advanced ECGs Flashcards
what can an abnormal p wave suggest
- conduction delay often caused by an atria being enlarged
what is pr interval
onset of p wave to start of qrs
what is normal pr interval
120 - 200 millisecond
what causes a prolonged pr interval
prolonged p wave interval caused by a delay conduction through the av node
shortened pr intervals cause patients to be more susceptible to what?
more susceptible to reentrant tachycardia
normal width for QRS is…
.12 seconds
what does lower amplitude indicate?
loss of viable myocardium or dampid effect of lots of fluid, fat, and tissue in the way
what is electrical alternanas?
QRS complexes that alternate in height
what does electrical alternans indicate?
indicates massive pericardial effusion
what are low voltage amplitude measurements for limb leads and precordial leads?
<5 and <10 respectivly
qt c measurement for men and women
men - 350 - 440
women - 350 - 460
over 500 milliseconds of qt interval increases risk for what deadly rhythm?
torsads de pointes
characteristics of digitalis toxicity on ECG
- ST depression
- Flat inverted or biphasic T waves
- Short QT
OR - SVT with slow ventricular response
what is the voltage criteria for LVH
V1 or V2 (s wave) + V5 or V6 (R wave) must = >35mm
and
T wave inversion and ST depression in V6
what can cause Right ventricular hypertrophy?
- PE
- chronic lung disease
- Pulmonary HTN
what are the ECG characteristics of RVH
- right axsis deviation
- dominant R wave in V1
- inverted T waves
what is the values for significant ST elevations in men ages <40 and >40 in V2 and V3
<40 : 2.5mm
>40 : 2.0mm
what is the value for ST elevation for women in V2 and V3
1.5mm
what are the characteristics of De Winter T waves
- tall symmetric T waves
- ST depression with upsloping in V1-V6
- 0.5 mm elevation in aVR
what coronary artery is effected when you see De Winter T waves
Proximal LAD involvement
what is wellens syndrom specefic of?
critical stenosis of the LAD
what is the risk of wellens syndrome
risk for extensive anterior MI
what is the characteristics of wellens syndrome
- biphasic or inverted T waves in V2 - V3 and the patient has no pain
what is type 1 wellens syndrome?
- inverted T wave
what is type 2 wellens
- biphasic t wave
what can cause ST elevation in AVR?
- LMCA stenosis
- LAD stenosis
- Severe tripplr vessel disease
- hypoxia following ROSC
what is the criterioa for LMCA occlusion?
- > 1mm of ST elevation in AVR and more than lead 1
- ST depression in 6 or more leads
what is brugada syndrome
- 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
risk factors for unmasking brugadas
- fever
- sodium channel blockers
- alcohol and drugs
- hypothermia
what is considered the classic sign of PE?
S1Q3T3
- s wave in lead 1
- q wave in lead 3
and inverted T wave in lead 3
what are other findings for PE in ECGs
- sinus tach
- RBBB
- RV strain pattern
- Right axsis deviation
- non specific ST segment
- T wave changes
at birth which ventricle is thicker and what ecg picture does this produce
right ventricles
- right ventricular hypertrophy
- marked rightward axsis deviation
- dominant r wave in v1
- t wave inversion in v1 - v3
- shorter PR and QRS
what are the risk factors for Vtach in a kid?
- open heart surgery
- cardiomyopathys
- myocarditis
-0 oncological treatment
what could cause VF in a kid
- Long QT syndrome
- brugadas syndrome
- cardiomyopathy
- structural heart disease
- chest trauma
what could cause thirdegree AV block in a kid?
- maternal lupus
- transposition of great arteries
what age can IN glucagon be administered to?
> = 4 years
what is the dose for IN glucagon?
3mg
