EKG diagnosis you cant miss Flashcards
- Regular cardiac rhythm originating from the sinus node w/ HR over 100bpm in adults
- can be normal but if at rest could be earliest sign of serious pathology
sinus tachycardia
regular cardiac rhythm originating from the sinus node w/ rate < 60bpm in adults
* caused by different intrinsic and extrinsic fctors which may increase vagal tone or compromise sinus node integrity
sinus bradycardia
inability of the SA node to generate a heart rate that meets physiologic needs
Sick sinus syndrome
these are common causes of what
- ischemia
- electrolyte issues
- lyme dz
- thyroid dysfunction
- toxins
bradycardia
PR interval > 0.2 seconds at rest w/o interruption in atrial to ventricular conduction; no dropped QRS
1st degree block
why is 1st deg. block not a true block
atrial impulses are still being conducted to ventricles, its just delayed
two people that could have 1st deg block as their normal
- ppl w/ increased vagal tone (young athletes)
- ppl w/ slow resting HR
first line in symptomatic 1st & both 2nd deg AV blocks
atropine
- progressively lengthening PR intervals until occasional non-conducted atrial beats
- shortened R-R interval
- AV dysfunction above bundle of HIS
2nd degree type I (wenckebach)
- AV dysfunction at the bundle of HIS
- fixed PR interval
- nonconducted P waves (dropped QRS after)
2nd degree type 2
which block is most common in presence of structural heart dz
2nd deg, type 2
- regular P-P intervals unrelated to regular R-R intervals
- AV dissociation = complete absence of AV condution where no atrial impulses conduct to the ventricle, so the atrial & ventricle activity are independent of each other
3rd degree block
- reentrant circuit in the atrium aroudn the valve annulus
- rapid, regular atrial depolarizations at rate around 300 d/t 1 single irritable atrial focus firing at fast rate
- increased risk of atrial thrombus formation
atrial flutter
- multiple irritable atrial foci fire at fast rates
- irregularly irregular
- increased risk of atrial thrombus formation
- most are asymptomatic
afib
most common chronic arrhythmia
afib
- tachyarrhythmias originating above ventricles
- AVNRT is the most common type
paroxysmal SVT
most common cause of narrow QRS complex tachycardia
AVNRT
ventricular preexcitation syndrome resulting in an abnormal conduction through an accessory pathway that bypasses the AV node
* a type of AVRT
* antegrade condutctio through fast accessory path otside AV that bypasses the slower conduction
WPW
premature beat from ventricle that causes wide, bizarre QRS earlier than expected
T wave usually in opposite direction
compensatory pause
PVC
- RCA occlusion
- leads: II, III, avF
- reciprocal: I and avL
- concave shape
inferior STEMI
- Leads V3, V4
- LAD/ widow maker
- often involves septal and lateral walls
anterior MI
which wall
I and avL
V5, 6
lateral wall
- ST depression in V1-3/4
- posterior descending artery
- get posterior EKG
posterior MI
ST elevation in V1-3
T wave inversions in V1 & V2
RBBB
brugada syndrome
why is new LBBB significant?
its STEMI equivalent
- high grade proximal LAD occlusion
- no troponin elevation/minimal
- no STE
- recurrent CP
wellens syndrome
which type of wellens has deeply inverted T waves in leads V2 and V3
Wellens B
which type of wellens has biphasic T wave in leads V2 and V3
wellens A
horizontal ST depressions in 2+ anterior leads (V1-V4)
tall broad R waves or dominant R wave in V2
posterior MI
why are posterior MIs significant
implies a much larger area of myocardial damage, with an increased risk of left ventricular dysfunction and death
