EKG Interpretation Lectures Flashcards
paced rhythm
can be atrial or ventricular
see a sharp spike in EKG
left BBB
cannot determine ischemia/infarction
paradoxical split S2
with bundle branch block
-ventricles are contracting out of synchrony
hyperkalemia
peaked T waves in majority of leads
T wave inversion
reciprocal changes - will substantiate infarction
interval
include wave
segment
between wave
atrial rhythm
upright P wave, normal QRS
junctional rhythm
absent or inverted P wave, normal QRS
ventricular rhythm
no P waves, wide QRS
escape beats
refractory periods
premature beats
irritable foci
reentry
wolf parkinson white
delta waves
-accessory conduction bundle of kent
atrial flutter
single atrial foci with reentry
-sawtooth pattern
wandering pacemaker
irregular ventricular rhythm
- multifocal atrial rhythm
- P’ varied
irregularly irregular rhythm
atrial fib
first degree block
PR longer than 0.2s
wenckebach
type I second degree AV block
-PR progressively longer, then dropped beat
mobitz
type II second degree AV block
-wide QRS and failure of AV conduction in fixed ratio/pattern
- multiple P waves that go before QRS is conducted
2: 1, 3:1, 4:1
third degree AV block
A/V dissociation
P wave and QRS each have own rate
ventricular tachycardia
usually reentry
prolonged QT
sets up torsades
-QT interval larger than 2 big boxes (0.4s)
right bundle branch block
QRS wide in V1 and V2
left bundle branch block
QRS wide in V5 and V6
biphasic P wave in lead V1
atrial enlargement
- positive right
- negative left
p-pulmonale
greater than 2.5mm amplitude of P wave in II, III, AVF
-indicate right atrial hypertrophy
abnormal large R wave in V1
right ventricular hypertrophy
left ventricular hypertrophy
V1 and V5 sum > 35mm
also see inverted/asymmetric T waves with strain pattern (humped ST)
bifascicular block
left bundle 0 either anterior fascicle or posterior fascicle
-and RBBB
LBB anterior fascicle block
LAD
LBB posterior fascicle block
RAD
necrosis
Q waves
-old injury
acute injury to myocardium
ST elevation - transmural infarction
symmetrical inversion of T waves
ischemia
ST segment depression
subendo infarction
angina
stress test
MI with LBBB
EKG doesn’t work anymore
inferior MI
II, III, AVF
anterior MI
V1-4
lateral MI
I, AVL, V5-5
posterior MI
V1,2 - tall R wave and ST depression
firemans hat
ST elevation
posterolateral MI
circumflex artery
-with anterior reciprocal changes
hyperkalemia
flat, wide P waves
wide QRS
peaked T waves
hypokalemia
flat T waves
U waves
hypercalcemia
short QT interval
wide T wave
hypocalcemia
prolonged QT interval
-flat T waves
hypothermia
sinus bradycardia
- long PR interval
- wide QRS
- long QT interval
- osborn wave
osborn wave
extra deflection at end of QRS - with hypothermia
pericarditis
ST elevation flat with T wave off baseline
- all leads***
- with PR segment depression
pericardial effusion
everything is muffled
paced rhythm
sharp depolarizations
-can be atrial, ventricular, or AV sequential
cannot interpret anything beyond this
brugada syndrome
RBBB with ST elevation V1-3
looks like QRS and T are merging