EKG: Abnormal Interpretations Flashcards
The P Wave is associated with the activation of what area of the heart?
Activation of the Atria
The QRS Complex is associated with the activation of what area of the heart?
Activation of the Ventricles?
The T Wave is associated with the activation of what wave of the heart beat?
The Recovery Wave
How much time is equivalent to one square on an ECG readout?
1 square = 0.04 sec (40 m/s)
What is a normal HR for an ECG analysis?
60-100 bpm.
What is a normal PR Interval for an ECG analysis?
0.12 - 0.20 sec (about small 3 boxes)
What is a normal QRS Interval for an ECG analysis?
< 0.12 sec
How do you calculate rate on an ECG?
Count the number of large boxes between consecutive R waves and divide 300 by this number.
What is Paroxysmal Supraventricular Tachycardias (PSVT)?
Sudden run of >3 premature beats (both sustained for up to hours or longer + brief & non-sustained: 3 beats up to 30 sec)
What are some characteristics of Atrial Flutter’s?
Atrial rate is constant, Ventricular rate depends on AV junction, Variable Rhythm (regular or irregular), and No Observable P Waves.
In Atrial Fibrillations Atrial Rates are _____ and Ventricular Rates are ______ ?
Atrial: Chaotic | Ventricular: Irregular
How would you describe the Rhythm of Atrial Fibrillation?
Irregular, with no specific pattern. No stable relationship between fibrillary atrial waves and the QRS complex’s.
How would you describe the P waves of Atrial Fibrillation?
No identifiable P waves, only fibrillary (f) waves, irregular movements of baseline.
Is the PR Interval measurable in Atrial Fibrillation?
Not measurable.
What triggers an Atrial Fibrillation?
Rapid electrical activity starting in the pulmonary vein and spreading to the atrium.
What is AV (Atrio-Ventricular) heart block?
Conduction disturbances, impaired transmission from atria to ventricles. (AV node dysfunction)
What is the primary measure of AV Heart Blocks?
PR Interval
How many types of AV Heart Block are there?
1st Degree, 2nd Degree (Type 1 & Type 2), and 3rd Degree
How would you describe 1st Degree AV Heart Block?
Mildest, more of a delay & not a block. Impulses moving through the AV node too slowly.
What is the PR Interval of 1st Degree AV Heart Block?
> 0.20 sec
What are some causes of 1st Degree AV Heart Block?
Medication-Induced, Myocardial Infarction, and Hyperkalemia.
How would you characterize 2nd Degree Heart Block Mobitz Type I?
Progressive lengthening of PR interval w/non-conducted P wave. (usually only 2-3 P waves occur before a QRS is dropped)
What are some causes of 2nd Degree Heart Block Type 1?
Medication-Induced, Ischemic Heart Disease, Acute Inferior Wall Infarction, and Enhanced Vagal tone (Athletes)
How would you describe the Rhythm of 2nd Degree Heart Block Type 2?
Irregular with “grouped” beats.
How would you describe the Rate of 2nd Degree Heart Block Type 2?
Atrial: Constant between 60-100 bpm. Ventricular: Varies due to non-conducted P wave.
How would you describe the P wave & PR Interval of 2nd Degree Heart Block Type 2?
P Wave: sudden appearance of a non-conducted P wave
PR Interval: NO progressive lengthening.
What is 2nd Degree Heart Block Type 2 a general sign of & what is the treatment?
General sign of severe conduction system disease (AV node & below)
Treatment: Pacemaker
How would you describe 3rd Degree Heart Block?
PR Interval is irregular & not related to the flow of electrical stimuli.
How is the pacemaker rhythm recognized?
Easily recognized through pacemaker spikes (vertical signals that represent the electrical activity of the pacemaker)
How do Premature Ventricular Contractions occur?
Randomly or may alternate with normal beats in a regular pattern.
What are some EKG rhythm properties associated with PVC’s?
P Wave: not conducted
PR Interval: not measurable
QRS Complex: > 0.12 secs with abnormal form
Rhythm: irregular
Rate: variable
A Triplet PVC is what shape?
Non-Sustained VTach
A Multifocal PVC is what shape?
More than one shape
What is Ventricular Tachycardia (V-Tach)?
Fast heart rhythm that originates in one of the ventricles.
A Ventricular Tachycardia has a run of ___ QRX complex’s?
> 3 (single, non-sustained, or sustained for > 30 sec)
What are some EKG rhythm properties associated with V-TACH?
Rate: Ventricular rate is 150-200 bpm
Rhythm: Regular or Slightly Irregular
P Wave: Usually not distinguishable
PR Interval: Not Measurable
QRX Complex: Wide & Bizarre (>0.12 secs)
What is a Ventricular Fibrillation (V-Fib)?
Uncoordinated contraction of the ventricles resulting in a “quivering” rather than a normal contraction.
What are some EKG rhythm properties?
P Wave: Not Identifiable
PR Interval: Not Measurable
QRS Complex: Not Identifiable
Rhythm: Chaotic, not identifiable
Rate: cannot be determined
In V-TACH & V-FIB, if the ventricles are not contracting properly, what is the outcome?
Decrease in cardiac output.
How is V-FIB identified?
Most commonly identified as arrhythmia in cardiac arrest patients.
What are Bundle Branch Blocks?
Delays in electrical signal conduction to the R & L ventricular tissue
How do you determine the presence of BBB?
Primarily examine QRS waves
How is a R Bundle Branch Block typically spotted? (characteristics)
“Bunny Rabbit Ears”
How is a L Bundle Branch Block typically identified?
Produced an R, R’ in the left chest leads V5/V6 with accompanying broad R-wave and deep S and inverted T-Wave.
