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EKG Flashcards

1
Q

LVH

A

Lead I >14boxes OR Lead avL >13 boxes, OR highest R in V5 and V6 + deepest S in V1 and V2 >/= 35

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2
Q

MI

A

St segment depression or prominent T wave inversion and/or elevation of cardiac enzymes in absence of ST seg elevation
Q waves-> dead tissue
Significant Q waves either greater than 1 box or 1/2 ht of QRS complex

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3
Q

RVH

A

RAD (F+, I-)

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4
Q

Sinus rhythm

A 
60-100bpm
nml upright P wave
PR interval 0.12-0.20 (3-5 boxes)
QRS interval </= 0.12 seconds
P:QRS ratio 1:1
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5
Q

V1-V6

A

V1-V5 will see R wave sizes progress, V6 R wave smaller than V5

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6
Q

V6-V1

A

V6-V2 S waves progress in size, V1 S wave usually smaller than V2

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7
Q

If suspicious of LVH what should you order?

A

ECHO, only 50% of LVH show up on EKG.

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8
Q

1st degree block

A

PR interval longer than normal
causes:nml heart, increased vagal tone, digitalis toxicity, inferior MI, myocarditis
Tx. underlying problem

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9
Q

2nd degree block Type 1

A

PR interval longer, longer, drop

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10
Q

2nd degree block Type 2

A

PR interval consistent (either nml or long), randomly dropped
causes: cardiomyopathy, MI

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11
Q

3rd degree block

A

No communication between P and QRS; nml QRS complex; RR interval same, PP interval same
causes: MI, drugs (digoxin, BB)

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12
Q

Sinus Arrhythmia

A

P with every QRS

Irregular rate

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13
Q

Pre-cordial leads

A

V1-V6 (located around the heart)

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14
Q

Limb leads

A

I,II,III, aVL, aVF, aVR

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15
Q

SA node rate

A

60-100bpm

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16
Q

AV node rate

A

40-60bpm

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17
Q

Muscle cells/ventricles

A

20-40bpm

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18
Q

What 3 components do you need in an EKG diagnosis?

A

Rhythm, axis, other EKG changes

eg. A. Fib w. normal axis and no other EKG changes
eg. 3rd degree block w. normal axis and R wave in V6 greater than R wave in V5

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19
Q

How do you indicate an Irregular rhythm

A

eg 90 I , 90 irregular

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20
Q

Reading an EKG

A

1) regular or irregular
2) Fast/slow/nml
3) Rate
4) PQRS present
5) P w/ every QRS
6) PR interval 0.12-0.20seconds
7) Width of QRS </= 0.12 seconds

21
Q

LAD indicates

A

Hyperkalemia, Cardiac pacing

22
Q

RAD indicates

A

Lung disease, Rt. Ventrical Hypertrophy

23
Q

ERAD indicates

A

Hyperkalemia, Cardiac pacing

24
Q

Artery in Inferior infarct

A

R coronary artery

25
Artery in Lateral infarct
Left Cirumflex
26
Artery in anterior infarct
anterior intraventricular
27
A. fib
shimmering baseline (atrial depolarization >400bpm) normal QRS width Causes: HTN, rheumatic heart dz, ischemic heart dz, PE, COPD, ETOH, pericarditis Beware of forming Thrombus! Symptoms: palpitations, lightheaded, fatigue, angina, dyspnea, syncope Unstable: electrical cardioversion stable: control rate with IV CCB (diltiazem) or BB or Digoxin Stable: can electrical cardiovert if A. fib less than 48 hrs, *must anticoagulate for 3 weeks prior to cardioversion
28
Ventricular Tachycardia
Rate >100 usually 150-200 Wide, bizarre QRS waves Flipped T-waves--> Ventricles do not depolarize normally therefore will not repolarize normally (supraventricular tachycardia will see narrow or reg QRS, normal T wave because the problem is above the AV node)
29
Sinus Tachycardia causes
caffeine, cocaine, nicotine, anxiety, fever, anemia, PE
30
Atrial flutter
``` Sawtooth flutter waves Atrial rate 250-350 bpm Ventricular rate 150 AV block 2:1 rate Almost always due to underlying heart disease (MI, ischemia), also PE, digoxin toxicity Tx: ventricular rate control: CCB, BB, Digoxin Chemical conversion: antiarrhythmics electrical cardioversion >90% successful ```
31
V. fibrillation
Irregular zigzag pattern with no P or QRS waves | immediate cardioversion
32
Criteria for RBBB
QRS complex greater than 0.12 seconds | RSR' in V1 and V2 with ST seg depression and T wave inversion
33
Criteria for LBBB
QRS complex greater than 0.12 seconds | Broad or notched R wave in I, aVL, V5, V6 with ST seg depression and T wave inversion
34
Sinus arrhythmia tx
none
35
Sinus bradycardia tx
none, unless <50bpm then atropine 0.5mg IV q 3-5min
36
Sinus tachycardia tx
None, unless in setting of acute MI then BB
37
Atrial flutter tx
Electrical cardioversion Ventricular rate with dig, CCB, BB Chemical cardioversion w antiarrhthmics
38
Atrial fibrillation tx
Unstable: electrical cardioversion Stable: rate control with CCB, BB, dig Chemical cardioversion
39
Supraventricular tachycardia tx
Vagal maneuvers: valsalbva, carotid sinus massage Adenosine: stops heart, hurts Verapamil: CCB, blocks the AV node Unstable: electrical cardioversion
40
Premature atrial contraction tx
stop any precipitating durgs tx underlying disorder PAC that trigger flutter/fib may be suppressed with quinidine, procainamide, BB
41
Premature ventricular contraction tx
Otherwise healthy: O2 first In setting of MI: tx underlying cause first Chronic PVC: antiarrhythmics may increase chance of sudden arrhythmic death, consider defibrillator if underlying heart disease
42
Ventricular tachycardia tx
Unstable: immediate electrocardioversion Stable: IV antiarrhythmics: amiodarone, lidocaine, bretylium, procainamide
43
Ventricular Fibrillation tx
IMMEDIATE ELECTRICAL DEFIBRILLATION CPR IV amiodarone, lidocaine, bretylium
44
Ventricular Asystole tx
CPR | Epinephrine, atropine
45
1st degree heart block tx
Underlying problem
46
Second degree heart block type 1 tx
Stable: no treatment | If hypoperfusion, atropine and/or cardiac pacing
47
Second degree heart block type 2 tx
If hypoperfusion, atropine and/or cardiac pacing | Permanent pacemaker
48
3rd degree heart block tx
O2, IV, atropine, pacing
49
BBB
May result in 1st, 2nd, or 3rd degree block

Cardiology (2 decks)

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