EKG Findings

Question 1

1st degree AV block

Answer 1

Long PR interval (>.2s)
No tx needed

Question 2

2nd degree AV block Mobitz type I: Wenckebach

Answer 2

PR interval lengthens and then QRS complex drops
No tx needed

Question 3

2nd degree AV block Mobitz type II

Answer 3

PR interval stays the same and QRS complex drops
NEEDS PPM

Question 4

3rd degree AV block

Answer 4

P wave and QRS complexes are regular but don’t coincide
NEEDS PPM

Question 5

Atrial Fibrillation

Answer 5

Irregularly irregular heart beat

No P waves, best seen in lead II, irregular
tx anticoagulants and keep HR >110

Question 6

Multifocal atrial tachycardia

Answer 6

Different P waves morphologies seen in lead II, irregular
NO ANTICOAGULANTS

Question 7

Atrial tachycardia

Answer 7

Inverted P waves in leads I, aVF; regular and fast

Question 8

Atrial flutter

Answer 8

Sawtooth pattern

Question 9

Junctional rhythm

Answer 9

No p waves, or RETROGRADE P waves, normal QRS complex
Mostly asx

Question 10

Sick Sinus Rhythm

Answer 10

Tachy-brady syndrome AND sinus pauses
NEEDS PPM

Question 11

PVCs and PACs

Answer 11

Premature P waves (inverted), normal to wide to no QRS complex that will reset on the next beat
Watch for AFib, benign, tx with beta-blockers or ablation

Question 12

RBBB

Answer 12

Broad, deep, slurred S waves in leads I, aVL, V5-V6 with a normal R wave

Rabbit ears in leaves V1-V2

Generally benign

Question 13

LBBB

Answer 13

NO Q WAVES

Broad R waves in leads I, V6 with QRS complex >.12s

Small R wave, broad S wave in lead V1

Generally benign

Question 14

LAFB

Answer 14

LAD, qR in leads I, aVL and rS in leads II, III

Question 15

LPFB

Answer 15

RAD, rS in lead I, qR in lead III

Question 16

PSVT

Answer 16

Fast, narrow, reglar QRS complex
Tx IV adenosine and cardioversion

Question 17

WPW

Answer 17

Short PR, delta wave/slurred upstroke to QRS

Watch for AFib/VFib, tx beta-blockers or ablation

Question 18

Torsades de pointes

Answer 18

Polymorphic VT, twisting
Tx SHOCK, Mg and replace electrolytes

Question 19

VFib

Answer 19

Ventricles quiver

Tx SHOCK

Question 20

VTach

Answer 20

Wide QRS complex (>.12s),

Tx SHOCK

Question 21

Mitral stenosis

Answer 21

Opening snap, decrescendo low-pitched rumble diastolic murmur

30’s

Question 22

Mitral valve prolapse

Answer 22

High-pitched MID/LATE SYSTOLIC CLICK at apex with/without late-systolic murmur

Earlier standing/valsalva
Later squatting/laying/legs raised

Question 23

Mitral regugitation

Answer 23

Med/high-pitched apical, holosystolic, harsh murmur with radiation to axilla

Question 24

Aortic stenosis

Answer 24

Loud mid-systolic murmur at 2nd right intercostal space with radiation to both carotids

50-70s

Question 25

Aortic regurgitation

Answer 25

High-pitched blowing decrescendo murmur with patient leaning forward

Question 26

Aortic dissection tx

Answer 26

Tx with beta-blockers IV to decrease contractility and HR

Question 27

Pericarditis

Answer 27

No chest pain, better when leaning forward