EKG

Question 1

Atrial Flutter

Pres on EKG (incl CLUE)?

Answer 1

PRES ON EKG:
Rapid succession of IDENTICAL back-to-back atrial depol waves =
“sawtooth” appearance of flutter waves.

Question 2

Atrial Fibrillation

Pres on EKG (CLUE + 2)?

Answer 2

PRES ON EKG: “irregularly irregular” (chaotic / erratic baseline)

• No discrete P waves
• Varying R-R intervals

Question 3

Ventricular Fibrillation (V-Fib)

Cause, Pres on EKG?

Answer 3

CAUSE = V-Tach.

PRES ON EKG:
Totally ERRATIC shape (due to total loss of rhythmic contraction) with no identifiable waves.

** Fatal arrhythmia without immediate CPR + Defibrillation **

Question 4

1st Degree AV Block

Pres on EKG (2)?

Answer 4

PRES ON EKG:

• 1:1 correspondence b/w P wave + R wave
• PR Interval > 0.20 s

** Asymptomatic **

Question 5

2nd Degree AV Block

Pres on EKG?

Answer 5

PRES ON EKG:
‘Dropped beats’ (P wave not followed by QRS complex) =
MISSING QRS

Question 6

2nd Degree AV Block- Mobitz I (Wenckebach)

Pres on EKG?

Answer 6

PRES ON EKG:
Progressively↑PR Interval
= “Progressive lengthening of PR Interval until beat is dropped”

** Usually Asymptomatic **

Question 7

2nd Degree AV Block- Mobitz II

Pres on EKG, Comp?

Answer 7

PRES ON EKG:
- 2:1 Block = 2 P waves : 1 QRS complex

COMP:
- 3rd Degree AV Block

Question 8

3rd Degree AV Block

Def’n, Causes, Pres on EKG (2), RX?

Answer 8

Atria and Ventricles beat INDEPENDENTLY of each other.
Atrial rate faster than the ventricular rate.

CAUSES:
- Lyme Dz

PRES ON EKG: “Cannon A waves” + Bradycardia.
No correlation of P waves + QRS complexes.

RX = Atropine then Pacemaker

Question 9

Premature Ventricular Contraction (PVC)

Pres on EKG?

Answer 9

PRES ON EKG:

Large wide QRS

Question 10

Ventricular Tachycardia (V-Tach)

Pres on EKG (2, incl HR)?

Answer 10

PRES ON EKG: ** Looks like prolonged sequence of PVCs **

• REPEATED large wide QRS
• HR = 150-250 / min

Question 11

Torsades de Pointes

Def’n, Pres on EKG?

Answer 11

V-Tach that can progress to V-Fib.

PRES ON EKG: “Shifting” sinusoidal waveforms

Question 12

Wolff-Parkinson-White Sx

Pres on EKG (2)?

Answer 12

PRES ON EKG:

• Delta wave
• SHORTENED PR Interval

Question 13

Class IA + Class III Antiarrhythmics

Pres on EKG?

Answer 13

PRES ON EKG:

↑QT Interval

Question 14

Class II + Class IV Antiarrhythmics

Pres on EKG?

Answer 14

PRES ON EKG:

↑PR Interval

Question 15

Digoxin Toxicity

Pres on EKG (5)?

Answer 15

PRES ON EKG:

• ↑PR
• ↓QT
• “ST scooping”
• “T wave insertion”
• AV Block

Question 16

MI

Pres on EKG (2)?

Answer 16

PRES ON EKG:

• ST Elevation
• New q wave

Question 17

SUBendocardial Ischemia

Mech, Pres on EKG, Pres, Seen In?

Answer 17

MECH: Coronary Art ATHEROSCLEROSIS.

EKG:
- ST Depression

PRES:
- Pain

SEEN IN:
- Stable + Unstable Angina

Question 18

TRANSMURAL Ischemia

Mech, Pres on EKG, Seen In (2)?

Answer 18

MECH: Coronary Art VASOSPASM.

EKG:
- ST Elevation

SEEN IN:

• Prinzmetal’s Angina
• Fibrinous / Autoimmune (Dressler’s Sx) Pericarditis

Question 19

Restrictive / Obliterative Cardiomyopathy

Pres on EKG (2)?

Answer 19

PRES ON EKG:

• Low-Voltage EKG
• ↓QRS amplitude

Question 20

K Imbalances

Pres on EKG (2 HYPO, 2 HYPER)?

Answer 20

PRES ON EKG:

• HYPOkalemia -> Flattened T waves
  - > U waves
• HYPERkalemia -> Peaked T waves
  - > Wide QRS