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PTRS 826 Exam 2 > Abnormal EKG > Flashcards

Abnormal EKG Flashcards

1
Q

Describe the purpose of the delay at the AV node

A

To optimize ventricular filling

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2
Q

Decribe the plateau during repolarization of the ventricles (ST segment)

A

Contraction CANNOT occuring during this time

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3
Q

_____1_____ of amoung grouping of EKGs are important because _______2______ across leads can solidify an ______3______.

A
  1. Patterns
  2. Inconsistencies
  3. Abnormality
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4
Q

_1_ waves tend to be taller in runners due to ___2___ ______3______

A
  1. T
  2. Rapid
  3. Repolarization
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5
Q

Describe normal sinus rhythm (5)

A
  1. Rate 60-100 bpm
  2. Contains P wave
  3. QRS for every P wave
  4. R waves are equidistant
  5. Contains T wave
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6
Q

Describe sinus arrhythmia (3)

A
  1. R waves not equidistant
  2. More beat to beat variability than normal
  3. More likely in those with smaller chest walls and narrow AP distance
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7
Q

Describe why it is important that there be beat to beat variability with heart rate.

A

It indicates that the heart is appropriately adapting to changes in altered thoracic pressure [from breathing]

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8
Q

Describe sinus bradycardia (4)

A
  1. Normal in athletes, on beta blockers, with decreased SA node function
  2. Generally asymptomatic unless pathologic condition exists
  3. May c/o dizziness, syncope, angina
  4. Concerning in elderly - decreased contraction force + slow HR = decreased Q, O2 to tissue
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9
Q

Describe sinus tachycardia (3)

A
  1. Generally benign, SA node automaticity increased
  2. T and P wave may be closer together, P wave may be difficult to see
  3. Pts. asymptomatic
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10
Q

List the causes of sinus tachycardia

A
  1. Stress
  2. Caffeine
  3. Sleep deprivation
  4. Pregnancy
  5. Obesity
  6. Over training
  7. Exercise
  8. Sickness
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11
Q

Describe sinus exit block (2)

A
  1. Block in conduction of impulse from SA node to atria
  2. Pause equal to 2 complete cardiac cycles
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12
Q

Describe Premature atrial contraction (PAC) (4)

A
  1. Ectopic focus in either atria initiates and impulse before the next impulse initiated by the SA node
  2. P wave less rounded, more peaked, comes faster after the T wave [or may be buried]
  3. Low frequency = asymptomatic; Increased frequency = a-tach or a-fib may result
  4. Q not effected b/c presence of P wave allowed time for filling
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13
Q

Describe Atrial Tachycardia (4)

A

AKA supraventricular tachycardia

  1. HR 100-200 bpm
  2. P wave may be difficult to define
  3. Q compromised if prolonged
  4. Sx include dizziness, fatigue, SOB
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14
Q

List the causes of atrial tachycardia (4)

A
  1. PAC
  2. Pulmonary HTN
  3. Altered pH
  4. COPD
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15
Q

Describe atrial flutter (4)

A
  1. Rapid rate due to the firing of an ectopic source in the atria
  2. Q not compromised unless ventricular rate becomes too high
  3. Extra P waves that have a saw tooth appearance
  4. Arrhythmia coming from ONE area
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16
Q

List the causes of atrial flutter (8)

A
  1. Mitral valve disease
  2. CAD
  3. Infarction
  4. Stress
  5. Renal failure
  6. Pericarditis
  7. Rheumatic heart disease
  8. MI
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17
Q

Describe atrial fibrillation (6)

A
  1. Erratic quivering of atria
  2. Multiple ectopic foci
  3. No true depolarization of atria
  4. AV node acts to control ventricles
  5. Can’t make out a P wave - not clear and discernable
  6. At risk for stroke
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18
Q

List the causes of atrial fibrillation (8)

A
  1. Advanced age
  2. CHF
  3. Ischemia/Infarction
  4. Cardiomyopathy
  5. Digoxin toxicity
  6. Drug use
  7. Stress/Pain
  8. Renal Failure
19
Q

List the problems associated with atrial fibrillation

A
  1. No atrial kick [responsible for 30% of Q]
  2. Ventricular rate < 100 at rest monitor w/exercise for Q compensation
  3. Ventricular rate > 100 at rest monitor w/all activities and engaged in w/caution
  4. Likely to have Q decompensation w/ventricular rate > 100
20
Q

Define RVR

A

Rapid ventricular rate, > 100 bpm

21
Q

Describe premature junctional contraction (3)

