ECG&IABP Flashcards
ECG changes expected for an anterior MI.
Location of infarct?
Elevation V2-V5
Possible elevation I, aVL, V1, V6
Depression III, aVF
LAD
What is a septal MI?
Subtype of anterior MI with greatest elevation in V1-V2
What is an anterioseptal MI.
Subtype of anterior MI with greatest elevation in V1-V4
What is an anteriolateral MI.
Subtype of anterior MI with greatest elevation in V3-V6, plus I, aVL
ECG changes expected for an inferior MI.
Location of infarct?
Elevation II, III, aVF
Depression I, aVL, V5-V6
RCA/LCx
ECG changes expected for an posterior MI.
Location of infarct?
(Horizontal) Depression V1-V3
Broad R wave
Upright T Wave
Distal RCA or LCx
Describe Wellens’ Syndrome
- Deep T wave inversions or biphasic T waves in V2-V3
- Occurs when pain-free (after nitro)
- STEMI Equivalent - LAD Occlusion
Describe De Winter’s T Waves
- Upsloping ST depression with symmetrically peaked T waves in V4
- STEMI Equivalent - LAD Occlusion
In inferior STEMI, RCA occlusion is suggested by
STE III > II
STD I
STE V4R
In inferior STEMI, LCx occlusion is suggested by
STE II > III
No STD I
STE V5-V6
ECG changes expected for an lateral MI.
Location of infarct?
Elevation I, aVL, V5-V6
Depression III, aVF
LAD/LCx
ST Elevation in aVR and V1 may suggest
Left Main Occlusion (LMCA)
Triple Vessel Disease
Proximal LAD
Possible STEMI Equivalent
What artery supplies the inferior portion of the heart?
Right Coronary Artery (RCA)
Leads V1-V6 are called
Precordial Leads
ST Elevation is measured at the
J-point
ST Elevation indicates
Infarction (death of tissue)
Hyperkalemia causes what ECG changes?
Peaked T-waves
Sinusoidal Pattern
WPW causes what ECG changes?
Delta Wave
ST depression can indicate
Ischemia, digitalis toxicity, old injury
Q waves seen with ST elevation may indicate
Old infarction
In what sequence does blood flow through the heart valves?
Tricuspid
Pulmonic
Mitral
Aortic
Hypokalemia may cause what ECG changes?
Peaked P waves
Flat T waves
U waves
A tricyclic antidepressant overdose may cause what ECG changes?
Prolonged QT
SR’ pattern in aVR (R > 3mm or S/R > 0.7)
The IABP purging during ascent is a result of which gas law?
Boyle’s (volume/pressure)
If the IABP becomes dislodged, you may see what two physiologic changes?
Loss of left radial pulse
Poor urine output
Rust color flakes in IABP tubing indicates what?
Balloon rupture
The primary trigger for most IABP operations is what?
ECG
IABP inflation is synchronized with what?
Dichrotic notch
The most harmful IABP timing errors are
Early inflation, Late deflation
If the IABP fails during transport, you must do what?
Manually inflate balloon at least every 30 minutes.
