Chapter 10: Miscellaneous Flashcards
What 3 important life-threatening syndromes can be detected from the EKG in relatively asymptomatic patients?
Brugada Syndrome
Wellens Syndrome
Long QT Syndrome
(p. 310)
What are the key EKG features of Brugada syndrome?
RBBB with ST elevation in V1, V2, and V3
p. 310
What are the key EKG features of Wellens syndrome and what do they suggest?
Marked T wave inversion in V2 and V3, suggest [left] anterior descending coronary stenosis
(p. 310)
What are the key EKG features of Long QT Syndrome? Implications?
QT interval longer than 1/2 of the cardiac cycle; this predisposes the patient to ventricular arrhythmias
(p. 310)
What treatment is indicated for Brugada Syndrome?
a pacer (AICD) (p. 310)
What treatment is indicated for Wellens syndrome?
angioplasty with stenting, or CABG
p. 310
How many forms of (hereditary) Long QT Syndrome are there?
6
p. 310
On EKG, COPD often produces…
What other conditions appear with the first feature?
…low voltage amplitude in all leads, and there is usually right axis deviation. Multifocal atrial tachycardia is also seen with COPD.
Low voltage in all leads appears in hypothyroidism and chronic constrictive pericarditis.
(p. 311)
With COPD, the right ventricle works against considerable __________, so there is usually some degree of _____ ___________ ___________ and therefore, associated _____ axis deviation. The example shows negative QRS’s in lead I.
resistance
right ventricular hypertrophy
right
(p. 311)
With pulmonary embolus, we usually see…
…a large S wave in lead I, ST depression in lead II, and a Q wave with inverted T wave in lead III. Remember: S1, Q3, T3
Pulmonary embolus also causes T wave inversion in V1 - V4, and frequently a RBBB.
(p. 312-313)
S1Q3T3 syndrome characterizes acute ___ _________ resulting from pulmonary embolus.
cor pulmonale
p. 312
Pulmonary embolus typically has a tendency toward…
…right axis deviation.
p. 312
With elevated serum potassium, the P wave ________ ____, the QRS complex ______, and the T wave becomes ______.
flattens down, widens, peaked
p. 314
In hyperkalemia, the P wave widens and flattens, and with extreme hyperkalemia, the P wave ______ __________.
nearly disappears.
p. 314
The QRS in hyperkalemia widens because…
…ventricular depolarization takes longer.
p. 314
In HYPOkalemia, the T wave becomes ____ or ________ and a _ ____ appears.
flat, inverted, U wave
p. 315
The U wave in hypokalemia becomes more…
…pronounced as the loss of K becomes more severe.
p. 315
Hypokalemia makes ventricular foci…
…and enhances the toxic effects of…
…extremely irritable,
…digitalis excess.
p. 315