ECG, Arrhythmias

Question 1

Right atrial dilation

Answer 1

Big Ps in INFERIOR leads

Right P wave axis

Question 2

Left atrial dilation

Answer 2

any negative deflection in V1 or V2 > 1 box wide

Question 3

Easy criteria for LVH

Answer 3

I + L >11: v. specific LVH

V2 and V5 > 35mm -sensitive

Question 4

Causes of roller coaster T waves

Answer 4

1. increased ICP (SAH)
2. metabolic
3. coronary disease

Question 5

Strain pattern

Answer 5

assymetric T waves in LATERAL leads (I, L, V5, V6)

-LVH and dig do this-too much Ca

Question 6

Low voltage everywhere

Answer 6

effusion

infiltrative process

Question 7

low voltage in precordial leads only

Answer 7

emphysema

Question 8

low voltage limb leads

Answer 8

edema, fat

Question 9

low voltage V4-V6

Answer 9

PTX

Question 10

SA node supplied by R side ____ of time

AV node supplied by RCA _____ of time

Answer 10

60%

90%

Question 11

Describe the rhythms of each type of heart block

Answer 11

I: Regular
II: Reg. Irreg.
III: Irreg Irreg.
IV: Regular

Question 12

Wide + Connected Ps=

Answer 12

BBB or WPW

Question 13

7 things to look for on ECG in pt with syncope

Answer 13

1. WPW/delta wave
2. Brugada
3. LVH
4. Long QT (1/2 RR)
5. HyperK
6. S1 Q3 T3
7. LV aneurysm?

Question 14

5 types of SVT

Answer 14

1. Afib (irreg)
2. MAT (irreg)
3. AVNRT (160+, no Ps)
4. A.flutter (150, no Ps)
5. Sinus tach (140s, Ps)

Question 15

Two rhythms for which Mg is 1st line antiarrhythmic

Answer 15

Torsades, MAT

Question 16

LV aneurysm pattern

Answer 16

QS pattern and ST elevation in V1, V2

Question 17

Where and what to look for posterior infarct?

Answer 17

Large R waves and ST depression in V1-V3

Question 18

What leads show Brugada Syndrome?

Answer 18

V1, V2, V3

• look for R’ in V1 and V2
• look for St elevation in V3

Question 19

> 1mm in 2 leads

Answer 19

for calling cath lab, not for ruling out MI

Question 20

Theophylline OD

Answer 20

MAT

Question 21

Sinus tacky with underlying causes treated:

Answer 21

myocarditis, thyroid storm, PE

Question 22

When there is a wandering baseline from breathing, where is the best place to look for ST elevation?

Answer 22

at apex or nadir

Question 23

Axis shift

Answer 23

If R, prob pulmonary part cicurlation problem

If shifted L, prob systemic prob