ECGs Flashcards
What is an Ectopic Beat?
Beat that originates from a site other than the sinus node (Sinoatrial Node)
Sinus Bradycardia Rate?
40 - < 60 bpm
(Everything else on EKG strip Normal)
Rate for Sinus Tachycardia?
> 100 - 160 bpm
(Everything else is normal on strip)
What is a Premature Atrial Contraction? Characteristics?
Originate from the Atria but not from the SA node
- Abnormal looking P wave
- May have Compensatory Pause
What is Paroxysmal Supraventricular Tachycardia?
Sudden Occurrence.
- Fast and Narrow
- Difficult to distinguish origin of each beat
What is Atrial Flutter? What can this imply?
- Rapid Atrial Depolarization
- Saw-Tooth Appearance
- Always implies Heart Disease
What is Atrial Fibrillation?
- Wavy baseline, no clear P’s, Irregular
- Most common rhythm after sinus rhythm
- Irregularly Irregular
- Rapid Atrial Depolarization
What is a Premature Junctional Contraction? Characteristics?
Ectopic pacemaker sit in the AV node (junction)
- P wave inversion, precede, follow or be hidden within the QRS complex
Normal instances in which ectopic beats (PACs or PJCs) can occur?
- Stress
- Nicotine
- Caffeine
What is junctional rhythm?
Arrhythmia originating at the AV junction (40 - 60 bpm)
- when impulses from the SA node fail to reach the AV node, this rhythm almost immediately takes over
Heart Block Poem
Characteristics of a First-Degree AV Block?
- Equal but long PR intervals >.20 seconds
- No dropped beats
“If the R is far from the P, then you have a first degree”
Second Degree AV Block (Mobitz I or Wenckebach)
- PR interval progressively lengthens, impulse then completely blocked.
“Longer, Longer, Longer drop. Then you have a Wenckebach”
Second Degree Heart Block Mobitz II
- Sudden blocked P waves without variation or prolongation of the PR interval
“If some P’s don’s get through, then you have a Mobitz II”
3rd Degree AV Block
- P wave completely blocked
- QRS complexes originate independently below the junction
- No relationship between P waves and QRS
- STOP EXERCISE
“If the Ps and Qs don’t agree then you have a 3rd Degree”
What is a PVC?
Ectopic Beat originating from the ventricles.
- Wide and Bizarre QRS complex
- Usually will have a complete compensatory pause
When to STOP exercise during VTACH?
Sustained or symptomatic VTACH
Uniform vs Multiform PVCs
Uniform: More than 1 PVC look alike
Multiform: When they look different
Ventricular Tachycardia?
3 or more PVCs in succession
- Sustained VT > 30 seconds is life threatening
- Need for Defibrillator
What is the most common fatal dysrhythmia?
Ventricular Fibrillation
- Ventricles do not beat in a coordinated manner; quiver
- Defibrillator!! Better hope that shit is working
(CPR or Drugs are not effective)
Asystole and Electrocardioversion
Does not work if there is no rhythm
One way to diagnose acute myocardial infarction on ECG?
ST segment elevation
ST segment depression is usually indicative of?
Myocardial Ischemia
Single PVCs and CO?
Single PVCs will not compromise CO if less than 7 per minute.
- if PVCs increase with activity, it should be stopped
What is R on T phenomenon
PVC fires very prematurely on the T wave of the previous cycle.
- She is very bad
- Can progress to Vtach or Vfib
What does the P Wave Represent?
Atrial Depolarization
What does the QRS complex represent?
- Ventricular Depolarization
- Atrial Repolarization
What does the T wave Represent?
Ventricular Repolarization
What is the necessary steps to take in the event of a First Degree AV Block?
Continue Exercise; no modifications needed
What is the necessary steps to take in the event of a Second Degree Type 1?
Monitor and Continue with Lower Intensity
What is the necessary steps to take in the event of a Second Degree Type 2?
Stop Exercise
- NOT AN EMERGENCY
- No need to call 911
What is the necessary steps to take in the event of a Third Degree Heart Block?
STOP IMMEDIATELY
- Activate Emergency Services
How many mm of ST segment depression is 911 warranted?
> 2 mm
How many mm of ST segment elevation is 911 warranted?
> 1 mm
Does Emergency Services or 911 need to be alerted in the event of Atrial Flutter?
NO! Do not call 911
What is the necessary steps to take in the event of Atrial Fibrillation?
911 not warranted
- Stop exercise, report to physician
What is the necessary steps to take in the event of multifocal PVCs?
Stop Exercise!
What is the necessary steps to take in the event of a Couplet (2 PVCs)?
Stop Exercise
What is the necessary steps to take in the event of VTach?
CALL 911
What is the necessary steps to take in the event of VFib
CALL 911
What is the necessary steps to take in the event of a single unifocal PVC?
Exercise at a lower intensity
- Do not need to consult with physician
