Drugs/Electrolyte Effects (Exam #2) Flashcards
What condition involves diffuse ST segment elevation?
Pericarditis
With Acute Pericarditis, what two findings may be seen on EKG?
- Diffuse ST segment elevation
- T wave inversion
What is seen on EKG with Pericarditis WITH Effusion?
Low voltage/amplitude in all leads
What is Electrical Alternans, and what condition may it be seen with?
Amplitude of QRS alternates with every other beat
- Seen with Pericarditis
What specific finding may be seen on EKG with a small PE? What if it’s a massive PE?
- Small PE: sinus tachycardia
- Massive PE: S1-Q3-(upside-down T)3 = deep S wave in lead I, deep Q wave in lead III, inverted T wave in lead III
What condition involves S1-Q3-(upside T)3, and what does this mean?
Massive PE
- Deep S wave in lead I
- Deep Q wave in lead III
- Inverted T wave in lead III
What rhythm finding is commonly seen with a PE?
Tachyarrhythmias
What is QTc Interval? When is it considered prolonged for male vs. female?
QTcI = depolarization and repolarization corrected for HR
- Prolonged QTcI for MALES = 0.44+ seconds
- Prolonged QTcI for FEMALES = 0.46+ seconds
What are you at increased risk of with QTc Interval of 0.50+ seconds?
TdP
What is a visual hint for a normal QT interval?
Normal QTI is less than HALF the R-R interval
What is a general rule for all HYPO- electrolyte abnormalities? What are you at increased risk for?
QTI prolongation
- Increased risk of VTach or TdP
What three specific findings are seen on EKG with Hyperkalemia?
- Tall/peaked T waves
- “Sine waves” = S and T waves merge/indistinguishable
- Wide QRS
What specific finding is seen on EKG with Hypokalemia?
U waves following flat T waves
What are “sine waves”, and what condition are they seen with?
S and T waves merge/indistinguishable
- Seen with Hyperkalemia
What condition involves U waves?
Hypokalemia
What two abnormalities/drugs involve shortened QTI?
- Hypercalcemia
- Digoxin (therapeutic levels, worse if toxicity)
What electrolyte abnormality involves shortened QTI, and why is this?
Hypercalcemia
- Shortened refractory period
What specific finding is seen on EKG with Hypercalcemia?
Shortened QTI
What specific finding is seen on EKG with Hypocalcemia?
Prolonged QTI
What EKG finding is seen with general Digoxin use?
Shortened QTI
What two EKG findings are seen with “Digoxin Effect”?
- Shortened QTI
- Gradual downward curve of ST segment
What two EKG findings are seen with Digoxin toxicity?
- WORSE shortened QTI
- Tachydysrhythmia
What is the most common tachydysrhythmia associated with Digoxin toxicity?
PAT with 2nd degree AV block (2:1)
What abnormality makes Digoxin toxicity worse?
Hypokalemia
What specific finding is seen on EKG with Hypothermia?
Osborn waves
What are Osborn waves, and what condition are they associated with?
Hypothermia
- Osborn waves = ST segment elevation then abrupt ascent at J point then plunge back to baseline
What three things are prolonged with Hypothermia?
- PRI
- QRS
- QTI
What condition is associated with sudden cardiac death? What is its etiology?
Brugada Syndrome
- Autosomal Dominant disorder
What EKG finding is seen with Brugada Syndrome?
Variable ST segment elevation abnormalities in V1-V3 (3 types)
What condition involves variable ST segment elevation abnormalities in V1-V3?
Brugada Syndrome
What five abnormalities/drugs involve prolonged QTI?
- Hypocalcemia
- Antiarrhythmics
- TCAs
- Phenothiazines
- Macrolides
With QTI prolongation, what are you at increased risk for?
TdP
