EKG II- Other EKG Changes (Electrolytes, Hypothermia, Pericarditis, PE, Stroke)

Question 1

Hyperkalemia

Answer 1

T waves start to peak (ALL LEADS.)
- if QRS progressively widens and merges w/T wave–> V FIB.

• progressive evolution
• LEADS TO V-FIB if not corrected

Question 2

Hypokalemia

Answer 2

• ST segment depression
• T wave flattening
• QT prolongation and U wave

U wave best seen in anterior leads

U wave is more prominent than T wave (pos deflection)
U wave after the T wave

Question 3

Calcium- Hypocalcemia and Hypercalcemia

Answer 3

HYPO- prologned QT interval
(concerns for Torsades de Pointes)

HYPER- shortened QT interval

remember that HR inc as QT shortens, and HR dec as QT prolongs

Question 4

Hypothermia

Answer 4

• sinus bradycardia
• ALL segments PROLONGED
• Osborn Wave: special ST segment elevation
• absrupt ascent with a plunge to baseline

J point is the exact end of QRS and start of ST segment–> in osborn wave there is a pos deflection at the J point

Question 5

Pericarditis

Answer 5

• diffuse ST segment and T wave changes
• large effusion can cause low voltage adn electrical alternans (change in amplitude of QRS)

electrical alternans- alternating amplitudes in QRS complex

Question 6

Acute Pulmonary Embolism

Answer 6

• Lead I: large S wave
• Lead III: deep Q wave
  (S1Q3 pattern)
• T wave inversion in II
  S1Q3T3

S1Q3T3 is all 3

Question 7

Central Nervous System events

CVA events- cerebrovascular events

Answer 7

• diffuse T wave inversions
• prominent U waves
• sinus bradycardia often seen

caused by CVA events (subarachnoid bleed or cerebral infarction)