EKG Flashcards

1
Q

What are the steps of EKG interpretation?

A
  1. Rate
  2. Intervals
  3. Axis
  4. Rhythm
  5. Hypertrophy
  6. Infarction / Ischemia
  7. Other
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2
Q

How do you determine rate?

A

Measure R-R intervals or count the # of complexes and multiply by 6

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3
Q

How do you measure rate using the RR interval?

A

use the 300 – 150 – 100 – 75 – 60 – 50 - 40

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4
Q

What are the intervals we measure?

A

PR, QRS, Qtc

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5
Q

What is the normal PR interval?

A

0.12 - 0.20 seconds

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6
Q

What does one “itty-bitty” box count for? what about one big box?

A

itty-bitty box = 0.04 seconds

big box = 0.20 seconds

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7
Q

What is the normal QRS interval?

A

0.06 - 0.10 seconds

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8
Q

What is the normal QTc interval?

A

0.30 - 0.46 seconds or as long as the Qt interval is less than half the preceding R-R interval

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9
Q

What is normal axis?

A

between -30 and 90

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10
Q

Where is the axis if lead I is positive and lead II is positive?

A

Normal axis! -30 to -90

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11
Q

Where is the axis if lead I is positive and lead II is negative?

A

left axis deviation! -30 to 270

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12
Q

Where is the axis if lead I is negative and lead II is positive?

A

right axis deviation! 90 to 150

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13
Q

Where is the axis if lead I is negative and lead II is negative?

A

no mans land! 150 to 270

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14
Q

PR interval more than 0.20 seconds with 1:1 conduction

A

1st degree AV block

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15
Q

PR interval lengthens followed by completely blocked P wave

A

2nd degree AV block type 1

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16
Q

PR interval stays the same, P waves are intermittently blocked

A

2nd degree AV block, type 2

17
Q

P waves are completely blocked, QRS originates independently

A

3rd degree AV block

18
Q

Right atrial hypertrophy

A

Either:
P wave in any limb lead is more than 2.5 mm
P wave in V1 is biphasic and the initial portion is the largest

19
Q

Left atrial hypertrophy

A

Either:
P wave in lead II is notched with > 0.04 sec between peaks
P wave in V1 is biphasic and the terminal portion is the largest with usually a negative deflection

20
Q

Right ventricular hypertrophy

A

Right axis deviation AND R wave in V1 is more than 7mm tall

21
Q

Left ventricular hypertrophy

A

Cornell criteria: R wave in aVL + S in V3 = > 24 in men or > 20 in women
Any R + S in precordial leas >45mm
R wave in V5 more than 26mm
R wave in aVL at least 12 mm (most specific)

22
Q

Ischemia

A

T waves biphasic with or without ST depression

23
Q

LBBB

A
QRS greater than or equal to 0.12 sec
Broad R waves in I, V5 and V6
    - ST depression and T wave inversion in these leads
         -large S wave in V1/V2
         -possible left axis shift
24
Q

Does having LBBB affect any other diagnosis?

A

hypertrophy and infarct

25
Q

RBBB

A

QRS equal to or more than 0.12 sec

rsR’ in V1 and V2, typically second R larger

26
Q

Diffuse Upward Concave ST segment elevation except for aVR with no reciprocal ST depressions

A

pericarditis

27
Q

Tall, narrow, peaked T wave with possible QT shortening

A

K+ = 5.5 - 6.5 mEq/L

28
Q

flattened wide P waves, widened QRS

A

K+ = 6.5 - 7.5 mEq/L

29
Q

Loss of P waves, very wide QRS, VT, VF, asystole

A

K+ > 7.5 mEq/L

30
Q

Prominent U waves, flat T waves, big P waves

A

hypokalemia

31
Q

Sinus Tach

S1Q3T3

A

PE

32
Q

A fib or sinus brady, or osborne waves

A

hypothermia