ECG Flashcards
4 Steps to check EKG
- Speed
- QRS Wide or narrow
- P wave
- Regular or Irregular
Rule of 300
5 Boxes: 60bpm
4 Boxes: 75bpm
3 Boxes: 100 bpm
2 Boxes: 150bpm
1 Box: 300bpm
Length of EKG Components
P Wave: 2-3 boxes
PR interval: 3-5 boxes
QRS: 1.5-3 boxes
Lead I
-limb lead
Right arm to Left arm
-normal wave form
-Circumflex A.
-lat wall of LV
Lead II
-limb lead
Right arm to lower limb
-normal wave form
-Right Coronary A.
-Inferior portion of heart/apex
Lead III
-limb lead
-leftt arm to lower limb
-normal wave form (may have inverted P and t wave)
-Right Coronary Artery
-Inferior portion of heart/apex
aVF Lead
-augmented lead
Middle of body to lower limb
-Right coronary Artery
-Inferior portion of heart/apex
-normal wave form
aVL Lead
-augmented lead
From middle to Left arm
-Circumflex A.
-lat wall of LV
-normal wave form
aVR Lead
-augmented lead
From middle of body to right arm
-Top of RV
-inverted wave form
V1
On Right 4th intercostal space
-septal, precordial lead
-L Ant. Descending A.
-inverted P-wave, deep S
-RV
V2
On Left 4th intercostal space
-septal, precordial lead
-L Ant. Descending A.
-inverted P-wave, deep s
-RV, septum
V3
On left between 2 and 4
-Anterior Heart, precordial lead
-Right coronary A.
-RV, septum, ant. heart
V4
On left 5th intercostal space mid clavicular line
-Anterior Heart, precordial lead
-Larger R, small s
-Right coronary A., ant heart
V5
On left 5th intercostal space anterior axillary line
-Lateral heart, precordial lead
-Larger R, small s
-Circumflex A., lat wall of heart
V6
On left 5th intercostal space mid axillary line
-Lateral heart, precordial lead
-Larger R, small s
-Circumflex A., lat wall of heart
Premature Ventricular Contraction
-random cell in ventricles fire out of sync of the rest, prematurely
-wide QRS
Ventricular Bigeminy
-PVCs occur every 2 beats
Ventricular Trigeminy
-PVCs occur every 3 beats
Ventricular Couplet
-PVCs occur in 2s
Ventricular Triplet
-PVCs occurr in 3s
-non sustained ventricular tachycardia
-STOP and check vitals
Ventricular Tachycardia
-fast/large/wide QRS with no p wave, regular
-emergency
Supraventricular Tachycardia
-fast/narrow QRS
-comes from atria not SA node
Junctional Rhythm
-slow (40bpm) /no p wave/inverted T wave
-originates away from atria but depolarizes ventricles
ST Elevation
-Acute MI
-Stimi
ST Depression
-Angina/ischemia
P Wave Inversion
-Heart block with junctional rhythm
T Wave Inversion
-MI or ischemia
-BBB
-hypertrophy
Ventricular Fibrilation
-dangerous, call code
-irregular/fast/small
Atrial Fibrilation
-chaos/irregular
-QRS present, no p wave
-multiple cells firing
Atrial Flutter
-saw tooth/bread knife
-1 cell going crazy
-QRS present and irregular
Torsades De Pointes
-V tach with prolonged QT, irregular
-Looks crazy…how are you alive
Right Bundle Branch Block
-delayed depolarization of RV
-right lead (V1): “M” in QR, deep S
-Left lead (V6): “W” in S wave
R-Wave to find HR
-add up r waves in one strip x 6= HR
Left Bundle Branch Block
-delayed depolarization of LV
-right lead (V1): “W” in R wave
-Left lead (V6): “M” in R wave
-anomally always at tip of QRS
1st Degree AV Block
-husband is late but comes home, long PR interval
-from SA node
-slow HR
2nd Degree AV Block : Type 1
-husband is later and later and then doesn’t come home
-longer PR interval then dropped QRS
-AV node
2nd Degree AV Block : Type 2
-husband randomly doesn’t come home
-normal PR intervals
-randomly dropped QRS
-Bundle of his
-DONT WORK WITHOUT PACEMAKER
3rd Degree AV Block
-normal p wave unrelated to QRS, no corrrelation of QRS
-random p waves
-DONT WORK WITHOUT PACEMAKER
