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EKG > Criteria > Flashcards

Criteria Flashcards

1
Q

Right atrial enlargement (P pulmonale)

A

Lead II and V1 (高>2.5格 in inferior leads)

  • No change in duration
  • Possible R axis dev.
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2
Q

Left atrial enlargement (P mitrale)

A

Lead II and V1 (terminal/negative portion 寬>1格)

*No L axis dev due to dominance

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3
Q

RVH

A

Limb leads: QRS R axis dev (>+100)

Precordial leads: R>S in V1, S>R in V6

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4
Q

LVH

A 
Limb leads:
       # R I + S III >25 mm (25 小格)
       # R VL > 13
       # R I > 14
       # R VF > 21
Precordail leads:
       # R V5/V6 + S V1/V2 > 35 mm
       # R V5 > 26
       # R V6 > 18
       # R V6> R V5

*Axis dev little help due to L predominance

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5
Q

Secondary repolarization abnormalities of ventricular hypertrophy

A

1) Down-sloping ST
2) T wave inversion

  • RVH: V1, V2
  • LVH: I, aVL, V5, V6
  • decompensated HTN–> CHF
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6
Q

RBBB

A
  1. QRS> 0.12 sec (3格)
  2. RSR’ in V1 and V2 (rabbit ears) with ST-depression and T inversion
  3. Reciprocal change in V5, V6, I, aVL (deep S waves)
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7
Q

LBBB

A
  1. QRS> 0.12 sec (3格)
  2. Notched R wave with prolonged upstroke in V5, V6, I, aVL with ST-depression and T inversion
  3. Reciprocal change in V1, V2 (deep S waves)
  4. L axis dev may present
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8
Q

Left anterior hemiblock

A
  1. Normal QRS, ST, T
  2. L axis dev b/t -30 to -90 degrees
  3. No other cause of L axis dev is present
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9
Q

Left posterior hemiblock

A
  1. Normal QRS, ST, T
  2. R axis dev b/t +90 to +180 degrees
  3. No other cause of R axis dev is present
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10
Q

Bifascicular block

A

RBBB + R or L fascicular hemiblock

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11
Q

WPW syndrome

Wolff-Parkinson-White

A
  1. PR less than 0.12 sec
  2. Wide QRS
  3. Delta wave in some leads
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12
Q

LGL syndrome

Lown-Ganong-Levine

A
  1. PR less than 0.12 sec
  2. Normal QRS
  3. No delta wave
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13
Q

Significant Q wave

A
  1. Wide: >0.04 sec (1格)

2. Deep: >1/3 R in the same QRS

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14
Q

Posterior MI

A

STD and tall R in anterior leads (esp V1)

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15
Q

Who needs emergent reperfusion?

A
  1. STE≥ 1 mm in two contiguous leads (incl posterior)
  2. New/resumed new LBBB
  3. LBBB (new/old) with Sgarbossa criteria
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16
Q

Modified Sgarbossa criteria

A
  1. STE≥ 1mm concordant with QRS in ANY lead
  2. STD≥ 1mm concordant with QRS in ANY of V1-V3
  3. Excessive discordant STE in ANY lead by ≥ 25% of the depth of the preceding S-wave
17
Q

Does new LBBB mean AMI?

A

No

18
Q

STD in treadmill that is suggestive of CAD

A

STD> 1 mm that is horizontal or down-sloping and persists for ≥ 0.08 sec

19
Q

Corrected QT interval (QTc)

A

QT divided by square root of RR

*

20
Q

HOCM

A
  1. Ventricular hypertrophy
  2. L axis dev
  3. Significant septal Q in lateral and inferior leads
21
Q

COPD

A
  1. Low voltage (dampening from expanded RV)
  2. R axis dev (expanded lungs)
  3. RVH with repolarization abnormalities (poor R propagation)
  4. Cor pulmonale
22
Q

EKG change suggestive of acute massive PE

A
  1. Pattern of RVH with repolarization abnormalities(RV dilatation)
  2. RBBB
  3. S1Q3
  4. Arrhythmias: sinus tachycardia, A Fib
23
Q

CNS diseases (ex. infarct, SAH)

A
  1. Diffuse T inversion (wide and deep)
  2. U waves
  3. Possible sinus bradycardia
24
Q

EKG of Brugada syndrome

A
  1. Pattern of RBBB

2. STE in V1-V3

25
Q

Most common EKG change in myocarditis

A

Conduction blocks (esp. BBB, hemiblock)

26
Q

EKG change in digitalis intoxication

A
  1. Conduction blocks (SA node, AV node–> for Rx suprraventricular arrhythmia)
  2. Tachyarrhythmias (enhances automatics: PAT and PVC»junctional>A flutter and A Fib)
  3. Combination (most common: PAT+second-degree AV block 2:1)
27
Q

What is digitalis effect of therapeutic blood levels? need discontinuing the drug?

A

STD (gradual down-sloping) + flat or inverted T

NO.

28
Q

EKG change in hypothermia

A

Everything slows down!

  1. Sinus bradycardia
  2. All segments/intervals prolong
  3. Osborne wave (= J wave)
  4. Slow A Fib
  5. Muscle tremor artifact
29
Q

EKG change in hypo-Ca

A

Long QR –> TdP!

30
Q

EKG change in hyper-Ca

A

Short QT

31
Q

EKG change in hypo-K

A
  1. STD
  2. T flattens
  3. U wave presents
32
Q

EKG change in hyper-K

A
  1. Peak T diffusely
  2. PR prolongs, then P flattens
  3. Wide QRS
  4. QRS merges with T = VF
33
Q

EKG changes in non-Q wave infarctions

A
  1. T inversion

2. ST depression

EKG (2 decks)

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