A

anterograde =towards the ventricle
retrograde= away from the ventricle

but majority of the time= it goes in both direction

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17
Q

what is the major risk for a patient with pre excitation syndrome with accessory pathways in both direction

A

three impulses going on at the same time and therefore you risk the pt PSVT

paroxysmal supraventricular tachycardia

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18
Q

delta wave symbolizes

A

signal fomr bundle of kent

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19
Q

which pre excitation syndrome is more common?

how many of those are symptomatic

A

WPW

50-60% become symptomatic

first peak early childhood 2nd peak in young adulthood

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20
Q

syncope

palpations syncope in young adult?

A

need ECG work up for WPW

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21
Q

bundle of kent is located in what part of the heart

A

can be on either side of the atrium L or R

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22
Q

two types of WPW

A

” Type A (MC): Kent’s –> LV: tall R waves in V1 & V2)

“ Type B: Kent’s –> RV:

23
Q

what is the difference in ECK finding with LGL and WPW

A

No Delta Wave)

24
Q

TYPICAL FINDINGS with type B WPW

A

predominantly NEGATIVE R waves & Delta waves in V1 & V2, deep QS waves
in V1& V2 –> anteroseptal pseudoinfarct

25
Q

Type A WPW is different than type b b/c

A

tall R wave in V1 and V2

26
Q

what V1 and V2 findings do you see with Type B

A

RS QS waves are negative in v1 and V2

27
Q

WPW if left untreated will cause

A

Can cause ventricular fibrillation & sudden death. Be suspicious of a healthy, young patient w/ syncopal episode.

need to cardiovert them and find out the underlying problem

28
Q

TX of WPW

A

Stable/asymptomatic—> Cardiology referral.

Patient dying? D/C cardioversion or Unsynchronized

Radiofrequency catheter ablation - heats the tissue enough to destroy the accessory pathway.

29
Q

QRS Interval - LONG (>0.12 sec) indicates

A

C. QRS Interval - LONG (>0.12 sec) —?>Bundle Branch Blocks (LBBB vs. RBBB)

Recall ventricular depolarization = 0.08-0.12 sec (2-3 small boxes

30
Q

BBB on EKG in what lead as what

A

R- S-R prime in V1 or bunny ears

SLURRED s WAVE IN v6

31
Q

RBB

A

left ventricle contracting first followed by the right ventricle

32
Q

S wave in RBBB

A

goes down to the isoelectric line

can go below too

33
Q

Left BBB in what lead as what

A

R knotch R seen in v6

34
Q

what leads do you look at to diagnose BBB

A

V1 and V6

35
Q

What is more common LBB or RBBB

A

RBBB

36
Q

RBBB is usually caused by

A

usually caused by MI

37
Q

LBBB usually indicated

A

possible MI

38
Q

in V1 LBBB will be

A

QRS deeply negative

39
Q

V5 V6

A

QRS wide

40
Q

two types of fascicular blocks

A

Left anterior fascicular block

Left posterior fascicular block

41
Q

Left anterior fascicular blocks are commonly seen with what other EKG finding

A

LAD

42
Q

left posterior fascicular blocks are usually associated with

A

RAD

43
Q

hemiblocks are also known as

A

fascicular blocks

44
Q

V1 rabbit ears
V6 slurred S wave
with LAD

A

left anterior block with RBBB

also known as a bi-fascicular block

45
Q

QRS intervals are long can be the result of these 4 situtations

A

> .12

bb BLOCKS
fascicular/hemiblockes
premature ventricular contraction
idioventircular rhythm

46
Q

A long QT is interval can be the sign of what electrolyte imbalnces

A

hypokalemia
hypomagnesemia
hypocalcemia

47
Q

second degree block type one is the result of

A

myocardial damage or atrial hypertrophy

48
Q

which pre-excitation syndrome is intranodal

A

Lown Ganong Levine

exists around the AV node

49
Q

paroxysmal supraventricular tachycardia (PSVT) usually arises through a ___________

A

paroxysmal supraventricular tachycardia (PSVT) usually arises through a reentrant mechanism.

50
Q

ventricular escape would be seen as

A

20-40 bpm

51
Q

junctional escape would be seen as

A

40-60 bpm

52
Q

unifocal and bifocal as well as trigemeny and bigemeney refer to

A

PVC

seen with wide opposing T

53
Q

first you’re cute and then you’re slurred

A

RBBB

54
Q

first you hit the floor hard then you’re a couple of small bunny ears

A

LBBB

EKG (7 decks)

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