Chapter 9 PowerPoint Flashcards
What occurs in normal ventricle depolarization?
L to Right from intraventricular septum
Simultaneous ventricular depol from inside out.
Bundle branch blocks can happen on the ____ and ____ side?
Bundle branch blocks can happen on the Right and Left side
What is a RBBB?
Delay in Depolarization of R Ventricle due to abnormal conduction
Signs and symptoms of A RBBB?
Non-pathologic – seen in healthy, asymptomatic
S/S – Bradycardia, Presyncope, Syncope
How does a RBBB appear on an ECG?
ECG appearance
Wide QRS complex > .10sec in V1
rSR’ pattern in V1
Inverted T wave (strain pattern)
Wide S wave in Lead I and V6
9 causes of a RBBB?
Causes: Aging, MI, COPD, HR changes, atrial septal defect, Myocarditis, hypertension, scar tissue post Heart surgery, pulmonary embolism
Pulmonary embolism
COPD
Aging
Atrial septal defect
HR changes
Hypertension
Myocarditis
Scar tissue post-heart surgery
MI
Treatment for a RBBB?
NONE!
What is a LBBB?
Delay of Depol in L Ventricle bc of conduction abnormality
What is the first clinical sign to underlying heart disease?
LBBB
What waves are lost when depolarization occurs from right to left (LBBB)?
Normal septal Q & R waves lost in Left leads
How does an ECG with a LBBB appear?
> .10sec QRS complex
Wide “W” neg QS in R chest leads
ST-T seg are opposite direction as QRS complex
Missing Q wave in L chest leads
Tall Notched RR’ or M pattern in L chest leads
L axis deviation
Causes of a LBBB (7)?
Aortic Stenosis
Acute MI
Myocarditis
Extensive CAD
Chronic hypertension
Congestive heart failure
LV hypertrophy
What is the most common conduction issue with anterior MI?
LBBB
What abnormality is often seen during an exercise stress tests and resolves during recovery?
LBBB
Treatment of a LBBB?
Full cardiac eval
Pacemaker
