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Cardiovascular + Pulmonary Systems > ECG Interpretation > Flashcards

ECG Interpretation Flashcards

1
Q

P wave

A

Atrial depolarization

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2
Q

PR interval

A

Time for atrial depolarization and condition form the SA node to the AV node

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3
Q

What is normal duration for the PR interval?

A

0.12 to 0.20 seconds

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4
Q

QRS complex

A

Ventricular depolarization and atrial repolarization

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5
Q

Normal QRS duration?

A

0.06 to 0.10 seconds

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6
Q

QT interval

A

Time for both ventricular depolarization and repolarization.

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7
Q

Normal QT duration

A

Ranges for 0.20 to 0.40 seconds; depending on HR

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8
Q

ST segment

A

Isoelectric period following QRS when the ventricles are depolarized

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9
Q

T wave

A

Ventricular repolarization

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10
Q

Normal sinus rhythm

A

Atrial depolarization begins in the SA node and spreads normally throughout the electrical conduction system

HR b/t 60 and 100 BPM

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11
Q

Sinus Bradycardia

A

Sinus rhythm with a HR <60 bpm (in adults)

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12
Q

Sinus tachycardia

A

Sinus rhythm with a HR > 100 bpm (in adults)

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13
Q

Sinus arrhythmia

A

A sinus rhythm, but with quickening and slowing of impulse formation in the SA node resulting in a slight beat-to-beat variation of the rate

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14
Q

Sinus arrest

A

A sinus rhythm, except with intermittent failure of either SA node impulse formation or AV node condition that results in the occasion complete absence of P or QRS waves

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15
Q

Premature atrial contractions (PAC)

A
  • occur when an ectopic focus in the atrium intimates an impulse before the SA node
  • The p wave is premature with abnormal configuration
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16
Q

Atrial flutter

A
  • ectopic, very rapid atrial tachycardia
  • rate of 250-350 bpm; ventricular rate dependent upon AV node conduction
  • Saw-tooth shaped P waves (also known as atrial flutter waves) are characteristic
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17
Q

A therapist is trying to determine the HR of a normal heart rhythm using a 6 second strip. How would he/she determine the HR?

A

Therapist should count the number of intervals b/t QRS complexes in 6-second strip and multiply by 10

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18
Q

A therapist is trying to determine the HR of a irregular heart rhythm using a 6 second strip. How would he/she determine the HR?

A

Therapist should use the longest strip available (up to 1 minute) to assess HR

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19
Q

What are premature ventricular contractions (PVCs)?

A

Premature beat arising from the ventricle

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20
Q

How do PVCs look on a ECG strip?

A
  1. No p wave

2. A bizarre and wide QRS complex followed by long compensatory pause

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21
Q

When are PVCs considered a Red Flag?

A

> 6 PVCs per minute occurring in pairs, or sequential runs, multifocal, very earl PVC (R on T phenomena)

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22
Q

What is a bigeminy PVC?

A

Normal sinus impulse followed by a PVC

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23
Q

What is a trigeminy PVC?

A

A normal sinus impulse followed by two PVCs.

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24
Q

What are some causes of PVC?

A
  1. Anxiety
  2. Caffeine
  3. Stress
  4. Smoking
  5. All forms of Heart disease
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25
Q

What is ventricular tachycardia (V-tach)?

A

A run of 3+ PVCs occurring sequentially; very rapid rate (150-200 bpm)

May occur paroxysmally (abrupt onset)

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26
Q

What does V-tach look like on a ECG stripe?

A
  1. No p waves

2. QRS waves are wide and aberrant in appearance

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27
Q

What is nonsustained v-tach (NSVT)?

A

3+ consecutive beats in duration, terminating spontaneously in <30seconds

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28
Q

What is sustained V-tach?

A

VT >30 second durations and/or requiring termination due to hemodynamic compromise in <30 seconds

> 30 seconds = life threatening !

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29
Q

If a therapist is assessing a patient and realizes their patient has had VT for more than 30 seconds, what should the therapist proceed to do.

A

Initiate emergency services

30
Q

True or False: Patients experiencing VT may be unable to keep appropriate BP, therefore they may experience hypotension

A

True

31
Q

True or False: VT may degenerate into Vfib causing cardiac arrest

A

True

32
Q

What are common causes of VT?

A
  1. MI
  2. Cardiomyopathy
  3. Valvular disease
33
Q

What is Ventricular fibrillation (Vfib)?

A

Chaotic activity of vetricle originating from multiple foci

Unable to determine rate

34
Q

What does Vfib look like on ECG?

A

bizarre, erratic activity without QRS complexes

No effective Cardiac output (CO)

35
Q

How quickly can clinic death occur if a patient is experiencing Vfib?

A

Clinical death occurs within 4-6 minutes

36
Q

True or False: A pulseless, emergency situation requiring immediate medical attention: CPR typically required!

