EKG things i keep missing Flashcards
lateral
avL
Limb I
V5
V6
inferior
Limb II
Limb III
avf
anterior (left)
V3
V4
septal
V1
V2
Right side of heart
avr
V1
V2
what direction do precordial leads look at
transversely
when is P wave inversion normal?
avr
lead III
V1
V2
(right side plus 3)
if p wave inversion occurs but abnormal?
heart block w/ junctional rhythm or p wave can be buried or absent within QRS
when can you work with a pt post acute MI?
If someone has had an MI → Q wave will drop lower and lower and lower
Diagnostic of MI or not (Q wave will stay depressed for a LONG time)
Scar tissue development increases risk for arrhythmias
PT IMPLICATION: DO NOT WORK WITH PATIENT POST ACUTE MI UNTIL ST WAVE SLOWLY GOING BACK UP TO NORMAL (after ST depression)
what does deeper Q wave mean?
tissues starting to heal
when is T wave inversion normal?
Lead III
Lead IV
avr
V1 (in adults and children)
V2 (children)
V3 (children)
what is characteristic of hypokalemia on ekg?
t wave: flat –> slow repolarization
PR interval: long
QT: prolongation
what is characteristic of hyperkalemia on ekg?
PR interval: short
T wave: peaked –> fast repolarization
QRS: wides –> conduction delay –> v fib
what does long PR interval indicate?
sign of a delay in electrical conduction through AV node. First degree heart block, beta blockers, calcium channel blockers, digoxin can slow conduction thru AV node , ischemic, increased vagal tone, hypokalemia or magnesium
What does ST depression mean?
myocardial ischemia, stable angina, unstable angina, NSTEMI, digoxin effect (downsloping) normal, hypokalemia or magnesium, CVa
what does ST elevation mean?
MI (STEMI), pericarditis, variant angina, early repolarization, LBBB or RBBB
what does digoxin look like on ekg?
PR interval: long –> slows AV condution b/c PNS affects
ST depression (sloped)
abnormal T inversion?
Myocardial ischemia and infarction
Bundle branch block
Ventricular hypertrophy “strain” patterns
Pulmonary embolism
Hypertrophic cardiomyopathy
Raised intracranial pressure
Upside down/inverted: myocardial ischemia or infarction; just like p wave can be normal
Ventricular hypertrophy/ high bp can present with inverted
absent T wave?
Ventricles are not repolarize normally; problem can cause ventricular arrhythmias
hypokalemia on EKG presents with
-PVC
-V fib
-V tach
-leg cramps
-a tachy
hyperkalemia on EKG presents with
-bradycardia
-heart block
-V fib
-V tach
-idioventricular rhythm
-ventricular arrest
-muscle weakness
-tetany
potassium increases due to
-renal failure: kidney can’t excrete K into urine
-dehydration
-hyperglycemia: disrupt insulin secretion so less insulin regulate blood sugar. Cause High blood sugar.
-increased K intake
-ACE inhibitors: blocks aldosterone. Reduced K excreted.
-hemolysis: swell and ruptures.
QT prolongation
toxic effects ; Prolonged QT can lead to Torsades de Pointes (TdP), a life-threatening polymorphic ventricular tachycardia.
-hypokalemia
-hypocalcemia
when potassium is too high
slows conduction and prolongs repolarization –> cardiac arrest
