Advanced 12-Lead EKG

Question 1

Bipolar Limb Leads

Answer 1

Question 2

Augmented Limb Leads

Answer 2

Question 3

Precordial Leads

Answer 3

Question 4

Atrial hypertrophy

Answer 4

Question 5

Diagnosis of right atrial hypertrophy

Answer 5

could be caused by tricuspid stenosis

Question 6

Diagnosis of left atrial hypertrophy

Answer 6

caused by left heart failure d/t systemic HTN

mitral stenosis

aortic stenosis

massive MI

2nd half of humpity larger

Question 7

Ventricular hypertrophy

Answer 7

Question 8

Diagnosis of right ventricular hypertrophy

Answer 8

Question 9

Diagnosis of left ventricular hypertrophy

Answer 9

Question 10

Ischemia, Injury, and Infarct

Answer 10

Question 11

Myocardial ischemia

Answer 11

Question 12

Myocardial injury

Answer 12

• Signifies that the MI is “acute” as in right now! This is a STEMI; pain is heavy from arm to jaw, hard to breathe
• Pericarditis- looks like ST elevation but its all across the 12-lead and maybe can hear rub and the pain is different
• Prinzmetal’s- can look like ST elevation; but it’s more of a spasm; responds well to CCB’s

Question 13

Reciprocal changes

Answer 13

• Supports diagnosis of STEMI
• Increased likelihood of complications
• High specificity
• Looking at opposite direction

Question 14

Myocardial infarction (non-transmural) NSTEMI a little less severe than STEMI

Answer 14

• Temporarily/resolving
• Excessive supply/demand: stress test
• Prolonged
• St- depression
• If they have the MI story

Question 15

Myocardial infarct (transmural

Answer 15

• “old” will have Q waves: (-) deflection (away from a (+) electrode
• Dead muscle doesn’t contract or depolarize
• Must be significant…1mm wide or 2mm deep or 1/3 QRS tall and 2 contiguous leads

Question 16

Poor R wave progression-
old mi

Answer 16

Question 17

Location of infarct

Answer 17

Question 18

Coronary arteries of infarct

Answer 18

Question 19

Axis deviation

Answer 19

Question 20

right axis deviation

Answer 20

• QRS is negative in Lead I
• Vertical heart
• RVH
• Anterolateral MI

Question 21

left axis deviation

Answer 21

• QRS positive in Lead I But negative in AVF
• Inferior MI
• Left ventricular hypertrophy
• Obesity

pregnancy

Question 22

look at P wave for all things related to the

Answer 22

atrai

Question 23

look at QRS for all things related to the

Answer 23

ventricle

Question 24

Answer 24

left atrial hypertrophy

Question 25

Answer 25

anterior lateral ischemia

lft ventricular hypertrophy

Question 27

Answer 27

inferior MI

w/ reciprocal changes

may also be junctional d/t no P wave

Question 28

Answer 28

acute anterior septal STEMI

Question 29

Answer 29

old MI inferior

inferior ischemia