EKG interpretation Flashcards
At what age are EKG screenings done
65 and over
Which coronary artery supplies blood to majority of the heart
RCA
Which leads are unipolar
augmented
When you look at an EKG strip, which leads are your view point
Positive leads
What congenital disease is known for a short PR interval
WPW
What is indicative on EKG if someone has an AV block
Long PR interval
What congenital issue can cause prolonged QT
K+ channelopathy
What are the biggest things to notice on lead 2
Rate
Rhythm
Intervals
How do you calculate the heart rate on a rhythm strip
QRS complexes seen
multiplied by 10
How to calculate the heart hate on a standard 12 lead
QRS complexes seen
multiplied by 6
What is the frequency of the AV node
45-50 bpm
Which leads are unipolar
V leads
How many seconds is 1 big square on an ecg
.2 seconds
How many seconds is 1 small square
.04 seconds
How long is a normal QRS duration
.06-.10 seconds
When will you see a U wave
Hypokalemia
medication toxicity
How long is each lead in seconds
2.5
Where is V1 located
R side sternum, 4th intercostal space
Where is V2 located
L side sternum, 4th intercostal space
Where is V3 located
between V2 and V4
Where is V4 located
L. mid clavicular, 5th intercostal space
Where is V5 located
L anterior axillary 5th intercostal space
Where is V6 located
L mid axillary, 5th intercostal space
What is the electrical axis
The average direction of all waves of depolarization in the heart at one time
Where does the electrical impulse in the ventricle start
Left side of the septum
What is the right axis deviation
+90 to 180 degrees
* from COPD / WPW / pulm. embolism
What is Left axis deviation
-30 to -90 degrees
* from pregnancy / hyperkalemia
/ left sided hypertrophy
What is extreme axis deviation
-90 to -150
*generally misplaced leads / Vtach / poor coronary artery perfusion
How do you determine axis deviation
By looking at lead 1 and AVF
What does normal axis deviation look like
Both Avi and lead 1 are going up
What does Right axis deviation look like
Lead 1 is going down
AVF is going up
What does left axis deviation look like
Lead 1 is going up and AVF is going down
What does no man’s land axis deviation look like
both lead 1 and AVF is going down
What is the QRS duration of an incomplete BBB
.10-.12
What is a bundle branch block
delay or blockage of the ventricular conduction system
During a BBB, where does the electrical impulse go
impulse will travel across the cardiac myocytes instead of the nodal pathway
when do you see a “saddle” on an EKG
Left atrial enlargement
What occurs on an EKG with ventricular hypertrophy
there will be an increase in amplitude and often will have ST depression
When is ventricular hypertrophy normal
Thin
Young adults
Athletes
What is the most common cause of LVH
HTN
*can also be caused by
-aortic stenosis
-aortic insufficiency
-hypertrophic cardiomyopathy
What is the sokolov-lyon criteria
Add the S wave in V1 plus the R wave in V5 or V6 (whichever is taller). If the sum is greater than 35 mm, LVH is present
f there is ST depression combined with T wave changes, what is it indicative of
Full thickness ischemia
If there is widespread ST depression without any T wave changes on an EKG, what does it mean
there is diffuse subendocardial ischemia
What ST segment changes are indicative of a ischemia
Downsloping & horizontal
What is Sgarbossa criteria used for
used in the diagnosis of an acute myocardial infarction when a left bundle branch block is present.
What is Brugada syndrome
Sodium channelopathy
Who does brugada syndrome occur in most frequently
Males
*most asians
What are the EKG findings in Brugada syndrome
ST elevation >2mm in V1-V3 followed by a negative T wave
Must meet clinical criteria
What is the clinical criteria for brugada syndrome
Family hx of sudden cardiac death <45 years old
Hx of syncope
Nocturnal agonal respiration
What is the treatment of Brugada syndrome
Internal Pacer
What will an EKG look like in someone who has pericarditis
ST depression w/ PR elevation in lead aVR
When is an Osborn wave seen
Hypothermia
