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EKG > Basics > Flashcards

Basics Flashcards

1
Q

Wolf-Parkinson-White Syndrome

A

Bundle of Kent. PR interval is less than 0.12. Wide QRS with Delta waves.

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2
Q

Atrial Fibrillation

A

Artial rate is greater than 350. Ventricular rate varies. Chaotic baseline (fibrillatory waves). Irregularly Irregular.

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3
Q

Hypothermia

A

All intervals are prolonged. Osborne waves: ST elevation with abrupt ascent at the J point and plunge back to baseline. Slow A-fib.

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4
Q

Interpolated PVCs

A

PVC that falls between two regular complexes and don’t disrupt the normal cardiac cycle.

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5
Q

Sinus Node Dysfunction

A

Degenerative disease of the elderly. Periods of bradycardia, tachycardia and prolonged pauses.

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6
Q

Myocardial Ischemia

A

ST Depression greater than 1mm in 2 or more leads. Inverted or tall peaked T waves ( larger than 6mm in limb leads and 12mm in precordial leads). T wave becomes more symmetrical.

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7
Q

Sinus Arrest

A

SA node transiently stops and 3 or more beats are lost.

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8
Q

Second Degree Heart Block Type II

A

“mobitz” 2:1 conduction. PR interval is prolonged but constant. Intermittently a P wave is not followed by a QRS

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9
Q

Ventricular Fibrillation

A

Chaotic baseline. No heart contraction.

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10
Q

Lown-Ganong-Levine Sydrome

A

James fibers. PR less than 0.12. Normal QRS. Absence of Delta waves.

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11
Q

Junctional escape rhythm

A

Rate of 40-60. Inverted P waves (P waves can be inverted, absent or after the QRS) with short PR interval.

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12
Q

Lead II position on axis

A

+60 degrees

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13
Q

Anterior MI

A

Changes in V1-V4

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14
Q

Bundle Branch Blocks

A

Prolonged QRS. Must be greater than 0.12 seconds. RR’ configuration (rabbit ears) in the chest leads.

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15
Q

Anteroseptal MI

A

V1-V3

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16
Q

Drugs that prolong the QT interval

A

Quinidine, Procainamide (pronestyl), disopyramide (norpace), amiodarone (cordarone), sotalol (betapace), TCAs, Phenothiazines, Erythromycin.

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17
Q

Hypocalcemia

A

QT prolongation. Easily progresses to torsades or V-tach.

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18
Q

Third Degree Heart Block

A

Upright and round P waves “march” through the QRS complexes. No association between the P waves or the QRS complexes.

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19
Q

Multifocal Atrial Tachycardia

A

Rate of 120-150. Irregular rhythm. Similar to wandering atrial pacemaker but a faster rate.

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20
Q

aVF

A

Towards the Foot. Inferior view of the heart.

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21
Q

Hemiblocks

A

Change in the axis without a change in the duration of the QRS.

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22
Q

Small Square Height

A

1 mm or 0.1 mv

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23
Q

Electrical Alterans

A

Changing amplitude of the QRS complex

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24
Q

Large Box Duration

A

0.20 Seconds

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25
Q

Second Degree Heart Block Type I

A

“wenckebach” PR interval progressively increases until a QRS complex is dropped and then the cycle repeats.

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26
Q

Atrial Dysrhytmia Characteristics

A

P waves will differ in appearance, abnormal/shortened/prolonged PR interval. QRS complexes will appear normal.

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27
Q

Left Posterior Hemiblock

A

Right axis deviation (greater than +120 or +180), Normal QRS duration. Have to exclude other causes of RAD. Best to use subsequent EKGs.

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28
Q

Bifasicular Block

A

RBBB with LAHB or LPHB. RBBB features with axis deviation.

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29
Q

Right Atrial Enlargement Criteria

A

P wave larger than 2.5mm and/or if biphasic: The initial component is taller than the terminal component. Can also have RVH, Right Axis Deviation and/or V1 R wave is greater than the S wave.

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30
Q

Premature Ventricular Complexes

A

Early beat . Wide QRS.

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31
Q

Premature Junctional Complex

A

Early impulse that arises from the AV node. Inverted P waves (P waves can be inverted, absent or after the QRS). Short PR interval. Followed by a noncompensatory pause.

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32
Q

Right Ventricular Hypertrophy Criteria

A

Right axis deviation (greater than +90 degrees) V1: R wave greater than the S wave V6: S wave greater than the R wave

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33
Q

Multifocal PVC

A

PVCs look different

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34
Q

Hypercalcemia

A

Increased PR interval and QRS complex. Bundle branch and AV blocks. Shortened refractory period (short ST and QT).

