EKG Pictures Flashcards
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/342/028/q_image_thumb.png?1509926685)
Normal Sinus Rhythm
- Rate: 60 – 99
- Rhythm: Regular
- P Waves: Present
- P-R Interval: 0.12 – 0.20 seconds
- QRS Complex: < 0.12 seconds
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/342/097/q_image_thumb.png?1509926727)
Sinus Tachycardia
- Rate: >100
- Rhythm: Regular
- P Waves: Present
- P-R Interval: 0.12 – 0.20 seconds
- QRS Complex: < 0.12 second
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/342/134/q_image_thumb.png?1509926757)
Sinus Bradycardia
- Rate: <60
- Rhythm: Regular
- P Waves: Present
- P-R Interval: 0.12 – 0.20 seconds
- QRS Complex: < 0.12 seconds
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/342/208/q_image_thumb.png?1509926871)
Sinus Arrhythmia
- Rate: 60 – 100
- Rhythm: Regularly Irregular
- P Waves: Present
- P-R Interval: 0.12 – 0.20 seconds
- QRS Complex: < 0.12 seconds
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/342/275/q_image_thumb.png?1509926932)
Junctional Escape Rhythm
Rate: 40 – 60
May be accelerated (60-100) or junctional tachycardia (rate >100)
Rhythm: Regular
P Waves: None
P-R Interval: NA
QRS Complex: < 0.12 seconds
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/342/317/q_image_thumb.png?1509926968)
Ventricular Escape Rhythm
or Idioventricular Rhythm
Rate: 20 – 40 bpm
Rhythm: Regular
P Waves: None
P-R Interval: None
QRS Complex: > 0.12 seconds
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/342/338/q_image_thumb.png?1509927031)
Premature Atrial Contractions (PACs)
- Rate: 60 – 100 (Normal, right?)
- Rhythm: Looks irregularly irregular if there are multiple PACs. If there is just one PAB, then, the regular rhythm is reset
- P Waves: Present, but can’t always be seen
- P-R Interval: 0.12 – 0.20 seconds
- QRS Complex: < 0.12 seconds
Why? When the SA node or the AV node become irritated by…
Increased epinephrine in the body
Caffeine, cocaine, albuterol, β agonist medications, methamphetamines or digitalis…
Hyperthyroidism
…it can fire spontaneously, ahead of when it should. This firing produces an unusually shaped and unusually placed p wave.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/342/480/q_image_thumb.png?1509927133)
Premature Atrial Contractions (PACs)
- Rate: 60 – 100 (Normal, right?)
- Rhythm: Looks irregularly irregular if there are multiple PACs. If there is just one PAB, then, the regular rhythm is reset
- P Waves: Present, but can’t always be seen
- P-R Interval: 0.12 – 0.20 seconds
- QRS Complex: < 0.12 seconds
Why? When the SA node or the AV node become irritated by…
Increased epinephrine in the body
Caffeine, cocaine, albuterol, β agonist medications, methamphetamines or digitalis…
Hyperthyroidism
…it can fire spontaneously, ahead of when it should. This firing produces an unusually shaped and unusually placed p wave.
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/342/512/q_image_thumb.jpg?1509982874)
Bigeminy-Premature Ventricular Contraction (PVC)
- Rate - any
- Rhythm – Irregular
- P Waves – None
- P-R - NA
- QRS – < 0.12 in the normal QRS complexes, however, PVCs are wider
- Comp. Pause – Yes
- Why? – A ventricular automaticity focus can be made irritable by low oxygen levels, hypokalemia, and injury to the heart muscle from infection, inflammation or infarction
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/390/718/q_image_thumb.png?1509983011)
Premature Ventricular Contraction (PVC)
3 or more PVCs in a row or 6 or more PVCs in a minute is Ventricular Tachycardia!
