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Cardiology > ECG Foundation > Flashcards

ECG Foundation Flashcards

1
Q

Einthoven’s triangle: green electrode:
Blue electrode:
Red electrode:

A

= neutral/ground
= Negative
= Positive

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2
Q

Einthoven’s triangle: Lead 1 & view:
Lead 2 & view:
Lead 3 & view:

A

= negative RA → positive LA (Left lateral camera view)
= negative RA→ positive LL (Inferior camera view)
= negative LA→ positive LL (slight lateral Inferior camera view)

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3
Q

(Coronary) left coronary artery supplies:

Left coronary artery 2 major branches are:

A

= L-ventricle, Intraventricular septum, part of R-ventricle & lower conductive system
= anterior descending artery and the circumflex artery

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4
Q

(T wave) Limb leads Amplitude:
Precordial “chest” leads amplitude:

A

= <5mm in LL
= <10mm in precordial

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5
Q

1 cause of death when having a MI

A

is from a lethal dysarrhythmia

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6
Q

12/15 Lead ECG Kev Approach) 1st.
2nd.

3rd.
4th.

5th.
6th.

7th.

8th

A

1st} Is there a clear isoelectric baseline? (Skin prep correctly)
2nd} Are QRSs upright leads I, II & III (Check attachment correctly)
3rd} good R wave progression? (Check lead placement)
4th} Is the monitor in the correct mode(diagnostic)? (0.05 to either 40 or 150 Hz)
5th} Is the axis normal? Any axis deviation present?
6th} Is there any ST elevation present? If yes, do you see it in 2 or more contiguous leads?
7th} Is there any ST depression? If yes, do you see it in 2 or
more contiguous leads?
8th} any pathological Q waves present? Yesterday’s news!

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7
Q

A Lateral Wall high view:
B Left Lateral low view:
C Inferior wall view:
D Septal wall view:
E L-Anterior view:

A

A= Lead I & aVL= LA
B= Lead 1, aVL, V5 & V6: views LCX & LAD
C= 2,3,aVF: LL most common block(RCA) Lots of blockages/infarcs
D= V1 & V2: Along sternal borders blockages from LAD commonly
E= V3 & V4: left anterior wall : LAD & LMCA blocks

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8
Q

3 Is of cardiac) Ischemia:
“Infarct” Injury:
Infarction:

A

= Ischemia: ST depres/, Hyperacute T waves>5chest avf >10 precordial
= “Infarct” Injury: ST elevation 50%,
= Infarction: old MI; >25% Q or QRS >1SB

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9
Q

3 I’S of cardiac) Pathologic Q

A

Infarction

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10
Q

3 I’S of cardiac) ST Elevation:

A

Injury

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11
Q

3 I’S of cardiac) ST Elevation:

A

Injury

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12
Q

A blockage of which of the following would result in the entire left ventricle not receiving blood supply?

A

Left Main Coronary Artery (LMCA)

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13
Q

ECG Camera views) Anterior

A

Lead V3 V4

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14
Q

Leads V3 & V4 view
Leads V1 & V2 view
Leads 2,3, & aVF view
Leads 1, aVL, V5, V6 view

A

= Anterior
= Septal
= Inferior
= Lateral

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15
Q

ARTsclerosis:
ARTHsclerosis:

A

= harding of arternia
= tunica media plaque build up in layers of media & intima pushing & narrowing lumen size,

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16
Q

Heart blocks are

A

blocks in AV node partial or complete
“Putting a rock or pebble on a cable”

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17
Q

Bundle Branch A&P) Fascicle of the conduction system:
Bundle branch blocks:

A

= Facilitates syncytium
= ventricles out of sync

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18
Q

Congitual:
Reciprocal changes:
Spodicks sign:

A

= same view leads
= mirrored effect in oppisute/corresponding leads for sure MI
= pericarditis PR slopes down aka STEMI imposter

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19
Q

De Winter’s T Waves:

A

V2 V3 most commonly but can happen any lead
ST depression at the J-point & upsloping ST-segments w/ tall, symmetrical T- waves in the precordial leads (LMCA or LAD occlusion)
“Hyper T w/ STD”

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20
Q

ECG Camera views) Left Lateral

A

Lead I, aVL, V4, V5

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21
Q

ECG Camera views) Septal

A

Lead V1 V2

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22
Q

ECG Camera views) LMCA - 3 vessel disease

A

Lead aVR

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23
Q

ECG Camera views) Posterior

A

Lead V5 V6

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24
Q

ECG Camera views) Right

A

Lead V4R

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25
Q

ECG Heart waves – P wave:
QRS complex:
T wave:

A

= Atrial depolarization
= Ventricular depolarization
= Repolarization of ventricles

