EKG Abnormalities Flashcards

1
Q

what abnormality is seen in V1 with RBBB?

A

called the rSR’ where the r is the first spike from IV septum depol then S is lower cause of the movement to left ventricular then R’ is from the spike of the right ventricle finally contracting

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2
Q

how long does the QRS need to be to have a RBBB of LBBB?

A

greater than 0.12 or more than 3 small boxes

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3
Q

what happens to the T wave in the leads with rSR’ pattern when having RBBB?

A

will have an inverted T wave

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4
Q

name the four EKG abnormalities found with a RBBB?

A

prolonged QRS greater than 0.12
rSR’ pattern in V1 lead
long S wave in lead 1 and V6
T wave inversions in V1-2

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5
Q

what happens in lead I and V6 in RBBB?

A

they get a widened S wave

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6
Q

what four leads to note with RBBB?

A

lead 1
V1, V6
maybe V2

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7
Q

four potential cause of RBBB

A

pulmonary hypertension
atrial septal defect
pulmonary embolism
CAD

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8
Q

four criteria for a LBBB

A
prolonged QRS of more than 0.12 seconds
rS or QS wave in V1
broad/notched R wave in lead I or V6
no Q waves in I or V6
T wave opposite RS deflection
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9
Q

what should you find in V1 with a LBBB?

A

rS or QS wave

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10
Q

what should you find in lead I or V6 in LBBB?

A

broad/notched R wave and absence of Q waves

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11
Q

what happens to T waves in LBBB?

A

they are opposite of direction of QRS deflection

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12
Q

what three leads to look at for an LBBB?

A

lead I, V6, and V1

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13
Q

four possible causes of LBBB?

A

hypertensive heart disease
valvular disorders
CAD
cardiomyopathy

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14
Q

what does ventricular pacing look like on EKG?

A

looks like a bundle branch block with little snips right before the QS complex

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15
Q

WPW EKG abnormality and why?

A

has a delta wave that leads up the R wave…this is because the ventricle has been pre excited by the bundle of Kent

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16
Q

bundle of Kent

A

bypass tract to LV in WPW

17
Q

What do Sodium channel blockers do to the QRS?

A

they make it wider

18
Q

name a class of sodium channel blocker

A

Class I anti arrythmics

19
Q

5 cause of low voltage QRS

A

hypthyroidism, amyloidosis, pleural/pericardial effusion, end stage myocardial disease, obesity, pneumothorax

20
Q

hyperkalemia

A

high potassium

21
Q

hyperkalemia effect on QT interval

A

shortens

22
Q

hyperkalemia effect on T wave

A

increases…looks like spike

23
Q

what is hyperkalemia prone to?

A

ventricular tachycardia or fibrillation

24
Q

what is the new wave we get with hypokalemia and when does it appear?

A

the new U wave comes right after the T wave

25
Q

what happens to the T wave in hypokalemia?

A

T wave will be slower and dampened…can be inverted

26
Q

what happens to the QT interval in hypokalemia?

A

gets longer…too long

27
Q

name the three changes of hypokalemia in EKG

A

the QT interval lengthens…the T wave gets smaller and can invert…U waves appear

28
Q

name the two changes with hyperkalemia of the EKG

A

T waves are higher and spikey

QT is shorter

29
Q

what two changes do we see with hypercalcemia in EKG?

A

osborn waves..waves directly following the R wave

and shortened ST segments

30
Q

Two changes to EKG due to hypocalcemia?

A

long ST segment…leading to long QT interval

31
Q

how to calculate the QTc

A

take length of QT in seconds and divide by square root of the RR interval

32
Q

when do we worry about the length of the QT interval

A

if it is longer than 1/2 RR

33
Q

3 congenital channelopathies leading to lengthened QTs

A

loss of function Ks channel
loss of function Kr channel
gain of function Na channel

34
Q

what is a disease risk with prolonged QT?

A

Torsade de pointes