Cardiology and 12-Lead Interpretation Flashcards
Your patient is having a massive inferior wall MI. What vessel is most likely occluded?
Right Coronary Artery
Your patient is in cardiogenic shock and you suspect this patient is having an infarct in their left ventricle (“Widow maker”). What vessel is most likely occluded?
Left Coronary Artery
If left without input, a single cardiac cell will contract rhythmically at a steady rate. If two cells are in contact, the first one to contract will in turn stimulate the other to contract. This characteristic of cardiac cells is called:
automaticity
T/F: During systole, sodium and calcium move out of the cells.
False
T/F: Potassium is primarily an intracellular ion.
True
____________ is the amount of blood ejected from the ventricles with each contraction.
Stroke volume
What is the formula for determining mean arterial pressure (MAP)?
[(2 x diastolic) + systolic] / 3
You are treating a patient complaining of severe chest pain that is made worse when the patient lays flat and is relieved when the patient leans forward. What cardiac condition should you suspect?
Pericarditis
T/F: An abdominal aortic aneurysm typically occurs between the renal and inferior mesenteric arteries.
True
What is the main risk for morbidity or mortality regarding non-bacterial thrombotic endocarditis (NBTE)?
A clot breaking loose and lodging in the heart or brain.
You are treating a 55-year-old male IV drug user and alcoholic. The patient is having excruciating pain in his back, abdominal rigidity, and has a blood pressure of 52/P. What condition should you suspect?
Abdominal Aortic Aneurysm Rupture
You are transporting a 78-year-old female who just received a diagnostic heart cath (a major blockage was found). The patient is now being transported to a larger facility for open heart surgery. During transport, the patient has sudden onset of chest pain, severe back pain that progresses down her flank, and is extremely diaphoretic. She tells you that it feels like something “just tore inside me”. You are seeing signs of ischemia in several leads when you perform a 12 lead. What should you suspect?
She is having an aortic dissection caused by her heart cath.
What is the target heart rate range and the target systolic blood pressure range for a patient with an abdominal aortic aneurysm (AAA)?
HR of 60 - 80
Systolic BP of 100 - 120
T/F: Atropine is typically the medication used for a bradycardic patient with a suspected AAA.
False, an AAA is a contraindication for administering atropine.
T/F: Hypertensive urgency is when organ damage occurs as a result of hypertension.
False, hypertensive emergencies are when organ damage occurs as a result of hypertension.
Mean arterial pressures should not be lowered more than ____% in the first hour of treatment for patients with hypertensive emergency.
20
If blood pressure is lowered too rapidly in a patient with hypertensive emergency, what condition can occur?
watershed stroke
T/F: A NSTEMI typically indicates a partial obstruction of the coronary artery.
True
T/F: An MI can often present as general malaise and weakness in the elderly without specific cardiac signs and symptoms.
True
T/F: All patients who have an MI will develop a “Q” wave.
False
Aside from cardiac related events, a CK-MB value may also be elevated in patients with ______________________.
skeletal injuries
T/F: Slightly elevated Troponin levels can still be indicative of damage to the heart muscle.
True
T/F: High flow oxygen is indicated for all patients with a suspected MI.
False
In a hemodynamically unstable cardiogenic shock patient, what intervention should you perform to maintain an adequate heart rate?
Pacing
When a cardiac cell is depolarized, _______ charges are on the outside and ________ charges are on the inside of the cell.
negative, positive
What is the optimal patient position for obtaining a 12 lead EKG?
supine
When obtaining a 12 lead, you decide to place the limb leads on the patient’s trunk. Upon printing out the strip, you should:
note on the strip that the limb leads were placed on the trunk.
What are the bipolar leads?
I, II, III
T/F: The “P” wave should typically be upright in leads II, III, and aVF and have a duration less than 0.1 seconds.
True
An elevation or depression of the ST segment of ____ mm or more above the isoelectric line may be indicative of myocardial injury or ischemia.
1
You are treating a 22-year-old female who developed sudden onset chest pain and shortness of breath. You observe “Q” waves in Lead III. What condition should you suspect?
Pulmonary embolus
Axis determination can be used to assist in diagnosing which of the following?
a) atrial fibrillation vs atrial tachycardia
b) the presence of hemiblocks
c) myocardial infarction vs angina
d) mitral valve prolapse
b) the presence of hemiblocks
T/F: The electrical impulse that travels towards the electrode is seen as a negative inflection on the EKG tracing.
False, it is seen as a positive inflection
In regards to axis deviation, what is the axis orientation when you observe upright QRS complexes in leads I, II, and III?
This is a normal axis
In regards to axis deviation, what is the axis orientation when you observe upright QRS complexes in lead I, and downward QRS complexes in lead II and III?
This is a pathological left axis
T/F: A right axis deviation is a normal finding in pediatrics, but may indicate a posterior hemiblock in adults.
True
Which leads look at the inferior surface of the left ventricle?
Leads II, III, and aVF
T/F: Acute MI’s cannot be determined if a left bundle branch clock is present.
True
T/F: Sodium is the primary extracellular ion.
True
Your patient is in Torsades de pointes. Should you expect this patient to be hypokalemic or hyperkalemic?
hypokalemic
You are transporting a 75-year-old female with heart failure. You notice on her EKG that she has a prolonged QT interval. She appears to have ST elevation in multiple leads, but her Troponin and CPK are negative. What should you suspect?
Hypocalcemia
T/F: If the QRS duration exceeds 0.12 seconds, then there may be a bundle branch block.
True
T/F: An anterior MI is usually more massive than an inferior MI because the left anterior descending (LAD) artery is the largest coronary artery so its blockage results in a massive infarct.
True
