EKG: Ischemia and Infarct Flashcards
PT presents to your clinic with chest pain and you conduct an EKG. Diffuse ST elevation is observed across all leads. PR segment is also depressed. What Dx does this lead you to consider?
Pericarditis
A >1mm peak to baseline elevation measurement is noted of the PT’s ST segment. What does this tell you?
Tissue injury has resulted in the myocardial tissues which has altered their repolarization ability. However they are not completely necrotic.
How is the Dx of an MI primarily made on an EKG? How would you measure that this EKG finding is abnormal?
Significant Q wave development. (1/3rd of QRS amplitude or >1mm wide)
In an otherwise healthy PT, ST-elevation is remarkable on EKG and is relieved quickly by Rx therapies. Stress test is negative and CAD is ruled out. What could be the cause of this PT’s abnormal EKG?
Prinzmetal’s (Variant) Angina
What leads will yield abnormal ST segments in an anterior wall MI?
V1 and V2 (with septal involvement)
V3 and V4 (apical involvement)
Which artery occlusion is primarily involved with an Anterior Wall MI?
Which chamber of the heart does it primarily supply blood to?
Left Anterior Descending Artery –> Poor prognosis, because it supplies blood to a large portion of the Left Ventricle
ST Seg Elevation
May have AV conduction defects of LBBB as well
When discussing an anterior wall MI Dx with a PT; what would you advise them on their prognosis?
Sudden risk of cardiac death.
Significant risk of CHF.
What EKG patterns AND leads will reveal ST segment elevation and depression with an INFERIOR WALL MI?
ST-Elevation- II, III, aVF
ST-Depression- I, aVL
Bradyarrhythmia (SA node)
–> causing hypotension
What artery is occluded when an Inferior Wall MI occurs?
Right Coronary Artery
What leads will be involved with a Lateral Wall MI? What appearance will the ST segments have?
ST-Elevation- I, aVL, V5, and V6
What artery occlusion will cause a Lateral Wall MI?
Circumflex artery (or one of its subsequent branches)
What appearance will a POSTERIOR WALL MI have on an EKG?
ST-Depression: V1, V2, V3
Increased R-wave Amplitude V1, V2, V3
Tall-wide symmetrical T-waves in V1, V2, V3
Voltage drop-off/R-wave LOSS at V5, V6
What arteries could be occluded with a Posterior Wall MI?
Circumflex or Right Coronary Artery
What arteries could be occluded with a Posterior Wall MI?
Circumflex or Right Coronary Artery
T/F
An EKG can rule out an AMI.
False, an EKG cannot be used to rule out an AMI.
