Clinical cases ECG

Question 1

sinus tachycardia

Answer 1

HR is greater than 100

Normal physiologic response: Pregnancy, emotion, anxiety, fear, exertion

Pathological: drugs, hyerpthyroid, fever, pregnancy, anemia, congestive herat failure (CHF), hypovolemia

Question 2

Sinus Bradycardia

Answer 2

HR less than 60

normal or pathologic

causes: vagal response sleep apnea, meds, MI, increased ICP, hypothyroid

Question 3

what are the three different types of premature beats

Answer 3

Premature beat is an irritable focus spontaneously fires a single stimulus

• Premature atrial beat
• premature junctional beat
• premature ventricular beat

Question 4

Premature Atrial contraction

Answer 4

often seen in absence of significant heart disease

associated with stress, alcohol, tobacco, coffee, COPD and CAD (coronary artery disease)

Question 5

Premature ventricular COntraction

Answer 5

many causes:

• Normal
• stress
• hypoxia
• Drugs: Nicotine, caffeine, thyroid, aminophylline, digitalis, intoxication, albuterol
• heart failre
• Acute myocardial infarction
• Ischemic heart disease
• Electrolyte disorder: hypokalemia, hyperkalemia, hypomagnesemia

also called PVC

wider QRS
-take a longer time because not going through SA or HIS

Question 6

Ventricular Tachycardia

Answer 6

VTACH

Nonsustained/sustained/pulseless

wide complex

causes: multiple, ex. coronary heart disease, heart failure, hypertropic cardiomyopathy, congenital heart disease, electrolyte abnormalities

Question 7

Torsades des Pointes

Answer 7

form of V tach that cauuses oscilations on the EKG and looks like a party streamer

treat with Mg+

Question 8

Supraventricular Tachycardia

Answer 8

SVT PSVT

narrow complex and a fast HR

cauuses: thyroid disease, caffeine, medications with stimulants or stress can cause an episode

atrial rate usually greater than 160-180 narrow and regular

At atrial rates greater than approximately 140 beats per minute the p wave tends to merge into the preceding T or U wave making the P wave identification difficult

stable: vagal mvmts
unstable: shock

Question 9

Atrial Fibrillation

Answer 9

atrial rate is greater than 350-600/min, undulating baseline, no discernible P waves, irregular RR interval (QRS complex) iregularly iregular ventricle rhythm

cases: hypertensive heart disease, valvular heart disease, CHF, CAD, obesity, DM, metabolic syndrome, chronic kidney disease

Question 10

1prime AV block

Answer 10

Long PR interval

PR remains consistently lengthened cycle to cycle