- Rate - any
- Rhythm – Irregular
- P Waves – None
- P-R - NA
- QRS – < 0.12 in the normal QRS complexes, however, PVCs are wider
- Comp. Pause – Yes
- Why? – A ventricular automaticity focus can be made irritable by low oxygen levels, hypokalemia, and injury to the heart muscle from infection, inflammation or infarction
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/390/845/q_image_thumb.png?1509983112)
Premature Ventricular Contraction (PVC)
multifocal PVCs-PVCs have different morphology which indicates multiple foci
- Rate - any
- Rhythm – Irregular
- P Waves – None
- P-R - NA
- QRS – < 0.12 in the normal QRS complexes, however, PVCs are wider
- Comp. Pause – Yes
- Why? – A ventricular automaticity focus can be made irritable by low oxygen levels, hypokalemia, and injury to the heart muscle from infection, inflammation or infarction
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/391/112/q_image_thumb.jpg?1509983173)
Premature Ventricular Contraction (PVC)
multifocal PVCs-PVCs have different morphology which indicates multiple foci
- Rate - any
- Rhythm – Irregular
- P Waves – None
- P-R - NA
- QRS – < 0.12 in the normal QRS complexes, however, PVCs are wider
- Comp. Pause – Yes
- Why? – A ventricular automaticity focus can be made irritable by low oxygen levels, hypokalemia, and injury to the heart muscle from infection, inflammation or infarction
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/391/181/q_image_thumb.png?1509983218)
Supraventricular Tachycardia (SVT)
Rate: >150-180
Rhythm: Regular
P Waves: Present or not discernable due to increased rate
P-R Interval: normal if it can be seen (which it usually can’t)
QRS Complex: < 0.12 seconds
Note: P waves may be hidden in preceding T
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/391/481/q_image_thumb.png?1509983263)
Supraventricular Tachycardia (SVT)
Onset 1/2 way through strip
Rate: >150-180
Rhythm: Regular
P Waves: Present or not discernable due to increased rate
P-R Interval: normal if it can be seen (which it usually can’t)
QRS Complex: < 0.12 seconds
Note: P waves may be hidden in preceding T
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/391/522/q_image_thumb.png?1509983350)
Ventricular Tachycardia
Rate: > 100
Rhythm: Regular
P Waves: None visible (SA nodes are still pacing, but p-waves buried in QRS)
P-R Interval: NA
QRS Complex: > 0.12 seconds
Note: 3 or more PVCs at a regular, rapid rate or 6 or more PVCs in a minute is V Tach
•Why?
–Ischemic heart disease
–Myocardial scar from previous MI can cause an ectopic electrical focus
–Hemodynamic compromise
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/391/678/q_image_thumb.png?1509983378)
Ventricular Tachycardia
Rate: > 100
Rhythm: Regular
P Waves: None visible (SA nodes are still pacing, but p-waves buried in QRS)
P-R Interval: NA
QRS Complex: > 0.12 seconds
Note: 3 or more PVCs at a regular, rapid rate or 6 or more PVCs in a minute is V Tach
•Why?
–Ischemic heart disease
–Myocardial scar from previous MI can cause an ectopic electrical focus
–Hemodynamic compromise
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/391/712/q_image_thumb.png?1509983418)
Torsades de Pointes
- Rate: > 100 (usually 250 – 350 bpm)
- Rhythm: roughly regular
- P Waves: None visible
- P-R Interval: None
- QRS Complex: > 0.12 seconds
- Why? ? Two competitive, irritable foci in the ventricular myocardium
- Causes
–Hypokalemia
–Hypomagnesemia
–Hypocalcemia
–Medications that block potassium channels including anti-hypertensives, antibiotics and anti-convulsants
–Congenital Long QT syndrome (especially in female patients)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/391/892/q_image_thumb.png?1509983502)
Atrial Flutter
Rate: Atrial – 250 – 360
Ventricular – Can vary
Rhythm: Regular Atrial Contraction
P Waves: Flutter (F) waves (aka “sawtooth waves”)
P-R Interval: N/A
QRS Complex: < 0.12 seconds
Why? The long AV node refractory period keeps the atrial signal from conducting through to the ventricles – therefore, the ventricular rate is much slower than the atrial rate
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/391/927/q_image_thumb.png?1509983518)
Atrial Flutter
Rate: Atrial – 250 – 360
Ventricular – Can vary
Rhythm: Regular Atrial Contraction
P Waves: Flutter (F) waves (aka “sawtooth waves”)
P-R Interval: N/A
QRS Complex: < 0.12 seconds
Why? The long AV node refractory period keeps the atrial signal from conducting through to the ventricles – therefore, the ventricular rate is much slower than the atrial rate
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/391/943/q_image_thumb.png?1509983574)
Atrial Fibrillation
Rate: Atrial – Fibrillation
Ventricular – Varies
Rhythm: ”Irregularly Irregular”
P Waves: Absent!
+ Fibrillation waves
P-R Interval: N/A
QRS Complex: < 0.12 seconds
Why? Atria not conducting or contracting with any regularity
![](https://s3.amazonaws.com/brainscape-prod/system/cm/224/391/988/q_image_thumb.jpg?1509983588)
Atrial Fibrillation
Rate: Atrial – Fibrillation
Ventricular – Varies
Rhythm: ”Irregularly Irregular”
P Waves: Absent!
+ Fibrillation waves
P-R Interval: N/A
QRS Complex: < 0.12 seconds
Why? Atria not conducting or contracting with any regularity