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26
Q

ECG Lead coronary arteries) Anterior

A

(LAD) Left Anterior Descending

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27
Q

ECG Lead coronary arteries) Inferior

A

(RCA) Right Coronary Artery

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28
Q

ECG Lead coronary arteries) Posterior

A

(RCA) Right Coronary Artery &/or (LCX)

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29
Q

ECG Lead coronary arteries) Right

A

(RCA)

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30
Q

ECG Lead coronary arteries) Lateral

A

(LCX) Left Circumflex

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31
Q

ECG Lead views) Lead aVR

A

LMCA - 3 vessel disease

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32
Q

ECG Lead views) Lead V5 V6

A

Posterior

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33
Q

ECG Lead views) Lead V3 V4

A

Anterior

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34
Q

ECG Lead views) Lead V1 V2

A

Septal

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35
Q

ECG Lead views) Lead I, aVL, V4, V5

A

Left Lateral

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36
Q

ECG Lead views) Lead V4R

A

Right

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37
Q

ECG Lead views) Lead aVR

A

LMCA - 3 vessel disease

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38
Q

ECG Lead views) Lead V5 V6

A

Posterior

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39
Q

ECG Lead views) Lead V3 V4

A

Anterior

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40
Q

ECG Lead views) Lead V1 V2

A

Septal

41
Q

ECG Lead views) Lead V4R

A

Right

42
Q

Horizontal Boxes: Each small box ?secs:
5 small boxes equal:
Each large box is ?secs:

A

= 0.04 sec
= 1 large box
= 0.20 sec

43
Q

Isoelectric line:
Used for:

A

= Down 1mV of calibration bar/ line (bottom of cal)
= ST seg depress/elevation, Hypertrophy, amplitude

44
Q

LBBB Definer Turn criteria

A

Down deflection before J point “turning left”

45
Q

STE leads criteria) Lead aVR, aVL, aVF

A

≥ 1mm

46
Q

STE leads criteria) Lead V1
Lead V2-3

A

Lead V1 ≥ 1mm
Lead V2-3}≥ 2mm M>40, 2.5mm M<40 1.5 all women

47
Q

STE leads criteria) Lead V4-6

A

≥ 1mm

48
Q

STE leads criteria) Lead V4-6

A

≥ 1mm

49
Q

15 leads views) Lead V4
Lead V5
Lead V6

A

Lead V4
Lead V5
Lead V6

50
Q

STE leads criteria) Lead V4R
Lead V8-9

A

Lead V4R ≥ 1mm
Lead V8-9 ≥ 0.5mm

51
Q

STE leads criteria) Lead V4R
Lead V8-9

A

Lead V4R ≥ 1mm
Lead V8-9 ≥ 0.5mm

52
Q

STE leads criteria) Lead V4R
Lead V8
Lead V8

A

Lead V4R
Lead V8
Lead V8

53
Q

15 leads views) Lead V4R
Lead V8
Lead V8

A

Lead V4R
Lead V8
Lead V8

54
Q

Leads 2, 3, aVF reciprocal leads

A

leads 1, aVL, V1-6

55
Q

Leads 1, aVL, V1-6 reciprocal leads

A

2, 3, aVF reciprocal leads

56
Q

Leads II, III and aVF look at what part of the heart?

A

Inferior wall (most common blockacke(RCA)

57
Q

Leads V1 and V2 look at what part of the heart?

A

Septal (blockages from LAD commonly)

58
Q

Leads 1, aVL, V5, V6 look at what part of heart:

A

L-Lateral (low view : views LCX & LAD)

59
Q

Leads V1 and V2 look at what part of the heart?

A

Septal (blockages from LAD commonly)

60
Q

Leads 1, aVL, V5, V6 look at what part of heart:

A

L-Lateral (low view : views LCX & LAD)

61
Q

Leads V3 and V4 look at what part of the heart?

A

L-Anteriorwall (LAD & LMCA blocks)

62
Q

Mirror Criteria

A

V1&2 leads (v2 most sensitive w/ R): ST depression w/ big R wave (accompany 15-20% inferior or lateral STEMI)

63
Q

Most common reason for MI & Stroke

A

ARTHsclerosis: Scab of artery can break open from intima, Body constricts, hemostasis, blocks blood flow (Asprin biggest helper antiplatelet) (R side of heart only) L side Lungs filters clots)

64
Q

Orthodromic Re-entry loop:
Antidromic Re-entry loop

A

= Clockwise rentry conduction loop >narrow QRS
= counterclockwise reentry conduction loop > wide QRS

65
Q

Posterior MI w/o post leads

A

V1 V2leads Mirror test

66
Q

Precordial Posterior Lead Placement) V8(5)
V9(6):

