Advanced 12-Lead EKG Flashcards
Bipolar Limb Leads
Augmented Limb Leads
Precordial Leads
Atrial hypertrophy
Diagnosis of right atrial hypertrophy
could be caused by tricuspid stenosis
Diagnosis of left atrial hypertrophy
caused by left heart failure d/t systemic HTN
mitral stenosis
aortic stenosis
massive MI
2nd half of humpity larger
Ventricular hypertrophy
Diagnosis of right ventricular hypertrophy
Diagnosis of left ventricular hypertrophy
Ischemia, Injury, and Infarct
Myocardial ischemia
Myocardial injury
- 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
Reciprocal changes
- Supports diagnosis of STEMI
- Increased likelihood of complications
- High specificity
- Looking at opposite direction
Myocardial infarction (non-transmural) NSTEMI a little less severe than STEMI
- Temporarily/resolving
- Excessive supply/demand: stress test
- Prolonged
- St- depression
- If they have the MI story
Myocardial infarct (transmural
- “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
Poor R wave progression-
old mi
Location of infarct
Coronary arteries of infarct
Axis deviation
right axis deviation
- QRS is negative in Lead I
- Vertical heart
- RVH
- Anterolateral MI
left axis deviation
- QRS positive in Lead I But negative in AVF
- Inferior MI
- Left ventricular hypertrophy
- Obesity
pregnancy
look at P wave for all things related to the
atrai
look at QRS for all things related to the
ventricle
left atrial hypertrophy