A

TRUE!! VFIB IS A SERIOUS EMERGENCY

37
Q

What are common causes of VFib?

A
  1. Any heart disease
  2. MI
  3. Cocaine use
38
Q

What is Ventricular Asystole?

A

Ventricular standstill; straight line on ECG

39
Q

T or F: Ventricular Asystole requires CPR and medications to stimulate cardiac activity

A

True

40
Q

What are common causes of Ventricle Asystole?

A
  1. Acute MI
  2. Ventricular rupture
  3. Cocaine use
  4. Lightening Strike
  5. Electrical shock
41
Q

What is Atrial fibrillation?

A

P waves area abnormal (variable in shape) or not identifiable

Depolarizes between 350-600 times/minute

42
Q

What are common symptoms of Afib?

A
  1. Palpitations
  2. Fatigue
  3. Dyspnea
  4. Lightheadedness
  5. Syncope
  6. Chest pain
43
Q

True or false: With afib, stagnation of blood may predispose to thrombi in the atria

A

True

44
Q

What is atrial flutter?

A

Very rapid atrial tachycardia

(250-350 bpm)

Ventricular rate depends on AV node conduction

45
Q

What does Atrial flutter look like on ECG?

A

Saw-tooth shaped P waves (also known as flutter waves)

46
Q

What are some symptoms of Atrial flutter?

A
  1. Palpitations
  2. Lightheadedness
  3. Aging due to rapid rate

Stagnation of blood in atria may predispose to thrombin in the atria

47
Q

List the type of Atrioventricular Conduction blocks.

A
  1. 1st degree heart block
  2. 2nd degree heart block
  3. 3rd degree heart block
48
Q

In a 1st degree heart block, the PR interval is _________ than ____ seconds, but relatively constant from beat to beat

A

Longer than 0.2 seconds

49
Q

Why may a 1st degree heart block occur?

A

For many reasons including medications that suppress AV conduction

50
Q

2nd degree heart block is a ____ conduction disturbance in which impulses between the atria and vertices fail intermittently

A

AV conduction

51
Q

Name the two types of 2nd degree heart block

A

Mobitz I Block

Mobitz II block

52
Q

Describe 2nd degree heart block: Mobitz I

A

Progressive prolongation of PR interval until one impulse is not conducted (generally benign)

53
Q

Describe 2nd degree heart block: Mobitz II

A

Consecutive PR intervals are the same and normal followed by non conduction of 1+ impulses

54
Q

True of false: 2nd degree heart block may progress to 3rd degree heart block

A

True

55
Q

True or false: If HR is slow, CO will decrease with the blocked impulse during mobitz II heart block

A

True

56
Q

Which is more serious: Mobitz I or Mobitz II

A

Mobitz II

57
Q

describe a 3rd degree AV block.

A

All impulses are blocked at the AV node and more are transmitted to the ventricles

Atrial rate > ventricle rate

58
Q

True or False: A third degree AV block is a medical emergency and will require pacemaker and medication

A

True

59
Q

what medication is given for a patient with third degree HR block?

A

Atropine

60
Q

True or false: if the ventricular rate is too slow, the cardiac output drops and the patient may faint

A

True

61
Q

Hypothermia affects heart rhythm in what way?

A

Elevates ST segment; slows rhythm

62
Q

how does digitalis affect the heart rate rhythm?

A

A. Depresses ST segment

B. flattens T wave (or inverts)

C.QRS lengthens

63
Q

How do beta blockers (propanol) affect HR and its rhythm?

A

Decreases HR

Blunts HR response with exercise

64
Q

How do nitrates (nitroglycerin) affect HR?

A

increase HR

65
Q

How do antiarrhythmic agents affect heart rhythm ?

A

May prolong QRS and QT intervals

66
Q

What is ST segment depression typically indicative of? What else may cause this?

A

Typically indicative of MI.

May also be caused by digitalis toxicity and hypokalemia

67
Q

ST segment elevation (STEMI) is the earliest sign of what?

A

Transmural infarction (large MI—usually affects entire ventricular wall)

Produces pathological Q waves hrs/days later—QMI = Transmural

68
Q

What is a characteristic marker of infarction and signifies the loss of (+) electrical voltages due to necrosis?

A

Q wave —usually longer than 0.04 msec and larger than 1/3 amplitude of the R wave (STEMI)

69
Q

When does a T wave inversion typically occur?

A

Usually occurs hours or days after an MI as the result of a delay in depolarization produced by injury

70
Q

ST segments not seen on a ECG are termed NSTEMI, this involves what portion of the heart?

A

Involves endocardium (known as nontransmural or subendocardial MI)

Does not acause acute injury to myocardial tissue

Cardiovascular + Pulmonary Systems (14 decks)

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