Cardiology Flashcards
How do you identify a Left Anterior Hemiblock on a 12-lead?
Normal QRS duration, left pathologic axis
(Lead 1 up
Lead 2 down or indeterminate
Lead 3 down)
Electricity -30 to -90
How do you identify a left posterior fascicular block?
Normal QRS duration. Right axis deviation
Lead 1 down
Lead 2 and 3 up
90 to 180 electricity
What is a bifascicular block?
Rbbb and a hemi-block
How do you identify a bifascicular block (RBBB and LAFB)
Prolonged QRS interval
Upward S wave in V1
Left axis deviation (left anterior fascicular block) (pathological)
How do you identify a bifascicular block (RBBB and LPFB)
Prolonged QRS duration
No evidence of RV
Rbbb present in V1
Right axis deviation
What leads should normally be negative?
V1 and aVR
How do you identify WPW syndrome?
Short PR interval
Lengthened QRS
“Delta” wave
Type A: QRS is primarily up V1 & V2
(Route LA to LV)
Type B: QRS is primarily down in V1 & V2
(Route RA to RV)
What are the 12-lead characteristics of hypokalemia?
Flat T, prolonged QT and prominent U wave
What are the 12-lead characteristics of hyperkalemia?
Peaked T waves
Flattened P waves
Prolonged PR interval
Widened QRS
What are the 12-lead characteristics of hypocalcemia?
Prolonged QTc
May cause T wave inversion
What are the 12-lead characteristics of hypercalcemia?
Shortened QTc
May cause sharply rise to a peak
What are the 12-lead characteristics of hypomagnesemia?
May be associated with hypokalemia and/or hypocalcemia
Prolonged QTc may precipitate torsades
Digitalis toxicity effects to heart
Bradycardia
AV blocks
Prolonged PR interval
Flattened T wave
Shortened QTc interval
Swooping ST segment (senor dali effect, mustache)
Quinidine toxicity effects
T waves are depressed and widened
Later T waves are notched then inverted
Prominent U waves
Prolonged QTc
Widened QRS complex (late finding)
TCA Tricyclic antidepressants OD
(Ending in pine or ine)
Prolonged QTc
Widened QRS-intervals
Ventricular arrhythmias
AV blacks/bundle branch blocks
What are the inferior leads and what vessel supplies them?
II, III, aVF
RCA
(Recip changes in 1, aVL)
What are the septal leads and what vessel supplies them?
V1, V2
LAD
What are the anterior leads and what vessel supplies them?
V3, V4
LAD
(Recip changes in II, III, aVF)
What are the lateral leads and what vessel supplies them?
I, aVL, V5, V6
Circumflex
(Recip changes in II, III, aVF)
What are the posterior leads and what vessel supplies them?
V7, V8, V9
Reciprocal findings in V1-V4
RCA (in some circumflex)
What are the right ventricular leads and what vessel supplies them?
V1R-V6R
RCA (and in some Circumflex)
Describe diastolic HF
Ventricles are failing to fill adequately prior to systole (need to increase pre-load)