A

= Mid-Scapular
= ½ way in-between the Scapula & Spine

67
Q

PRI:
ST segment:
P-T is:
RR:

A

= AV holding impulse for sync
= ventricular contraction
= 1 full cardiac cycle
= gives rate & rhythm

68
Q

Printz metal angina

A

Coronary artery spasm usually w/ stimulant (cocaine) & then occlusion arteries

69
Q

QRS complex:
T wave:
U wave:
QT segment:

A

= ventricular depolarization
= ventricular depolarization
= “late bloomer
= all ventricle’s action

70
Q

RBBB Definer turn criteria

A

Up defelection before J point “turning right”

71
Q

Re-entry loops

A

= stuck in nascar loop in a chambers pathway causing commonly SVT / no P waves

72
Q

Reciprocal leads:

A
73
Q

Right BBB can produce:
LBBB can produce a

A

a classic rsR’ (r prime) R prime “2nd version of wave”, NO BUNNY EARS
QRS complex Discordis (oppisite)

74
Q

RPM:
LAC:

A

RPM: Posterior & Marginal
LAC: anterior descending circumflex

75
Q

Rs 6sec strip method:
big box method:
Small box method:
Triplicate method:

A

= # of Rs x 10
= 1R to R BB#s then 300/BB#
= 1R-R SB#s then 1500/ SB#
= descend W/ SB 300, 150, 100, 75, 50, 43, 38

76
Q

SA node rate:
AV node rate:
Purjunkie rate:

A

=100-60BPM
=60-40BPM
=40-15BPM

77
Q

Spodicks sign:

A

sloping down P wave into QRS (evidence of pericarditis)

78
Q

3 I’S of cardiac) ST depression, Hyperacute or flipped T Wave:

A

Ischemia

79
Q

STE leads criteria) Lead I-III

A

≥ 1mm

80
Q

STE leads criteria) Lead I-III

A

≥ 1mm

81
Q

Systematic approach

A
  1. rate, 2. rhythm, 3. P waves, 4. PRI, 5. QRS
82
Q

Coronary) Right coronary artery (RCA) supplies:
Right Coronary arteries’ 2 major branches:

A

= part R-atrium & ventricle, upper part conduction system
= posterior descending artery & marginal artery

83
Q

Coronary) Right coronary artery (RCA) supplies:
Right Coronary arteries’ 2 major branches:

A

= part R-atrium & ventricle, upper part conduction system
= posterior descending artery & marginal artery

84
Q

Unipolar Limb Leads:
aVR:
aVL:
aVF:

A

= Augmented by the cardiac monitor
= Right Arm positive (inferior)
= Left Arm positive (lateral )
= Left Leg positive (inferior)

85
Q

V1 & V2

A
86
Q

V1 V2 leads view:

A

Septum

87
Q

V3 & V4

A
88
Q

V3 V4 leads look at

A

Left lateral wall

89
Q

V5 & V6

A
90
Q

V5 V6 leads look at

A

Inferior

91
Q

V8 & V9 STEMI criteria:

A

0.5mm or greater

92
Q

Vertical Boxes Each small box is:
Each small box also equals:
5 small boxes equal:
Each large box is:
2 large boxes equal: 1 mV

A

= 0.1mV
= 1 mm
= 1 large box
= 0.5 mV
= 1 mV

93
Q

Wellen’s wave type A:

A

Biphasic T waves in V2 or V3, min STE <1mm (V2 usually biggest shower
Highly specific for for a critical blockage of the LAD

94
Q

Wellen’s wave type B:

A

DEEP inverted T waves V2 or V3,

95
Q

When obtaining a 12 lead ECG, where do you place V2?
When obtaining a 12 lead ECG, where do you place V5?
When obtaining a 12 lead ECG, where do you place V6?
When obtaining a 12 lead ECG, where do you place V3?
When obtaining a 12 lead ECG, where do you place V1?
When obtaining a 12 lead ECG, where do you place V4?
When obtaining a 15 lead ECG, where do you place V4R?

A

= 4th ICS just left of Sternum
= Left 5th ICS anterior of auxiliary
= 5th ICS midaxillary
= ½ in between V2 & V4
= Right of Sternum 4th ICS
= 5th ICS left Midclavicular
= Right ICS midclavicular

96
Q

Which coronary artery feeds the inferior wall of the heart?

A

Right Coronary Artery (RCA)

97
Q

Which coronary artery feeds the left lateral wall of the heart?

A

Left Circumflex (LCX)

98
Q

ECG change represents active myocardial injury:

A

ST-Segment Elevation

99
Q

Which of the following ECG changes represents myocardial ischemia:

A

Hyperacute T-Waves

Cardiology (18 decks)

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