EKG review Flashcards
Steps of EKG reading
- Rhythm
- Rate
- QRS Axis
- P waves/PR interval
- QRS complex
- ST Segment
- T waves
regular rhythm strip
R-R intervals: <0.12 secs
if regular rhythm, how to determine rate?
300
150
100
75
60
50
if irregular rhythm how to determine rate?
count # of R waves in 6 sec strip and multiply by 10
If LAD is based on I and aVF, what lead should be checked?
Lead II
QRS predominately positive in Lead II
abnml or nml axis?
normal axis (0-30)
If QRS is predominantly neg in Lead II
abnml or nml axis?
LAD < -30 degrees
What leads do you look in for P wave morphology?
II & V1
P wave morphology in normal sinus rhythm?
positive/upright in I, II, aVF
negative in aVR
each P wave must be followed by a QRS comples
How long is a normal PR interval?
between .12-.20 sec
What shows left atrial enlargement?
m-shaped P wave in Lead II >0.12secs
biphasic P wave in V1 with larger terminal component
What shows R atrial enlargement?
tall P wave in Lead II >3mm
Biphasic P in V1 with larger initial component
normal QRS complex
<0.12 sec
should you worry about blocks if the QRS is narrow?
NO
Left BBB
Wide QRS > 0.12
Broad, slurred R in V5, 6
Deep S wave in V1
Right BBB
Wide QRS > 0.12sec
RdR’ in V1,2
Wide S wave in V6
Signs of RVH
LOOK IN V1
R>S
or
R > 7mm
Signs of LVH
S in V1 + R in V5 or V6 >35mm in men and >30mm in women
What is considered a pathological Q wave?
>1 box
What is an abnormal ST segment?
ST depression or elevation > 1mm in depth/height
Signs of Abnml T wave
T wave inversions
T wave flattening
QT interval prolonging
What are the inferior leads?
II, III, aVF
What are the anterior leads?
V1-V4
Septal: V1 & V2
What are the lateral leads?
Leads I, aVL, V5, V6
What will you see on EKG if area of infarction is anterior wall?
What artery is involved?
V1-V4 (V1-V2 if septal)
Left Anterior Descending (LAD)
What will you see on EKG if area of infarction is anterior lateral wall?
What artery is involved?
I
aVL
V5
V6
Circumflex
What will you see on EKG if area of infarction is anterolateral?
What artery is involved?
I
aVL
V4 + V5 + V6
mid LAD or CFX
What will you see on EKG if area of infarction is inferior?
What artery is involved?
II, III, aVF
Right coronary artery (RCA)
What will you see on EKG if area of infarction is posterior wall?
What artery is involved?
ST depressions in V1 V2
RCA, CFX
Vectors move towards _____ and away from _______
Vectors move towards hypertrophy and away from infarction
What is the normal QRS axis?
-30 to 90
