Abnormal ECG

Question 1

• What cardiovascular condition is seen here?

Answer 1

• Sinus tachycardia
• PR interval may be shortened
• QT interval is shorter

Question 2

• What is shown in the following image?

Answer 2

• Sinus bradycardia
• Normal appearance of cardiac cycle, longer periods in diastole

Question 3

• What is shown on the images below?

Answer 3

• Premature atrial contraction (PAC)
• RR interval between PAC and preceding beat is shorter than normal

Question 4

• What is shown on the images below?

Answer 4

• PVC
• RR interval is shorter than normal
• NO P WAVE PRIOR TO QRS COMPLEX
• T wave is abnormal
• Compensatory pause after the PVC

Question 5

• What is shown in the image below?

Answer 5

• Ventricular tachycardia

Question 6

• What is shown on the image below?

Answer 6

• Atrial fibrillation
• P waves absent
• QRS and T waves are normal
• Looks like “noise” in the baseline

Question 7

• Be able to distinguish between the following disease states

Answer 7

• See image

Question 8

• What is shown in the following image?

Answer 8

• Ventricular fibrillation
• Usually a PVC preceding it

Question 9

• What is different about ventricular flutter compared to ventricular fibrillation?

Answer 9

• V flutter is usually more rounded and less of a saw tooth appearance than ventricular fibrillation

Question 10

• How can you identify a SA Nodal Block?

Answer 10

• Usually intermittent
• Only effect is a missed beat

Question 11

• What characterizes a first degree AV block?

Answer 11

• Prolonged PR interval (>0.2 sec)
• EVERY P WAVE IS FOLLOWED BY A QRS

Question 12

• What characterizes a second degree AV block (specifically a Mobitz II)

Answer 12

• NOT EVERY P WAVE IS FOLLOWED BY A QRS COMPLEX
  REGULAR PATTERN OF MISSED QRS COMPLEXES

Question 13

• What characterizes a second degree AV block (Mobitz 1/Weckeback)

Answer 13

• PR interval gets progressively longer in a series of beats until a QRS is dropped completely
• QRS complexes that do occur are result of depolarization in the SA node
• Pulse is irregular

Question 14

• What characterizes a third degree AV block?

Answer 14

• Complete dissociation of P wave and QRS complexes
• Atrial rate higher than normal because the slow ventricular rate leads to a decrease in systemic blood pressure
• QRS complex is dependent on ventricular pacemaker
• If Bundle of His takes over as the ventricular pacemaker, junctional rhythm will be present

Question 15

• What is shown on the following image?

Answer 15

• 1st degree AV block

Question 16

• What is shown on the following image?

Answer 16

• Mobitz I (Weckeback) 2nd degree AV block

Question 17

• What is shown on the following image?

Answer 17

• Mobitz 2 Second Degree AV block

Question 18

• What is shown in the image below?

Answer 18

• 3rd degree AV block

Question 19

• In which leads can you best see a RBBB?
• What are the characteristics of ANY type of BBB?

Answer 19

• Leads V1 and V2 (septal leads)
• Bunny ear appearance
• T wave abnormal
• QRS complex prolongesd (>0.12 sec)
• Amplitude of QRS increased

Question 20

• What is shown in the image below

Answer 20

• RBBB