ECG and Common Arrhythmias Flashcards
12 lead ECG (# of electrodes and leads)
10 electrodes
12 leads
what does the PR interval mean
atrial depolarization
what does the PR segment mean
atrial contraction
normal PR interval (ms)
< 200ms
QRS complex normal (ms)
<100ms
5 step method to determining arrhythmias
- HR: normal 50-100 bpm
- Rhythm: ir/regular
- P waves: uniform? one per QRS
- PR interval: normal <200ms
- QRS complex: normal <100ms
Healthy Routines Promote Physical Quality
if we note an arrhythmia while scanning a _______ image should be taken
still
when taking doppler measurements on a patient with an arrhythmia, you should take an average of _____ beats
3-5
NSR
normal sinus rhythm
impulse travels through a normal conduction pathway through the heart at a normal rate
Sinus bradycardia numbers
<50bpm
sinus tachycardia numbers
> 100bpm
sinus arrhythmias (2)
Sinus bradycardia
sinus tachycardia
two types of heart blocks
bundle branch blocks
Av blocks
AV block types (3)
- 1st degree
- 2nd degree (type I, type II)
- 3rd degreee
what is a bundle branch block (what, result, changes ECG)
refers to a signal slowing up or being blocked at either the right or left bundle branch= impulse cant go further and has to be stimulated by other ventricle = wider QRS complex (>120ms)
RBBB (what, appearance)
right branch bundle block
rabbit ear appearance
LBBB (what, appearance)
left branch bundle branch
wide QRS with broad notched R wave
what is an AV block
a disturbance in the conduction at the AV node level
1st degree AV block
prolonged PR interval (>200ms)
one P wave before QRS
2nd degree AV block Mobitz I (what, AKA)
AKA Wenckebach
gradually lengthening PR interval until there is a dropped QRS complex
2nd degree AVB Mobitz II
normal PR interval
has a P wave with no QRS following (signal blocked after atria contract=no ventricular contraction)
if the R is far from the P then you have a _____ (AVB)
1st degree
3rd degree AVB (what, AKA, results in)
AKA AV dissociation
no association between P waves and QRS complexes
(ventricles making own beating rate)
results in pacemaker
longer, longer, longer drop then you have a ______ (AVB)
Wenckebach (2nd degree Mobitz I)
if some Ps don’t get through then you have a _____ (AVB)
Mobitz II
if Ps and Qs don’t agree then you have a ______ (AVB)
3rd degree
3 types of atrial arrhythmias
premature atrial contractions
atrial flutter
atrial fibrillation
PAC (stands for,what, result of)
premature atrial contractions
when atrial muscle tissue produces its own impulse leading to atrial contraction followed by ventricular contraction (early beat then compensatory pause)
result of too many catecholamines (stress, hormones, caffeine)
atrial flutter (what, AV reacts by, ECG)
abnormal atrial pacemakers set firing rate very high, up tp 300bpm
AV node cant handle, only lets some impulse through
many atrial beats for every ventricular signal (saw tooth)
atrial fibrillation (what, associated with, ECG)
atria quiver rather than contract
many ectopic atrial electrical signals competing to pace the heart = irregular rhythm
associated with: atrial enlargement, patients lose atrial kick (30% of filling)
no detectable p waves, smaller waves than A-flutter, irregular R-R intervals)
3 types of ventricular arrhythmias
premature ventricular contractions
ventricular tachycardia
ventricular fibrillation
PVC (stands for, what/ECG, causes)
premature ventricular contractions
QRS early= no P wave before and usually higher voltage/compensatory pause
causes: catecholamines, blocked artery causing zone of ischemia
when do PVCs become a significant finding
when there are multiples (2/3/4… in a row)
Multifocal PVCs
impulses originate from more than one site within the ventricles (12-lead finding)
VT
ventricular tachycardia
rapid but coordinated, re-entry loop through ventricles only= no P wave
can be due to MI
sustained VT= medical emergency
VF
ventricular fibrillation
rapid, incoordinate motion, ventricles quiver (not beat)
extremely emergent situation
SVT (stand for, 3 identifying factors)
supraventricular tachycardia
HR > 150bpm
P waves hidden
narrow QRS complex
ST segment depression indicates
myocardial ischemia (not emergent)
ST segment elevation indicates
MI (or recently had one)
we compare the level of the ST segment with the ____
PR segment
difference between PAC and PVC on ECG
PAC has p wave with early beat and compensatory pause
PVC has no p wave with early beat and compensatory pause and usually has higher voltage on that beat
