EKG rhythms review Flashcards
sinus pause
2 missed beats
sinus arrest
3 or more missed beats
wandering atrial pacemaker
p waves that change in appearance (3 or more)
is wandering atrial pacemaker concerning?
not really
normal in children, older adults, and athletes
PAC- premature atrial complex
normal QRS, just one is early because an ectopic beat originates outside of the SA node
the p-wave of the early beat will be diff from the rest of the p-waves
PACs are followed by
non-compensatory pause
in what situation are PACs concerning?
sometimes can preD pts w heart dz to more serious dysrhythmias:
atrial tachy
atrial flutter
a- fib
what can PAC serve as an early indicator to?
electrolyte imbalance, CHF
atrial tachycardia
atrial rate of 150-250
a bunch of p waves b/w each QRS
why is atrial tachycardia dangerous?
increases oxygen requirements, can compromise CO in those w underlying heart dz
—-> lead to MI
multifocal atrial tachycardia
same features as wandering atrial pacemaker, but this rate is faster
120-150
what two atrial beats can be confused?
multifocal atrial tachycardia (120-150 bpm)
A-fib
SVT
p waves cannot be seen
atrial flutter
“saw-tooth” waves
“F waves”
with atrial flutter, the atrial rate is 250-350, but what is the ventricular (QRS) rate?
can vary depending on # of impulses conducted thru AV node
slower rates <40 or faster rates >150 can seriously compromise CO
A-fib
Atria >350 !!
Why is A-fib dangerous?
Leads to loss of Atrial kick, decreasing CO by 25%
Intra-atrial emboli bc the blood is sitting there in the atria
A-fib leads to increased risk of
STROKE
what is absent with SVT?
p waves are absent
3 types of JUNCTIONAL complexes
junctional escape
accelerated junctional
junctional tachycardia
p waves of Junctional rhythms
inverted
premature junctional complex- PJC
the random early wierd beat has a p wave that is inverted, QRS Is normal
junctional escape rhythm
40-60 bpm
accelerated junctional rhythm
60-100 bpm
junctional tachycardia
100-180 bpm
3 diff categories of rates for junctional rhythms
40-60
60-100
100-180
Things to look for on EKG
Mean axis (lead 1 and avF)
p waves for sinus rhythm, atrial enlargement (lead II and V1)
BBB (lead I and V6)
RVH or LVH (V5-V6)
ventricular dysrhythmia key points
wide, bizarre QRS complexes
T waves in opp direction
no p-waves
3 breakdown types of ventricular dysrhythm
idioventricular
accelerated idioventricular
ventricular tachycardia
Premature Ventricular Complex
wierd beat out of nowhere
wide, bizarre QRA
idioventricular rhythm
20-40
what beat is suuuuuuper slow?
and wide QRS
idioventricular rhythm
accelerated idioventricular rhythm
40-100 bpm
ventricular tachycardia
100-250 bpm
torsades de pointes is a type of
v-tachy, it’s polymorphic
v-fib
chaotic firing of many sites in ventricles
heart muscle is quivering
full cardiac arrest, unresponsive, pulseless
v-fib rate
300-500 vent unsynchronized impulses per minute
1st degree AV block
not a true block
just a consistently prolonged PRI
longer than 0.2 seconds
which type of 2nd degree block is more dangerous?
type II
bc this one more often progresses to 3rd deg complete heart block
2nd degree type 2 block
considered “malignant” in emergency setting
can –> decreased CO, signs of hypoperfusion
can progress –> more severe block and Ventricular asystole
3rd degree heart block
atria and ventricles are each doing their own thing
atria- SA node 60-100
ventricles- AV jx or ventricles
SA node
60-100 bpm
AV node
40-60 bpm
ventricules rate
20-40
very slow
