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Fundamentals of Medicine: Cardiology > EKG Characteristics > Flashcards

EKG Characteristics Flashcards

1
Q

P-wave

A

atrial depolarization, causing atrial contraction

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2
Q

QRS Complex

A

ventricular depolarization, causing ventricular contraction

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3
Q

ST segment and T-wave

A

ventricular re-polarization

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4
Q

U wave

A

will probably result from slow or delayed re-polarization of Purkinje fibers

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5
Q

View of Heart: II

A

inferior

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6
Q

View of Heart: III

A

inferior

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7
Q

View of Heart: aVF

A

inferior

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8
Q

View of Heart: I

A

lateral

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9
Q

View of Heart: aVL

A

lateral

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10
Q

View of Heart: V5

A

lateral

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11
Q

View of Heart: V6

A

lateral

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12
Q

View of Heart: V3

A

anterior

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13
Q

View of Heart: V4

A

anterior

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14
Q

View of Heart: V1

A

septal

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15
Q

View of Heart: V2

A

septal

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16
Q

tall P-waves in II, III, and aVF

A

indicates right atrial overload

seen in Pulmonary Valve Stenosis

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17
Q

right axis deviation (negative QRS in V1) and rSR’ in V1

A

Atrial Septal Defect

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18
Q

RVH and right axis deviation; right bundle branch block pattern in patients who have had surgical repair; beware of arrythmias if QRS width is greater than 180 msec

A

Tetralogy of Fallot

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19
Q

1 mm horizontal or downsloping ST-depression that occurs, then reverses after ischemia disappears; occurs during stress test then goes away

A

Stable Angina

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20
Q

1 mm elevation of ST-segment; new Q waves; may see T-wave inversion

A

STEMI

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21
Q

STEMI Location: II, III, aVF

A

inferior wall

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22
Q

STEMI Location: I, aVL, V4-V6

A

lateral wall

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23
Q

STEMI Location: V1-V3

A

anteroseptal

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24
Q

STEMI Location: V1-V6

A

anterolateral

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25
Q

Right ventricular

A

RV4, RV5

26
Q

Posterior Wall

A

R/S ratio greater than 1 in V1 and V2 adn T-wave changes in V1, V8, and V9

27
Q

an increase in duration or a QRS complex is sign of

A

delayed conduction through the ventricle

28
Q

a large q-wave may indicate a ______, and a diagnostically significant Q wave is usually ______.

A

recent or old infarction

0.04 seconds in duration and 1/3 the size of the QRS complex

29
Q

How does Ventricular Hypertrophy effect the QRS?

A

amplitude greater than 35 mm

30
Q

a QRS amplitude less than 5 mm indicates?

A

CAD, emphysema, marked obesity, generalized edema, or pericardial effusion

31
Q

ST-segment depression

A

ischemia or NSTEMI (20-25%)

32
Q

ST-segment elevation

A

injury/STEMI (unless in Prinzmetal Angina)

33
Q

Right Axis Deviation

A
  • QRS in I; + in aVF
34
Q

Left Axis Deviation

A

+ QRS in I; - in aVF

35
Q

Right Chest Leads

A

V1 and V2

36
Q

Left Chest Leads

A

V5 and V6

37
Q

Right BBB

A

widened QRS

R,R’ in V1 and V2

Positive QRS in V1

38
Q

Left BBB

A

widened QRS

R,R’ in V5 and V6

negative QRS in V1

39
Q

Atrial Hypertophy

A

look in V1

P-wave is diphasic – both positive and negative

Initial portion is larger or taller, right atrial hypertrophy.

Terminal portion is larger, left atrial hypertrophy.

