ECG&IABP

Question 1

ECG changes expected for an anterior MI.

Location of infarct?

Answer 1

Elevation V2-V5
Possible elevation I, aVL, V1, V6
Depression III, aVF

LAD

Question 2

What is a septal MI?

Answer 2

Subtype of anterior MI with greatest elevation in V1-V2

Question 3

What is an anterioseptal MI.

Answer 3

Subtype of anterior MI with greatest elevation in V1-V4

Question 4

What is an anteriolateral MI.

Answer 4

Subtype of anterior MI with greatest elevation in V3-V6, plus I, aVL

Question 5

ECG changes expected for an inferior MI.

Location of infarct?

Answer 5

Elevation II, III, aVF
Depression I, aVL, V5-V6

RCA/LCx

Question 6

ECG changes expected for an posterior MI.

Location of infarct?

Answer 6

(Horizontal) Depression V1-V3
Broad R wave
Upright T Wave

Distal RCA or LCx

Question 7

Describe Wellens’ Syndrome

Answer 7

• Deep T wave inversions or biphasic T waves in V2-V3
• Occurs when pain-free (after nitro)
• STEMI Equivalent - LAD Occlusion

Question 8

Describe De Winter’s T Waves

Answer 8

• Upsloping ST depression with symmetrically peaked T waves in V4
• STEMI Equivalent - LAD Occlusion

Question 9

In inferior STEMI, RCA occlusion is suggested by

Answer 9

STE III > II
STD I
STE V4R

Question 10

In inferior STEMI, LCx occlusion is suggested by

Answer 10

STE II > III
No STD I
STE V5-V6

Question 11

ECG changes expected for an lateral MI.

Location of infarct?

Answer 11

Elevation I, aVL, V5-V6
Depression III, aVF

LAD/LCx

Question 12

ST Elevation in aVR and V1 may suggest

Answer 12

Left Main Occlusion (LMCA)
Triple Vessel Disease
Proximal LAD

Possible STEMI Equivalent

Question 13

What artery supplies the inferior portion of the heart?

Answer 13

Right Coronary Artery (RCA)

Question 14

Leads V1-V6 are called

Answer 14

Precordial Leads

Question 15

ST Elevation is measured at the

Answer 15

J-point

Question 16

ST Elevation indicates

Answer 16

Infarction (death of tissue)

Question 17

Hyperkalemia causes what ECG changes?

Answer 17

Peaked T-waves

Sinusoidal Pattern

Question 18

WPW causes what ECG changes?

Answer 18

Delta Wave

Question 19

ST depression can indicate

Answer 19

Ischemia, digitalis toxicity, old injury

Question 20

Q waves seen with ST elevation may indicate

Answer 20

Old infarction

Question 21

In what sequence does blood flow through the heart valves?

Answer 21

Tricuspid
Pulmonic
Mitral
Aortic

Question 22

Hypokalemia may cause what ECG changes?

Answer 22

Peaked P waves
Flat T waves
U waves

Question 23

A tricyclic antidepressant overdose may cause what ECG changes?

Answer 23

Prolonged QT

SR’ pattern in aVR (R > 3mm or S/R > 0.7)

Question 24

The IABP purging during ascent is a result of which gas law?

Answer 24

Boyle’s (volume/pressure)

Question 25

If the IABP becomes dislodged, you may see what two physiologic changes?

Answer 25

Loss of left radial pulse

Poor urine output

Question 26

Rust color flakes in IABP tubing indicates what?

Answer 26

Balloon rupture

Question 27

The primary trigger for most IABP operations is what?

Answer 27

ECG

Question 28

IABP inflation is synchronized with what?

Answer 28

Dichrotic notch

Question 29

The most harmful IABP timing errors are

Answer 29

Early inflation, Late deflation

Question 30

If the IABP fails during transport, you must do what?

Answer 30

Manually inflate balloon at least every 30 minutes.