EKG Flashcards
what leads do we look at for LAE and RAE and what changes?
- look at P waves in II and V1
- in II, RAE increases P wave height while LAE increases P wave duration
- in V1, RAE increases height of hump, LAE increases depth of dip
criteria for LAE in V1
dip is at least 1mm deep AND 1mm wide
BBB or His block indicated by…
QRS longer than .12
look for RBBB in what lead?
V1, bunny ears, terminal vector positive, >.12
look for LBBB in what lead?
V6, terminal vector positive, >.12
what diagnoses can not be made in the presence of LBBB?
LVH, anterior MI, inferior MI, because of mimicry
left anterior hemi block sign
marked LAD
left posterior hemi block sign
marked RAD
LVH look for what signs?
- LAD
- add S in V1 and R in V5, >35?
RVH look for what signs?
- RAD
- tall R in V1
anterior MI signs
pathological Q waves in V1-V4
inferior MI signs
pathological Q waves in II, III, aVF
lateral MI signs
Q waves in I, aVL, V5, V6
sub-endocardial ischemia signs
- ST depression in anterior leads I and II, and lateral leads V4-V6
- late ischemia will have downslope
transmural ischemia signs
- ST elevation in leads corresponding to LAD artery V1-5
- early is concave upward
- late is concave downward
in which lead are P waves supposed to be negative or biphasic?
V1
sick sinus syndrome?
- well conditioned athletes, just a slow sinus rhythm or…
- delayed conduction after end of fit of a-fib, causing syncope
mobitz I also known as
wenckebach
mobitz I and II are examples of what degree of AV block?
2nd degree
what is the main problem in first degree AV block?
delay in conduction - there is a Q for every P
what is the main problem in second degree of AV block?
intermittent failure in conduction - there are some Ps with no Qs
big difference between mobitz I and II on EKG?
mobitz I has the wenckebach phenomenon with increasing length of PR segment.
what does third degree heart block look like?
- ventricular escape rhythm with non-conducting P waves dispersed in unrelated manner
what does the backward depolarization in WPW look like on an EKG?
inverted P wave in lead II
heart rate in WPW?
150-250
three conditions for re-entry
- two pathways
- pathways have different refractory periods
- pathways have different rates of conduction
two types of SVTs
- re-entrant (WPW)
- AV nodal re-entrant
compare WPW EKG to AV nodal reentry EKG
- WPW - inverted P waves in lead II, delta waves during normal sinus rhythm
- AV nodal has P waves buried in QRS complex, QRS is normal
what is a left ventricular strain pattern?
ST depression in leads V5-V6
what is a right ventricular strain pattern?
ST depression in leads V1-V4