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35
Q

Unifocal PVC

A

PVCs look the same

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36
Q

QT Interval Duration

A

0.36-0.44 seconds (9-11 small squares)

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37
Q

Inferior MI

A

Leads II, III and aVF.

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38
Q

First Degree Heart Block

A

Consistent delay of conduction at the AV node. Consistently prolonged PR interval. Regular rhythm.

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39
Q

Anterolateral MI

A

V1/2-V5/6

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40
Q

Atrial Tachycardia

A

Rate of 150-250. P waves will appear different. the PR interval will be shorter than normal.

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41
Q

Left Anterior Hemiblock

A

Left Axis Deviation (-45 to -90), Tall R waves in lead I, Deep S waves in avf, Normal QRS duration.

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42
Q

R-on-T PVC

A

PVCs occuring on/near the previous T wave. Can precipitate V-Tach or V-Fib.

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43
Q

Q wave duration

A

less than 0.04 seconds (one small square)

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44
Q

Pulseless Electrical Activity

A

Organized ECG rhythm but patient is pulseless. Associated with severe underlying heart disease.

45
Q

T wave height

A

5mm in limb leads, 10mm in precordial leads

46
Q

Normal Electrical Axis

A

Down and to the left. From 0 to +90 degrees.

47
Q

Prior Infarction

A

Pathologic Q waves in the absence of ST segment or T wave abnormalities.

48
Q

Ventricular Dysrhythmias Characteristics

A

Wide/bizarre QRS complexes. T waves in the opposite direction of the R wave. Absence of a P wave.

49
Q

Sinus Pause

A

SA node transiently stops and 1-2 beats are lost.

50
Q

Idioventricular Rhythm

A

Rate of 40-100. Wide bizarre QRS with no P waves.

51
Q

Ventricular Tachycardia

A

Rate of 100-250. Regular rhythm. No P waves. Wide/bizarre QRS. Can occur with/without a pulse.

52
Q

Small Square Duration

A

0.04 seconds

53
Q

Polymorphic V-Tach

A

The appearance of each QRS varies.

54
Q

Sinus Dysrhythmia

A

Patterned irregularity. Cycle of slowing then speeding. HR increases with inspiration and decreases with expiration.

55
Q

Wandering Atrial Pacemaker

A

Normal rate. Slightly irregular rhythm. P waves that change in appearance from beat-to-beat. The PR interval varies.

56
Q

Lead I position on axis

A

0 degrees

57
Q

Premature Atrial Complexes

A

Irregular rhythm due to early beat. P wave will appear different then the underlying rhythm. QRS complex is normal. Followed by a non compensatory pause.

58
Q

Evolution of a Q-Wave MI

A

1.) Hyperacute T wave changes with ST elevation 2.) Marked ST elevation 3.) Pathologic Q waves with less ST elevation, Terminal T wave inversion 4.) Pathologic Q waves with T wave inversion 5.) Pathologic Q waves with upright T waves

59
Q

Right Deviation Axis

A

Between +90 and +180 degrees

60
Q

Accelerated Junctional Rhythm

A

Rate of 60-100. Inverted P waves (P waves can be inverted, absent or after the QRS) with short PR interval.

61
Q

Brugada Syndrome

A

Autosomal Dominant. Variable St elevation abnormalities. Less than 30 yo, more common in Asians. Treat with an ICD.

62
Q

aVL

A

Towards Left Arm. Lateral view of the heart.

63
Q

PR Interval Duration

A

0.12-0.20 seconds (3 to 5 small squares)

64
Q

Right Atrial Enlargement Leads

A

Lead II and V1 are most helpful

65
Q

P wave duration

A

0.06-0.10 seconds (1.5 to 2.5 small squares)

66
Q

Left Circumflex Artery

A

Left atrium, anterolateral, posterolateral and posterior left ventricle.

67
Q

Lead II

A

From Right arm to the Left leg. Inferior view of the heart.

68
Q

aVR

A

Towards Right Arm. Views base of the heart.

69
Q

Posterior MI

A

Reciprocal (ST depression) changes in V1-V3. R waves longer than 0.04 seconds and larger than the S wave. Patient is greater than 30 yo.

70
Q

Pulmonary Embolism

A

Sinus Bradycardia is most commmon. RBBB in V1-V3. Signs of RAE or RAD. S1 Q3 T3 pattern (Large S wave in lead 1, Deep Q wave and inverted T wave in lead 3).

71
Q

Couplet PVC

A

Two PVCs in a row

72
Q

Supraventricular Tachycardia

A

P waves can’t be identified so can’t determine is atrial or junctional.

