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Z 2nd Exam Exercise Cardiology > Chapter 7 PowerPoint > Flashcards

Chapter 7 PowerPoint Flashcards

1
Q

What leads to look at for axis deviation?

A

Lead I
aVf

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2
Q

+ lead 1 and + aVf?

A

Normal QRS axis

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3
Q

+ lead 1 and - aVf?

A

Left axis deviation

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4
Q
  • lead 1 and + aVf?
A

Right axis deviation

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5
Q
  • lead 1 and - aVf?
A

Extreme axis deviation

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6
Q

Chamber enlargements can be seen on ____?

A

ECG’s

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7
Q

How do chamber enlargements present themselves on ECGs?

A

Changes are noted in Amplitude, morphology, and duration of P wave, QRS complex, T wave or ST segments

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8
Q

What are the 3 different ways a chamber can be enlarged?

A

Increases in Tissue mass, Chamber Diameter, Intracardial Blood Volume

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9
Q

What is RAE?

A

Right Atrial Enlargement
Any condition that increases pressure to the right atria

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10
Q

4 different causes/pathophysiology of RAE?

A

Pulmonary system usually causing the pressure increases
-Atrial stenosis
-Pulmonary dysfunction
-Myocardial tissue scarring
-Atrial shunts

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11
Q

How does RAE appear on an ECG?

A

ECG appearance
Tall, symmetrical, peaked P waves in lead 2, >2.5mm
Biphasic P wave in V1
Pos > Neg portion

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12
Q

7 causes of RAE?

A

COPD
Obstructive Sleep Apnea
Tricuspid Valve Disease
Pulmonary Embolism
Cystic Fibrosis
Scarring of lung Tissue
Severe Kyphoscoliosis

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13
Q

Treatment for RAE (3)?

A

Benign
Focus is on treating Pulmonary conditions
Preventing clots
-Small clots are not deadly but damaging
-Large clots can lead to quick death

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14
Q

Pulmonary embolism has same signs and symptoms of ____?

A

MI

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15
Q

What does LAE result from (5)?

A

Left Atrial Enlargement
Results from Pressure overload associated with increased LV filling.
High Cardiac Output, Mitral Valve regurgitation, Arteriovenous fistula, L to R Shunt

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16
Q

How does LAE appear on an ECG?

A

ECG appearance
Wider than normal P wave, >.12 sec in Lead II
Biphasic P wave in V1, Neg>Pos, >1mm, >1mm Deep

17
Q

4 causes of LAE?

A

Chronic hypertension
Heart failure

Mitral valve insufficiencies
Atrial Fibrillation

18
Q

What typically occurs before LAE?

A

LVH

19
Q

Treatment for LAE?

A

BP meds to stabilize LAE, manage by preventing enlargement
(No other specific treatment)

20
Q

People who are ____ are at an increased risk of stroke?

A

Obese

21
Q

Signs and symptoms of RVH?

A

Right ventricular hypertrophy (Often benign and asymptomatic)

If symptomatic, often respiratory issues: dyspnea, dizziness, syncope, edema of ankles & feet, frequent episodes of sinus tachycardia

22
Q

How does RVH appear on an ECG?

A

R axis deviation >100°
Tall R waves in V1 & V2 > 7mm
RS ratio > 1 in V1 & V2
R Ventricular strain pattern [V1 and V2}
Down slopping ST segment w/ inverted T wave
(May be seen in Limb Leads II, III, aVf)
Deep s wave in L chest leads

23
Q

What may or may not be present with RVH?

A

RAE may or may not be present

24
Q

6 causes of RVH?

A

RV must work harder to circulate Blood to Pulmonary Artery
-COPD
-Pulmonary Valve Stenosis
-Pulmonary Hypertension
-Chronic Mitral Stenosis
-Congenital Lesions
-Tetralogy of fallot

25
Q

Treatment for RVH?

A

ID underlying condition
Medications focused on breathlessness and respiratory restrictions
Pacemaker if HR needs regulated

26
Q

With pulmonary disease, everything ____ goes ____?

A

With pulmonary disease, everything Right goes wrong

27
Q

What four things can go wrong? (Clinical Tip: With pulmonary disease, everything Right goes wrong)

A

Right Axis Deviation
Right Atrial Enlargement
Right Ventricular Hypertrophy
Right Bundle Branch Block

28
Q

What is LVH?

A

Left ventricular hypertrophy
Myocardial Blood Flow issues
Development of Diastolic dysfunction
-Increase in Diastolic pressure at rest and exercise
-Decrease in ejection fracture leading to congestive heart failure

29
Q

What does LVH lead to if untreated?

A

If untreated LVH leads to Ventricular Arrythmias leading to sudden death

30
Q

The appearance of ECG with LVH?

A

QRS complex increase
Taller than normal R waves
Deeper than normal S waves
S wave in V1 or V2 plus R wave in V5 or V6 > 35mm
LV strain pattern (Down slop ST segment and w/ inverted T wave)
Back up criteria
R wave > 11mm in aVL
S Wave in Lead I plus R Wave in Lead III > 25mm

31
Q

Why does an ECG with LVH look the way it does?

A

ECG Appearances – As walls thicken, electrical impulses take longer to cross and arrive at epicardium

32
Q

What is Romhilt-Estes Score?

A

A unique composite ECG criterion that determines probability of LVH

33
Q

8 causes of LVH?

A

Stimulus of SNS
Chronic Systolic Hypertension
Elevated afterload
Aortic stenosis and insufficiency
Increased filling of LV
Coronary artery disease
Genetics
Mitral insufficiency

34
Q

Treatment for LVH?

A

Control hypertension
Angiotensin II receptor blocker (ARB)
Angiotensin- Converting enzyme inhibitor (ACE)

Z 2nd Exam Exercise Cardiology (6 decks)

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