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CV II > ECG Patterns > Flashcards

ECG Patterns Flashcards

1
Q

Cycle length variation (irregular vent rhythm)
P waves shape variation
Rate within normal range

A

Wandering Pacemaker

- P waves change shape as pacemaking center moves

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2
Q 
Cycle length variation (irregular vent rhythm)
P wave shape varies 
Pts have COPD 
HR >100bpm
Also digitalis toxicity in CVD pt
A

Mulifocal Atrial Tachycardia

- P wave shape changes due to 3 or more atrial foci

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3
Q

Continuous chaotic atrial spikes (no discernible P waves)
Irregular ventricular rhythm
(No single impulse depolarizes atria completely so random QRS rhythm)

A

Atrial Fibrillation

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4
Q

Irregular rhythm that varies with respiration

All identical P waves

A

Sinus Arrhythmia

- Considered normal

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5
Q

Normal sinus rhythm followed by normal rhythm at 60-80bpm

A

Atrial Escape Rhythm

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6
Q

Normal sinus rhythm followed by normal rhythm at 40-60 bpm

A

Junctional Escape Rhythm

Idiojunctional rhythm

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7
Q

Inverted P wave before each QRS
Inverted P wave after each QRS
Inverted P wave buried in QRS

A

Junctional Automaticity with Retrograde Atrial Depolarization

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8
Q

Fairly normal rhythm at 20-40bpm

A

Ventricular Escape Rhythm

“Idioventricular rhythm”

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9
Q

Normal sinus rhythm followed by a pause and an irregular P wave

A

Atrial Escape Beat

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10
Q

Normal sinus rhythm followed by a pause and inverted P wave

A

Junctional Escape Beat

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11
Q

Normal sinus rhythm followed by a pause and a large, widened QRS complex

A

Ventricular Escape Beat

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12
Q

Junctional and Atrial Irritability causation

A 
Epinephrine release 
Increased SNS 
Caffeine, amphetamines, cocaine
Excess digitalis, ethanol 
Hyperthyroidism 
Stretch (low O2)
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13
Q

Normal sinus rhythm followed by an early P wave with characteristic downslope immediately afterwards (sideways Z) followed by normal sinus rhythm

A

Premature Atrial Beat

- Sideways Z is the SA node resetting

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14
Q

Normal sinus rhythm followed by an early P wave with characteristic downslope immediately afterwards (sideways Z) followed by normal sinus rhythm with initial widened QRS

A

Premature Atrial Beat with aberrant ventricular conduction

- One Bundle Branch not completely repolarized leads to widened QRS

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15
Q

Normal sinus rhythm beat followed by closely coupled premature atrial beat with different morphologic P wave and normal QRS complex

A

Atrial Bigeminy/Trigeminy

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16
Q

Normal sinus rhythm beat closely followed by a widened QRS complex

A

Premature Junctional Beat

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17
Q

Normal sinus rhythm beat coupled closely to an inverted P wave and QRS complex

A

(AV) Junctional Bigeminy/Trigeminy

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18
Q

Normal sinus rhythm closely followed by a widened QRS complex (usually opposes polarity of normal QRS) followed by a compensatory pause

A

Premature Ventricular Contraction (PVC)

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19
Q

Normal sinus rhythm closely followed by a widened QRS complex (usually opposes polarity of normal QRS) followed by a compensatory pause
- When coupled to a normal beat

A

Ventricular Bigeminy/Trigeminy

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20
Q

Normal sinus rhythm with interspersed larger QRS complexes

PVC’s coupled to normal sinus rhythm

A

Ventricular Parasystole

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21
Q

Various shaped QRS complexes in close proximity interrupting a apparently normal sinus rhythm

A

Multifocal PVC’s

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22
Q

Normal sinus rhythm followed by sudden tachycardia with rate 150-250/min
Normal looking P waves and QRST cycle, P waves different than sinus rhythm P

A

Paroxysmal Atrial Tachycardia

Supraventricular Tachy

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23
Q

Rate of 150-250/min with a 2:1 ratio of P spikes to QRS complexes

A

PAT with AV block

- AV node blocks every other atrial stimulus

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24
Q

Inverted P waves before/after/buried

Rate of 150-250 bpm

A

Paroxysmal Junctional Tachycardia

Supraventricular Tachy

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25
Q

Widened QRS complexes

Rate of 150-250bpm

A

Paroxysmal Ventricular Tachycardia

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26
Q 
Lengthened QT segment 
Progressively larger then smaller 
Caused by low K, K channel blockers 
Rate of 250-350bpm
Increased risk with U wave
A

Torsades de Pointes

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27
Q

Identical back to back atrial depolarization waves (1 of 3 usually leads to QRS)
“Sawtooth”
Rate of 250-350bpm