73
Q

aVR position on axis

A

-150 degrees

74
Q

Pathological Q Waves

A

Longer than 0.04 seconds. 1/3 the height of the R wave (or deeper than 1mm). Present in at least two leads.

75
Q

Digoxin Toxicity

A

AV blocks, Tachy-Dysrhythmias. Paroxysmal Atrial Tachycardia with second degree AV block is most common.

76
Q

Pericarditis with Effusion

A

Low Voltage EKG. With diffuse ST elevation. Electircal Alterans.

77
Q

Incomplete Bundle Branch Block

A

RR’ Configuration with a normal QRS interval

78
Q

Torsades De Pointes

A

Polymorphic V-tach. “twisting about the points”

79
Q

Atrial Flutter

A

Atrial rate of 250-350. Absent P waves with saw-tooth flutter waves. The number of impulses conducted through the AV node determines the ventricular rate.

80
Q

Pericarditis

A

Diffuse ST elevation

81
Q

Large Box Height

A

5 mm or 0.5 mv

82
Q

Monomorphic V-Tach

A

Each QRS looks similar.

83
Q

Junctional Tachycardia

A

Rate of 100-180. Inverted P waves (P waves can be inverted, absent or after the QRS) with short PR interval.

84
Q

Left Deviation Axis

A

Between 0 and -90 degrees

85
Q

QRS complex Amplitude

A

5-30 mm

86
Q

QRS Complex Duration

A

0.06-0.11 seconds (1.5 to 2.75 small squares)

87
Q

Lateral MI

A

Lead I, aVL, V5-V6

88
Q

Hyperkalemia

A

Tall, peaked T waves. Flattened P waves. First degree AV block. Widened QRS. Merging of S and T waves producing a “sine-wave” pattern.

89
Q

P wave Amplitude

A

0.5-2.5 mm

90
Q

aVL position on axis

A

-30 degrees

91
Q

Right Bundle Branch Block

A

Prolonged QRS (Greater than 0.12), M-shaped RR’ in V1, Wide S-wave in Lead I and V6. T wave is in opposite direction as the terminal portion of the QRS (if they were same direction it would be indicative of ST-T changes).

92
Q

Lead I

A

From the Right arm to the Left arm. Lateral view of the heart.

93
Q

Junctional Dysrhytmias Characteristics

A

P waves can be inverted, absent or after the QRS. the QRS is normal.

94
Q

Left Anterior Descending Artery

A

Anterior/lateral left ventricle, anterior 2/3 of the septum, right and left bundle branches.

95
Q

Nonspecific Intraventricular Conduction Deficits

A

Prolonged QRS without features of RBBB or LBBB

96
Q

Myocardial Infarction

A

ST elevation greater than 1mm in 2 or more leads. Release of cardiac enzymes.

97
Q

Conditions with Right Atrial Enlargement

A

Pulmonic or tricuspid stenosis and tricuspid regurgitation.

98
Q

Hypokalemia

A

U waves (extra wave after the T, may be more prominent than the T wave). Flattening of the T wave. ST depression.

99
Q

Accelerated Idioventricular Rhythm

A

Rate of 40-100. Wide bizarre QRS with no P waves.

100
Q

Right Coronary Artery

A

Right atrium, Right ventricle and inferior/posterior walls of the left ventricle.

101
Q

Left Bundle Branch Block

A

Prolonged QRS with a wide R wave (flat or notched top) in leads I and V6.

102
Q

Lead III position on axis

A

+120 degrees

103
Q

aVF position on axis

A

+90 degrees

104
Q

Asystole

A

Absence of any cardiac activity. Flat line.

105
Q

Septal MI

A

V1-V2

106
Q

“Digoxin Effect”

A

Expected with therapeutic levels. Shortened QT. Flattened T waves. Asymmetric ST depression and T wave inversion in leads with tall R waves. Gradual down slope of the ST.

107
Q

Left Ventricular Hypertrophy Criteria

A

Sum of the deepest S in V1/V2 and the tallest R wave in V5/V6 is greater than 35mm R wave in aVL is greater than 11mm Sum of the R wave in Lead I and the S wave in Lead III is greater than 25mm

108
Q

Lead III

A

From Left arm to the Left leg. Inferior view of the heart.

109
Q

Left Atrial Enlargement Criteria

A

P wave duration longer than 0.10 seconds in the frontal plane (Lead II) often with notching. V1: Terminal potion of the P wave is negative, duration greater than 0.04 seconds and depth greater than 1mm.

EKG (1 decks)

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