A
  1. P wave missing prior to QRS
  2. QRS fairly normal
  3. SA node didn’t fire
22
Q

Describe junctional escape rhythm (4)

A
  1. SA node not functioning properly
  2. AV junction takes over, ventricular rate 40-60 bpm
  3. No P waves, QRS a little wider, inverted T wave
  4. Low Q = dizziness, fatigue, SOB, angina
23
Q

List the causes for junctional escape rhythm (4)

A
  1. Increased vagal tone
  2. Digoxin toxicity
  3. Infarction
  4. Severe ischemia to conduction system (R CAD)
24
Q

Define unifocal PVC

A

Arrhythmia coming from one place in the ventricle

25
Q

Define multifocal PVC

A

Arrhythmia coming from more than one place in the ventricle

26
Q

The more PVCs that occur in a row the more _______1______ the __2__

A
  1. Compromised
  2. Q
27
Q

List the causes of PVCs (9)

A
  1. Caffeine
  2. Nicotine
  3. Stress
  4. Overexertion
  5. Electrolyte imbalance
  6. Ischemia/Acute Infarction
  7. Cardiac disease
  8. CHF
  9. Overdistention of ventricle
  10. Chronic lung disease/Hypoxemia
28
Q

List the name for 2 and 3 beat PVCs

A

2 = bigeminy

3 = trigeminy

29
Q

Describe the effect of increased fequency of PVCs (5)

A
  1. Filling time of ventricles decreased
  2. Decreased pre-load, SV, Q
  3. Dizziness, SOB
  4. Activity can be compromised, monitor activity
  5. Can lead to ventricular tachycardia
30
Q

Describe the effect on Q following any delay in the cardiac cycle

A

Larger Q following any delay

31
Q

Describe ventricular tachycardia (4)

A
  1. Only QRS waves
  2. Q and BP greatly diminished
  3. Sx: light-headedness, syncope, weak thready pulse, disorientation
  4. Non-shockable, do CPR, will only be upright for 10-15 sec
32
Q

List the causes of ventricular tachycardia (4)

A
  1. Ischemia
  2. Acute infarction
  3. Hypertensive heart disease
  4. Reaction to meds (digoxin)
33
Q

Describe ventricular fibrillation (4)

A
  1. Sequel to ventricular tachycardia
  2. Life-threatening, emergency
  3. Shockable rhythm
  4. Can lead to a-systole
34
Q

Abnormal rhythm: looks like v-tach, begin close to baseline, gradually increasing and decreasing in a repeating pattern. Medical emergency

A

Torsades de Pointes

35
Q

Describe idioventricular rhythm (5)

A
  1. 20-40 bpm
  2. Absent P wave, paced low
  3. Small R wave
  4. Probably in lead V1-2
  5. Not sustainable for life, can cause death
36
Q

Describe a 1st degree heart block (4)

A
  1. Increased PR interval
  2. Delayed signal at AV nodes
  3. Normal QRS
  4. Asymptomatic unless bradycardic
37
Q

List the causes of 1st degree heart block (3)

A
  1. CAD
  2. Infarction
  3. Reacting to digoxin
38
Q

Describe 2nd degree heart block type 1 (3)

A

AKA Wenckebach

  1. Benign arrythmia, generally asymptomatic
  2. Not a QRS for every P wave
  3. P wave gets longer, longer, skips a beat
39
Q

List the causes of 2nd degree block type 1 (4)

A
  1. Right CAD
  2. Infarction
  3. Digoxin toxicity
  4. Excessive beta blocker
40
Q

Describe a 2nd degree block type 2 (3)

A
  1. Multiple missing QRS complexes
  2. PR interval normal, P waves punctual/right on time
  3. Symptomatic when HR is low and Q compromised
41
Q

List the causes of 2nd degree heart block type 2 (3)

A
  1. MI (esp. LAD)
  2. Ischemia/infarction of AV node
  3. Digoxin toxicity
42
Q

Describe 3rd degree heart block (3)

A

AKA complete block

  1. Random P, QRS a little wider
  2. No rhyme or reason to anything
  3. P and QRS act as 2 independent systems
43
Q

List the causes of 3rd degree heart block (3)

A
  1. Acute MI
  2. Digoxin toxicity
  3. Degeneration of conduction system
44
Q

Describe Pacemaker Rhythms (Ventricular)

A

A properly functioning pacemaker will show a sharp spike, followed immediately by depolarization of the chamber it is intended to pace.

**Note absence of mappable P waves and sharp spikes followed immediately by wide QRS complexes.

PTRS 826 Exam 2 (10 decks)

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