EKG continued Flashcards
What are the different types of ST depression
downsloping
upsloping
horizontal
If an upscoping ST depression with peaked T wave in V1-V3 is seen on an ECG, what is the likely diagnosis
Proximal LAD occlusion
What type of ST depression is most concerning for ischemia
horizontal depression
What is a J wave
Short deflection following a downscoping R wave (fishhook appearance)
What are J waves useful for
to differentiate between benign early repolarization vs. STEMI
When are J waves seen on an ECG
Benign early repolarization
hypothermia
hypercalcemia
brugada syndrome
Which leads is it normal to see T wave inversion in
V1, V2, lead 3
If there is a T wave inversion in aVL only, what are you concerned for
inferior MI
How big does a T wave inversion have to be, to be concerning
> 1mm
What are the ddx for t wave inversion
LVH strain
Increased ICP
PE
BBB
Ischemia
What is a hyper acute T wave
Tall broad base with asymmetric peak
**Can fit QRS in hyperacute T wave
When are hyper acute T waves seen
vasospasm
early STEMI
What is a biphasic T wave
Initial positive deflection followed by a downward deflection (could also go in reverse order)
When are biphasic T waves seen
ischemia
hyperkalemia
When are flat T waves seen
Ischemia
hypokalemia
What are peaked T waves
Tall, narrow base, relatively symmetrical peak
> 10mm in height
What are the ddx for peaked T waves
hyperkalemia
hypermagnesemia
Ischemia
Which leads should you NEVER see a T wave
V1-V3
What are the criteria for a pathologic T wave
> .04 sec
2mm depth
or
25% QRS
What are some causes of pathologic Q waves
MI (old or new)
PE
LBBB
LVH
What is the criteria for low voltage QRS
Voltage of leads I, 2, 3 = <15mm
OR
V1+V2+V3 = <30mm
What are some ddx of low voltage qrs
pericardial effusion
obesity
COPD
HF
What are some causes of shortened QT-I
Hyperkalemia
hypermagnesemia
digoxin toxicity
Which leads do you right and left atrial enlargement in
2 and V1
If the P wave in lead 2 is >2.5mm, what is the likely dx
RAE
If there is a positive deflection that is > than the negative deflection p wave seen on ECG, what is the common cause
RAE
If a bifid Pwave in lead 2 that is >.04 seconds, what is it indicative of
LAE
If the negative deflection of the P wave is greater than the positive in V1, what is the Dx
LAE
What are the ddx for RAE
tricuspid stenosis
pulmonary HTN
Pulm. valve stenosis
What are the DDX for LAE
mitral valve stenos
HTN
aortic valve stenosis
What are you concerned about when there is a short PR-I on an ECG
PAC
or
WPW
What is prinzmetal angina
vasospasm
What is the criteria for ST elevation
> 1mm elevation in 2 contiguous leads
**except V2-V3 where 2mm elevation is required
What are examples of narrow and regular rhythms
Sinus tachy
2:1 aflutter
SVT
What are examples of narrow and irregular rhythms
afib
variable aflutter
MAT
What are examples of wide regular rhythms
vtach
SVT with BBB
Sinus tachy with BBB
WPW
What is the funny current
slow, constant flow of Na+ until transmembrane potential is -60mV