A

Atrial Flutter

28
Q

Rapid series of smooth sine-waves of similar amplitude

Rate of 250-350 bpm

A

Ventricular Flutter

29
Q

Wavy baseline w/o identifiable P waves
QRS not regular (Erratic rhythm)
Rate of 350-450bpm

A

Atrial Fibrillation

30
Q

Erratic rhythm (no regularity)
No identifiable waves
Rate of 350-450bpm

A

Ventricular Fibrillation

31
Q

Delta wave before QRS

Appearance of shortened PR and lengthened QRS –> upsloping of QRS complex

A

Wolff-Parkinson-White Syndrome

Due to accessory AV conduction pathway: Bundle of Kent

32
Q

Prolonged PR interval of a consistent length

A

Primary AV Block

33
Q

PR interval length

A

Less than 1 large box

From beginning of P wave to beginning of QRS complex

34
Q

QRS wave length

A

Less than 3 little boxes

35
Q

T wave length

A

Less than 2 big boxes

36
Q

Progressively prolonged PR intervals with subsequent lone P wave (usually fixed rhythm/ratio)

A

Secondary AV Block Wenckebach

Type 1

37
Q

Multiple P waves per QRS (2:1/3:1)
Widened QRS
Series repeats
P wave not premature

A

Secondary AV Block

Mobitz (Type 2)

38
Q

Complete atrial and ventricular dissociation (P waves irregular relationship to QRS complex)
P wave at fast rate superimposed over slower QRS rate

A

Complete Tertiary AV Block

39
Q

Widened QRS

Rabbit ears in V1/V2

A

Right Bundle Branch Block

40
Q

Widened QRS
Rabbit ears in V5/V6
(more sloped btw R peaks)

A

Left Bundle Branch Block

41
Q

Biphasic P wave more +

A

Right Atrial Hypertrophy

42
Q

Biphasic P wave more -

A

Left Atrial Hypertrophy

43
Q

Large R wave in V1

A

Right Ventricular Hypertrophy

44
Q

Large S wave V1 and R in V5

A

Left Ventricular Hypertrophy

45
Q

Symmetrically inverted T waves

ST segment depression

A

Ischemia

46
Q

ST segment elevation with reciprocal ST segment depression

A

Acute Injury

47
Q

Q waves

Significant if..

A

Old Injury
Necrosis
At least 1 small square wide (.04 sec)

48
Q

ST segment elevation in leads II, III, AVF with Q wave

Caused by occlusion of…

A

Inferior MI

- Either LCA/RCA depending on dominant supply

49
Q

ST segment elevation in leads V1-V4 with Q wave

Caused by occlusion of…

A

Anterior MI

- Anterior descending branch of LCA

50
Q

ST segment elevation in leads I, AVL, V5-6 with Q wave

Caused by occlusion of…

A

Lateral MI

- Circumflex branch of LCA

51
Q

Leads V1, V2, tall R wave and ST depression

Caused by occlusion of…

A

Posterior MI

- RCA

52
Q

When can ECG not be a diagnostic tool for Acute MI?

A

LBBB

53
Q

Pattern of RBB and persistent ST elevation in V1-V3

ST segment “saddle-like” especially in V1/V2

A

Brugada Syndrome

- Results in sudden cardiac arrest in absence of coronary obstruction

54
Q

Flat elevated ST segment
T wave elevated off baseline
Present in all leads
PR segment depression

A

Pericarditis

55
Q

Minimal bimodal presentation of QRS complexes

Blunting of all electrical activity

A

Pericardial Effusion

56
Q

QT Interval longer than half of cardiac cycle

A

Long QT Syndrome

- Predisposed to ventricular arrhythmias

57
Q

Large S wave in 1
ST depression in 2
Large Q wave in 3 with T wave inversion (in leads V1-V4)
Afib common

A

Pulmonary Embolism

58
Q

Peaked T waves in all leads
Wide QRS
Flat/widened P waves

A

Hyperkalemia

59
Q

Flattened T waves in all leads
Prominent U waves
Non-monomorphic baseline

A

Hypokalemia

60
Q

Shortened QT interval

Widened T waves

A

Hypercalcemia

61
Q

Prolonged QT interval

Flattened T waves

A

Hypocalcemia

62
Q

Gradual downward curve of ST segment - lowest portion being below the baseline

A

Digitalis effect

Dali stash

63
Q 
Severe bradycardia 
Prolonged PR interval 
Widened QRS 
Prolonged QT 
Osborn wave
A

Hypothermia

(Osborn wave is extra deflection at end of QRS)

64
Q

Normal but everything is reversed

A

Dextrocardia

65
Q

Spike before P wave

A

Atrial paced rhythm

66
Q

Spike after P wave but before QRS complex

A

Ventricle paced rhythm

67
Q

Spike before P wave and before QRS complex

A

Atrial and ventricle paced rhythm

CV II (5 decks)

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