40
Q

• Regular tachycardia
• QRS complex usually narrow unless there is aberrant conduction or a pre-existing bundle branch block
• ST-segment depression may be seen with or without the presence of CAD
• P waves may be:
o Buried in the QRS complex
o Visible after the QRS complex (this example)
o (Rarely) visible before the QRS complex
o atria and ventricles are contracting at about the same time

A

AVNRT

41
Q
  • Short PR interval (<120 ms)
  • Delta wave: “slurring” of initial portion of QRS (ventricular pre-excitation)
  • QRS prolonged > 110 ms
  • S-T and T waves can be inverted (opposite to the major portion of the QRS)
A

AVRT

42
Q

irregularly irregular rate and rhythm

absence of P-waves

irregular ventricular response

rate can be slow or fast

A

Atrial Fibrillation

43
Q

back-to-back identical flutter waves described as having a “sawtooth” appearance; especially in leads II, III, and aVF

not a QRS for every P-wave

A

Atrial Flutter

44
Q

Varying P wave morphology and irregular P-P intervals

rate exceeds 100

A

Multifocal Atrial Tachycardia (MAT)

45
Q

wide QRS complexes that vary from other QRS complexes in the same lead and are not preceded by a P-wave

A

Premature Ventricular Contractions

46
Q

3 or more consecutive premature ventricular beats (wide QRS complexes)

rapid rate: >120, but typically 160-240

A

Ventricular Tachycardia

47
Q

wide complex rhythm

rate of 60-120 bpm

A

Accelerated Idioventricular Rhythm

48
Q

QT intervals greater than 440 msec

A

Long QT Syndrome

49
Q

Regular, generally narrow, QRS complexes without p-waves preceding them.

May sometimes see retrograde p-waves after the QRS in the ST segment or t-wave

A

Junctional Rhythms

50
Q

fixed, prolonged PR interval

every P has a QRS

normal QRS width

A

First Degree AV Block

51
Q

Progressive lengthening of PR interval until a QRS is dropped

P wave falls in refractory period of ventricles and fails to conduct impulse to ventricles

Regular P-P interval

Irregular R-R interval

QRS width is normal

A

Second Degree AV Block Mobitz Type I

52
Q

Fixed normal PR interval with intermittent dropped QRS

Regular P-P interval

Irregular R-R interval

There is a P for every QRS but not a QRS for every P

QRS may be widened if the block occurs below the bundle of His

A

Second Degree AV Block Mobitz Type II

53
Q

No relationship between P waves and QRS complexes: PR interval varies

Atria and Ventricles beat independently

Regular P-P and R-R interval

A

Third Degree AV Block

54
Q

alternating bradycardia and tachycardia

A

Tachy-Brady Syndrome

55
Q

Narrow Complex Tachycardias with Regular Atrial Rhythm

A

Sinus tachycardia
Atrial tachycardia
Atrial flutter

56
Q

Narrow Complex Tachycardias with Irregular Atrial Rhythm

A

Atrial fibrillation
Atrial flutter with variable block
Multifocal atrial tachycardia

57
Q

Narrow Complex Tachycardias with Regular Atrioventricular Rhythm

A

AV nodal re-entry tachycardia (AVNRT): Stuck in a roundabout

Atrioventricular re-entry tachycardia (AVRT) (bypass tract): there is a detour back to the atria, stuck driving around the main road-detour circle every time

Junctional tachycardia

58
Q

Wide complex tachycardias; Regular

A

Ventricular tachycardia

SVT with aberrant conduction

AVRT with antidromic conduction

59
Q

Wide complex tachycardias: Irregular

A

Ventricular fibrillation

Polymorphic ventricular tachycardia

Torsades de Pointes

AVRT/WPW with atrial fibrillation

60
Q

Bradycardias: P wave present

P always followed by QRS

A

Sinus bradycardia

First degree AV block

Sinus pause/arrest

61
Q

Bradycardias: P wave present

P not always followed by QRS

A

Second degree AV block: Mobitz I (Wenckebach), Mobitz II, Fixed ratio, eg 2:1, 3:1

Third degree AV block

62
Q

Bradycardias: P wave absent

A

Narrow Complex: Junctional Escape Rhythm

Wide Complex: Ventricular Escape Rhythm

Fundamentals of Medicine: Cardiology (10 decks)

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