advanced ECGs

Question 1

what can an abnormal p wave suggest

Answer 1

• conduction delay often caused by an atria being enlarged

Question 2

what is pr interval

Answer 2

onset of p wave to start of qrs

Question 3

what is normal pr interval

Answer 3

120 - 200 millisecond

Question 4

what causes a prolonged pr interval

Answer 4

prolonged p wave interval caused by a delay conduction through the av node

Question 5

shortened pr intervals cause patients to be more susceptible to what?

Answer 5

more susceptible to reentrant tachycardia

Question 6

normal width for QRS is…

Answer 6

.12 seconds

Question 7

what does lower amplitude indicate?

Answer 7

loss of viable myocardium or dampid effect of lots of fluid, fat, and tissue in the way

Question 8

what is electrical alternanas?

Answer 8

QRS complexes that alternate in height

Question 9

what does electrical alternans indicate?

Answer 9

indicates massive pericardial effusion

Question 10

what are low voltage amplitude measurements for limb leads and precordial leads?

Answer 10

<5 and <10 respectivly

Question 11

qt c measurement for men and women

Answer 11

men - 350 - 440
women - 350 - 460

Question 12

over 500 milliseconds of qt interval increases risk for what deadly rhythm?

Answer 12

torsads de pointes

Question 13

characteristics of digitalis toxicity on ECG

Answer 13

• ST depression
• Flat inverted or biphasic T waves
• Short QT
  OR
• SVT with slow ventricular response

Question 14

what is the voltage criteria for LVH

Answer 14

V1 or V2 (s wave) + V5 or V6 (R wave) must = >35mm
and
T wave inversion and ST depression in V6

Question 15

what can cause Right ventricular hypertrophy?

Answer 15

• PE
• chronic lung disease
• Pulmonary HTN

Question 16

what are the ECG characteristics of RVH

Answer 16

• right axsis deviation
• dominant R wave in V1
• inverted T waves

Question 17

what is the values for significant ST elevations in men ages <40 and >40 in V2 and V3

Answer 17

<40 : 2.5mm
>40 : 2.0mm

Question 18

what is the value for ST elevation for women in V2 and V3

Answer 18

1.5mm

Question 19

what are the characteristics of De Winter T waves

Answer 19

• tall symmetric T waves
• ST depression with upsloping in V1-V6
• 0.5 mm elevation in aVR

Question 20

what coronary artery is effected when you see De Winter T waves

Answer 20

Proximal LAD involvement

Question 21

what is wellens syndrom specefic of?

Answer 21

critical stenosis of the LAD

Question 22

what is the risk of wellens syndrome

Answer 22

risk for extensive anterior MI

Question 23

what is the characteristics of wellens syndrome

Answer 23

• biphasic or inverted T waves in V2 - V3 and the patient has no pain

Question 24

what is type 1 wellens syndrome?

Answer 24

• inverted T wave

Question 25

what is type 2 wellens

Answer 25

- biphasic t wave

Question 26

what can cause ST elevation in AVR?

Answer 26

- LMCA stenosis - LAD stenosis - Severe tripplr vessel disease - hypoxia following ROSC

Question 27

what is the criterioa for LMCA occlusion?

Answer 27

- >1mm of ST elevation in AVR and more than lead 1 - ST depression in 6 or more leads

Question 29

what is brugada syndrome

Answer 29

- inherited disease the predisposes individuals to cardiac disrythmias - 8 to 10 times more common in males - southeast Asian - 41 is the mean age - 4% of all sudden cardiac deaths

Question 30

risk factors for unmasking brugadas

Answer 30

- fever - sodium channel blockers - alcohol and drugs - hypothermia

Question 31

what is considered the classic sign of PE?

Answer 31

S1Q3T3 - s wave in lead 1 - q wave in lead 3 and inverted T wave in lead 3

Question 32

what are other findings for PE in ECGs

Answer 32

- sinus tach - RBBB - RV strain pattern - Right axsis deviation - non specific ST segment - T wave changes

Question 33

at birth which ventricle is thicker and what ecg picture does this produce

Answer 33

right ventricles - right ventricular hypertrophy - marked rightward axsis deviation - dominant r wave in v1 - t wave inversion in v1 - v3 - shorter PR and QRS

Question 34

what are the risk factors for Vtach in a kid?

Answer 34

- open heart surgery - cardiomyopathys - myocarditis -0 oncological treatment

Question 35

what could cause VF in a kid

Answer 35

- Long QT syndrome - brugadas syndrome - cardiomyopathy - structural heart disease - chest trauma

Question 36

what could cause thirdegree AV block in a kid?

Answer 36

- maternal lupus - transposition of great arteries

Question 37

what age can IN glucagon be administered to?

Answer 37

>= 4 years

Question 38

what is the dose for IN glucagon?

Answer 38

3mg