ECG Findings

Question 1

prolonged PR + QT interval

Answer 1

HYPOmagnesium

Question 2

torsades de pointes

Answer 2

HYPOmagnesium

Question 3

t wave flattening (early) –> prominent U wave

Answer 3

HYPOkalemia (+/- hypoMg changes)

Question 4

tall peaked T waves –> QR shortening, wide QRS –> p-wave flattening

Answer 4

HYPERkalemia

Question 5

Shortening of the QTc interval, PR prolongation, and QRS widening.

Answer 5

HYPERcalcemia

Question 6

prolonged QT interval

Answer 6

HYPOcalcemia

macrolides

Question 7

ST Depression

Answer 7

usually indicates ischemia
-HORIZONTAL AND DOWNSLOPING ARE ALMOST ALWAYS PATHOLOGICAL

-UPSLOPING MAY BE BENIGN - exception is De Winter T waves = upsloping ST depressions w/ hyperacute T waves - common w/ acute occlusion of proximal LAD

Question 8

shape of ST elevation

Answer 8

CONVEX DOWN - SAD FACE
-most likely ischemic

CONCAVE UP - happy face
-usually benign or reflects other causes of ST elevation (early repolarization, pericarditis)

Question 9

transient ST elevations w/out MI

Answer 9

VARIANT (PRINZMETAL) ANGINA or COCAINE INDUCED

• CHEST PAIN USUALLY NONEXERTIONAL, OFTEN OCCURING AT REST
• COCAINE - CORONARY ARTERY VASOSPASM

-tx: CCB, nitrates prn

Question 10

low voltage QRS complex
electric alternans (tall then short qrs, alternate)

Answer 10

large pericardial effusion or tamponade

Question 11

diffuse ST segment elevation (concave upward) + PR segment depression in leads w/ st elevation

Answer 11

acute pericarditis

-aVR: PR elev w/ ST depress (knuckle sign) reflects atrial injury

Question 12

junctional rhythm

Answer 12

digoxin toxicity (common association)

Question 13

sinus tachycardia and nonspecific ST/T wave changes

Answer 13

mc ECG finding –> PULMONARY EMBOLISM

• deep S in lead I
• pathological Q wave and T wave inversion in lead III