Ecg

Question 1

What are the reciprocal leads?

Answer 1

Septal (v1,v2) - none
Anterior (v3,v4) - none
Anteroseptal (v2,v3,v4,v5) - none
Lateral (v5,v6, 1, avl) - 2,3,avf 
Inferior (2,3,avf) - 1, avl 
Posterior (none) - v1, v2, v3, v4)

Question 2

What is the criteria for p-pulmonale?

Answer 2

A peaked p wave taller than 2.5 mm in the limb leads.

Question 3

What is p-mitrale?

Answer 3

A notched p wave greater than .12sec in the limb leads with a distance between the bumps of greater or equal to .04sec.

It is indicative of left atrial enlargement.

Question 4

What is a RBBB pattern ?

Answer 4

1) QRS prolongation greater than or equal to 0.12 seconds.
2) Slurred S wave in leads 1 and v6
3) RSR pattern in lead v1 ( turn right)

Question 5

STEMI criteria

Answer 5

ST segment elevation in 2 or more contiguous leads or new LBBB.

J-point elevation of greater than 2mm in leads v1 and v2 (2.5mm in men under 40, 1.5mm in women) and 1mm or more in all other leads.

Question 6

Ischemia (n-stemi ace) criteria

Answer 6

ST-segment depression of 0.5mm or greater or dynamic t-wave inversion with pain or discomfort.

Non persistent or transient ST elevation of 0.5 mm or greater for less than 20 minutes is included

Question 7

What is the criteria for LVH

Answer 7

Most commonly: S wave depth in v1 + tallest R wave height in v5-v6 greater than 35mm.

Also:
R wave in avl > 11mm
S wave in 1 > 12mm
R wave in avf > 20mm
Any precordial leas > 45mm

Plus left ventricular strain pattern - t wave inversions and st depression in the lest sided leads.

Question 8

What is a pathological q wave?

Answer 8

A q wave wider than 0.03s or deeper than 1/3 of the R wave.

Question 9

RVH criteria

Answer 9

Right axis deviation (+110 or more)
Dominant R wave in V1
Dominant S wave in V5 or V6

Supported by RAE or right ventricular strain pattern.

Question 10

Right ventricular strain pattern

Answer 10

ST depression / T wave inversion in right precordial (V1-V4) and inferior ( 2,3, avf)

Question 11

Signs of pericarditis

Answer 11

1 tachycardia
2 pr depression
3 diffuse st segment elevation (concave up with scooped appearance)
4 notched qrs complex

Question 12

Causes of right axis deviation

Answer 12

1 Normal in adolescents and children
2 Right ventricular hypertrophy
3 Left posterior hemiblock 
4 Dextrocardia
5 Ectopic ventricular beats and rhythms

Question 13

Causes of left axis deviation

Answer 13

1 Left anterior hemiblock

2 Ectopic ventricular beats and rhythms

Question 14

Criteria for LBBB

Answer 14

1 Duration greater or equal to .12sec
2 broad, monomorphic R waves in 1 and V6 with no Q waves.
3 broad, monomorphic S waves in V1; may have small r wave.

Question 15

Criteria for RBBB

Answer 15

1 QRS prolongation of greater or equal to .12sec
2 Slurred S wave in 1 and v6
3 RSR pattern in V1 with R’ taller than R

Question 16

What is Sgarbosa criteria in LBBB

Answer 16

1) Concordant ST elevation of > or equal to 1mm in any lead
2) Concordant ST depression of > or equal to 1mm in v1, v2, v3
3) Discordant ST elevation of > 25% of S wave.

Question 17

What is Sgarbosa criteria in LBBB

Answer 17

1 Concordant ST elevation of > or equal to 1mm in any lead
2 Concordant ST depression of > or equal to 1mm in v1, v2, v3
3 Discordant ST elevation of > than 25% in any lead.

Question 18

What are 6 criteria for a right ventricular infarction

Answer 18

1 IWMI
2 ST elevation greater in lead 3 than 2
3 ST elevation in v1 (possibly extending to v5 to v6)
4 ST depression in v2
5 ST depression in v2 cannot be more than half the st elevation in AVF
6 More than 1mm of ST elevation in the right-sided leads (v4r to v6r)

Question 19

What does poor R wave progression represent ?

Answer 19

LATE acronym 
L- lafb or lbbb
A- Acute myocardial infarction
T- Tension (LVF)
E- Emphysema