EKG Flashcards
What are the leads associated with LCX?
Lead I and aVL
V5-6
What does it mean if the rate is over 300?
It is artifact or non-mammalian.
What leads are associated with RCA?
Lead II, III, aVF
V1-3
What does a rate of 200 make you think?
Bypass tract
What does a rate of 150 or close to 300 make you think?
A fib or a flutter
What does a rate of 160+ make you think?
PSVT
At what rate is it probably no longer sinus tachy?
140+
What is the rate at which the AV node takes over?
50
At what rate do the ventricles take over?
40
Why is Lead I my friend?
Because all the waves should be positive in this lead and if they aren’t it means an abnormal heart
What is a q wave?
A negative force before the R wave
How can you kill someone with pericarditis?
By missing it and calling the cath lab. Can cause tamponade
In what lead should all waves be negative?
AVR
What should you do if there is isolated ST elevation in aVR?
Look for ST depression in other leads because this is an LAD or left main issue
What else should you think of if you see positive waves in aVR?
TCA overdose
How long should QT be?
No longer than 440 ms (11 boxes)
What are Sgarbossa’s rules for reading a MI in the setting of a bundle branch block?
- Concordat ST elevation
- Discordant ST elevation over 5 mm
- Concordat ST depression in V1-V3
What does diffuse ST elevation mean?
Pericarditis
What is first degree AV block?
Increased PR interval greater than .2
What does an infarct in the widow maker look like?
ST elevation in I, aVL, V1-V4
ST depression in II, III, aVL
What does a negative R wave with a large hump mean?
Ventricular aneurysm
How can you kill someone with an ventricular aneurysm?
Giving thrombolytics because there could be a clot in the aneurysm
What does an inferior wall MI look like?
ST elevation in II, III, aVF
ST depression in I, aVL, V5-6
What does S1Q3T3 mean?
S1- negative deflection in lead 1 which indicates right heart strains
q3- shows a q wave in lead III
T3: means an inverted T wave in lead 3
pulmonary embolism
What is a poor prognostic indicator in PE?
T wave inversions in v1-3
What else might you see in right heart strain?
Big R waves
What determining axis what is most important?
Look at lead I and aVF then lead II - area under the curve is what matters
What does an inferoposterior wall MI look like?
ST elevations in II, III, aVF, V5-6
ST depression in I, aVL, V1-3
T wave inversion in V1-3
What artery is blocked in inferoposterior wall MI?
Proximal RCA
What are the five treatments of WCT?
Amiodarone Lidocaine Mg Procainamide Shock
What points toward a right atrial abnormality?
Big p waves in the inferior leads
Rightward p axis
What is unique about type I second degree heart block?
Regularly irregular
Increased PR interval and then a dropped beat
What should wide QRS make you think of?
Heart block
How can you tell which side the block is on?
The area under the curve in lead I will tell you
Positive= left
Neg= right
Wide complex with p’s connected =?
BBB
What is the first EKG change you see in hyperkalemia?
Peaked t waves
What is the order of changes in the EKG with hyperkalemia?
- Peaked t waves
- PR prolongation
- P wave disappearance
- Widened QRS
What do you see in hypokalemia?
- U waves (V4-6)
- ST depression
- Decreased amplitude of the T wave
- QT prolongation (especially less than 3.0)
St elevation in I, aVL, V1-V3 with reciprocal changes?
Anterolateral infarct (lesion in the LAD)
What would right atrial abnormality look like?
Inverted p waves
P waves in lead II greater than 2.5 mm
What would left atrial abnormality look like
P wave width greater than 3 boxes in lead II
Negative deflection in V1 greater than 1 mm and 40 msec
Notched p waves in lead II
What is LVH?
Amplitude of S in V1 + R in V5 or V6 greater than 35 mm
