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SUMEKG > EKG-Blocks_Pre-Excite > Flashcards

EKG-Blocks_Pre-Excite Flashcards

1
Q

What is conduction disturbance btwn Atria and ventricles?

A

Heart block

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2
Q

This is normal at rest but concerning, can be seen with Meds, stimulants, caffiene?

A

SVT; TX w/ adenosine or valsalva

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3
Q

What measure time from atria to AV node and if delayed means AV block?

A

PR interval. Normal is .12-20, 4x. Delayed transient or permanent impaired transmission through AVjx

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4
Q

This rhythm is regual, under a NSR, consitent PRI is >4bx, w/ QRS normal?

A

1 Degree AV block

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5
Q

2 degree type I AV has what?

A

Progressively longer PRI 2. Then One QRS drops

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6
Q

What is occureing with second degree blocks?

A

Gets longer bc retracing. Ventricular Irregular, Atria rythm is regular. QRS normal

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7
Q

What occurs at bundle of his, branches or trifascular?

A

2nd degree AV block TYPE 2. QRS wide w/ drop 3. PR consitently normal or prolonged 4. Ventricular irregular 5. PAC is Early

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8
Q

3 degree AV block have regular what?

A

P-P, R-R 2. Wide QRS. NO association btwn atria ad ventricles

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9
Q

Which AV blocks require pacemaker?

A

2 degree Type 2 and 3rd degree. both symptomatic, palpitations, or syncope

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10
Q

WHat are formed during cardiac development in a variety of locations where impulses can travel?

A

Pre exciation syndromes. Wolfe Parkinson-White, Lown-Ganong-Levine (james fibers) Mahaim-type fibers

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11
Q

What is the fiber called within a WPW?

A

Bundle of kent fiber

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12
Q

In a pre excitation syndrome, what affect the appearance of the ECG?

A

Accessory pathway can conduct impulse MC in both directions. Anterograde towards ventricle, Retrograde- away from

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13
Q

Why are pre excitation syndromes concerning?

A

Cause PSVT, Vfib, Sudden Death. RECOGNIZE to save a life. SX- dizzy, palpitain, syncompe, sudden death

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14
Q

During WPW Delta way is noted. what does it mean?

A

Ventricle is activated prematurely, short PRI, impulse delayed at AV node-Widen QRS

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15
Q

What are stats fro WPW?

A

50-50% symptomatic. Bimodal- 1peak childhood, 2nd peak adult

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16
Q

Which leads will show delta wave, tall R waves, and ST and T wave changes in WPW?

A

V1-V2

17
Q

THis is MC, when kent fiber goes to LV?

A

Type A- WPW patern tall R wave V1-2

18
Q

THis is LC, when kent fiber goes to RV?

A

TYPe B-WPW patern NEG RS or QS wave V1-2. V1-V2 close to septum

19
Q

What is treatment for WPW?

A

Radiofrequency catheter ablation. DX- electrphysiogram determine pathways

20
Q

WHat occurs when ventricale contraction must wait for opposite ventricle(cell to cell)?

A

Slower activation, LONG bizzarie shaped QRS complexes. Bundle branch blocks. Recall QRS .8-.12 2-3bx, SA-AV-HIs-Branches-purkinje

21
Q

In a normal conduction, but ventricles contract at same time, superimposed, what is indicatvie if L brance is blocked?

A

Notched, M-shaped, wide QRS. 1st notch is R, 2nd notich Rprime is L. Left stronger, but delayed.

22
Q

what leads show BBB for L?

A

LC, V1- DEEP NEG QRS, strong impulse away from RV. V5 OR V6- QRS wide. RSR*, notched

23
Q

What is lead with LBBB and MI?

A

V1 deep neg will have tombstone- ST elevation,MI

24
Q

WHat are the rabbit ears?

A

RBBB Rl* is R delayed. MC. Leads V1- RSR rabbit ears, V6- slurred S

25
Q

What should be clinical concern with LBBB and RBBB?

A

RBBB- benign, monitor HTN, vitals, electrolyets, meds/yr. LBBB-MI

26
Q

If there is partial block in LBB system then what is suspected?

A

Fasciular hemiblocks alos likely a Left axis deviation. NOT all LAD and RAD are hemiblocks

27
Q

What are DDx if QT interval is long >0.45sec?

A

HYPOK, MG, CA

28
Q

What are DDx if QRS interval is long >0.12sec?

A

BBB, fasicular block, PVC, Idioventrciular rhythm

29
Q

What are DDx if PR interval is long >0.20sec?

A

AV blocks, 1-3

30
Q

What are DDx if PR interval is short >0.12sec?

A

WPW, LGL

SUMEKG (8 decks)

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