ECG finishing touches lecture Flashcards
Bundle of Kent that directly connects atrium to ventricles
Wolff-Parkinsons White
PR interval shortened to under 0.12 seconds
QRS widened to more than 0.10
***delta wave present
WPW
hallmark*** slurring of upstroke due to Kent bundle conduction (delta wave), wide QRS at base (between 2-2.5 boxes wide), narrow QRS at top
WPW
Arrhythmias associated with WPW
PSVT A fib (even faster than usual bc Kent Bundle conducts faster than AV node)
**can have vent rates up to 300 with a fib in WPW
Cannot read what in a WPW EKG?
Ischemia
Infarct
LVH
- *Cannot interpret Q waves (if present) for MI in the presence of WPW abnormality on ECG.
- *Cannot interpret LVH by voltage criteria (if present) in the presence of WPW abnormality.
- *Cannot interpret ischemia via ST segment depression or T wave inversion in the presence of WPW abnormality.
WPW
99% of the time, irregularly irregular EKG means…
A fib
Bypass from atrium into Bundle of His
Lown-Ganong-Levine Syndrome
Very short PR interval
Associated w PSVT
Lown Ganong Levine Syndrome
This drug has a narrow therapeutic to toxic ration and is a potent stimulator of arrhythmias
Digoxin
ST segment scooping
Digoxin
Multiformed PVCs are most common EKG presentation of
Digoxin toxicity
Digoxin causes SA nodal suppression and…
AV block
- Accelerated junctional rhythm
* Atrial tachycardia with AV block
seen with Digoxin
mild ST segment depression
Flattening of the T wave
Appearance of a U wave
HYPOkalemia
T waves across the entire 12 lead EKG begin to peak
HYPERkalemia
PR interval become prolonged, and the P wave gradually flattens and then disappears
HYPERkalemia
Ultimately, QRS complex widens until it merges with the T wave, forming a SINE WAVE** pattern. V fib may eventually develop
Hyperkalemia
QT interval should not exceed ______ of the R-R interval
one half
tricyclic antidepressants erythromycin (and other macrolides) antifungals myocardial ischemia myocardial infarction
can cause…
QT prolongation
Pt comes in with chest pain. EKG shows HUGE!!! T waves n V3-V5..whats going on?
Early MI!!! Anterolateral*
Prolonged QT interval puts at risk for…
V fib
OD of tricyclic antidepressants can cause…
ST depression
Pt comes in with diffuse ST elevation..seen in all leads except aVL and aVR. What is it? And DOC?
Acute pericarditis
tx with NSAIDS
EKG with LOW VOLTAGE…what could be going on?
Pericardial effusion
EKG with narrow QRS and rate of 150. Can be 3 things….
- atrial flutter with 2:1 AV block
- PSVT
- sinus tachycardia
Young healthy individual
Sinus bradycardia
Slight ST elevation
Early repolarization
deep T wave inversions until proven otherwise mean…
ischemia or NSTEMI
wide, bizarre QRS complexes
**small vertical line seen before every QRS
electronic ventricle pacemaker!
ventricles are conducting on a cell to cell basis, which is why there are wide QRS
vertical line seen before every P wave
atrial pacemaker
Causes SA nodal suppression and AV block
*can basically cause any arrhythmia
Digoxin
Most common arrhythmia caused by Digoxin
Multifocal PVCs
2 most specific arrhythmias caused by Digoxin
Accelerated junctional rhythm
Atrial tachycardia with AV block
Diffuse peaked T waves
no P waves
QRS widens, merges with T waves
Sine wave forms
*V fib may eventually develop
HYPERkalemia
Pt comes in with NVD
ECG shows BIG** T waves in precordial leads
HYPERkalemia
class 1a, 1c, 3 anti-arrhythmic agents
erythromycin, non sedating anti histamines
macrolides, antifunals
can all cause…
QT prolongation
