Cardiovascular and Pulmonary: Interpretation of ECG's Flashcards
Calculate Heart Rate: Large boxes
- Count the number of QRS complex peaks in a 6 second strip and multiply by 10.
- Each large box, outlined by a dark line=0.2 seconds therefore you need 30 large boxes to=6 seconds
- If heart rate is irregular use the longest strip possible up to one minute.
Calculate Heart Rate: Small boxes
- Count the number of small boxes between two adjacent QRS complex peaks and divide by 1500.
- Each small box=0.04 seconds.
Arrhythmias: Ventricular
- Conduction in the ventricles outside the normal conduction system
- Significant in adversely affecting cardiac output
Arrhythmias: Ventricular: Premature Ventricular Contraction
- Premature beat arising from the ventricle
- Sometimes occurs occasionally in the majority of the population
Arrhythmias: Ventricular: Premature Ventricular Contraction: Presentation on ECG’s
- No p wave
- Premature and wide QRS
- Long compensatory pause
Arrhythmias: Ventricular: Premature Ventricular Contraction:
- Serious of greater than 6 PVC’s per minute
Arrhythmias: Ventricular: Premature Ventricular Contraction: R on T phenomenon
- Very early PVC
- Sharp drop in conduction just before and continuous with T wave
Arrhythmias: Ventricular: Ventricular Tachycardia (V-tach)
- Four or more PVC’s occurring sequentially
- Very rapid rate 150-200bpm
Arrhythmias: Ventricular: Ventricular Tachycardia: Non-sustained V-Tach
- Four or more PVC’s terminating spontaneously in less than 30 seconds
Arrhythmias: Ventricular: Ventricular Tachycardia: Sustained V-Tach
- Four or more PVC’s for duration greater than 30 seconds.
- May require termination due to hemodynamic response
Arrhythmias: Ventricular: Ventricular Fibrillation (V-fib)
- Chaotic electrical activity in the ventricle originating from multiple places outside the normal conduction pathway.
- Is an emergency and will require a medical treatment with CPR and defibrillation
Arrhythmias: Ventricular: Ventricular Fibrillation: Presentation on ECG’s
- No QRS complexes
- No effective cardiac output
Arrhythmias: Atrial
- Electrical signaling from outside the sinus node in the atria
Arrhythmias: Atrial: General presentation on ECG’s
- P waves will be abnormal
Arrhythmias: Atrial: Atrial fibrillation
- Non-identifiable p-waves
- P waves will be close to flat lined with QRS complexes
- P waves will be difficult to identify from QRS complexes
- Greater than 300bpm HR
Arrhythmias: Atrial: Atrial Tachycardia
- Several heart beats in a short period of time initiated at the atria, indicated by a p wave, followed by several QRS complexes over a few seconds.
- P waves during rapid QRS complex portion of ECG will be difficulty to define from T waves of previous QRS complex and initiation of following QRS complex
- 140-250bpm
Arrhythmias: Atrial: Atrial Flutter
- Several P waves in a sawtooth pattern between QRS complexes
- 250-350bpm
Arrhythmias: Atrioventricular Blocks
- Abnormal delays or lack of conduction in conduction system.
- Conduction from the atria to the ventricles is blocked or delayed.
Arrhythmias: Atrioventricular Blocks: First Degree
- Condition of abnormally slow conduction through the AV node.
- Defined by ECG changes that include a PR interval of greater than 0.20 without disruption of atrial to ventricular conduction.
Arrhythmias: Atrioventricular Blocks: Second Degree
- Conduction of atrial impulse through the AV node and/or His bundle is delayed or blocked
Arrhythmias: Atrioventricular Blocks: Second Degree: Mobitz Type I
- Conduction is slowed usually due to high vagal tone not typically associated with structural heart disease.
- Gradual prolongation of PR interval until block occurs
Arrhythmias: Atrioventricular Blocks: Second Degree: Mobitz Type II
- Conduction is slowed often associated with structural heart disease
- Constant PR interval before a block occurs
- Can progress to a Third degree AV block
Arrhythmias: Atrioventricular Blocks: Third Degree
- Complete block
- Can be life threatening
- Requires medication, pacemaker or surgery
Arrhythmias: Atrioventricular Blocks: Third Degree: Presentation in ECG
- No conduction through the AV node
- Complete dissociation between the atria and the ventricles
- Random dissociated P waves and QRS complexes on an ECG
Arrhythmias: ST segment Changes: Impaired coronary perfusion
- Lowered ST segment
Arrhythmias: ST segment Changes
- ST changes of greater than 1mm on 2 consequeitve leads is considered abnormal EXCEPT in leads V2 and V3
Arrhythmias: ST segment Changes: Gender and Age
- ST elevation of greater than or equal to 2mm in men over 40
- ST segment elevation of greater than 2.5mm in Men under 40
- ST segment elevation of greater than 1.5mm in women
