EKG UW

Question 1

What are the EKG findings for 1st degree AV block?

Answer 1

Prolonged PR interval (greater than 0.2 seconds or 200 ms, i.e., greater than 5 small boxes), P wave always follows QRS complexes. Often normal sinus rhythm.

Question 2

First degree AV block

Answer 2

Prolonged PR interval of >0.2 seconds. PR interval remains constant and there is a QRS complex for every P wave.

Question 3

Second degree Mobitz type I AV block (Wenkebach)

Answer 3

Progressive prolongation of PR interval leading to a non-conducted P wave and a dropped QRS complex. Due to impaired conduction within the AV node. Constant P-P interval, Increasing P-R interval, Decreasing R-R interaval, Group beating (clusters of beats followed by drpped QRS).

Question 4

Second degree Mobitz II AV block

Answer 4

2 P waves for every QRS complex.

Question 5

Complete AV block/3rd degree block

Answer 5

Regular P waves that are temporally unrelated to QRS complexes. Can be found before, after, or buried in QRS complexes. R-R interval that is independent of P wave occurrence.

Question 6

Paroxysmal supraventricular tachycardia (PSVT)

Answer 6

Sudden, regular, narrow complex tachycardia. “P” waves are usually buried or hidden or seen just after the QRS complex. SOMETIMES PSVT can be wide-complex (eg. Associated bundle branch block, aberrancy) but fusion beats and AV dissociation are not seen.

Question 7

Ventricular tachycardia?

Answer 7

Wide complex QRS waves.

Question 8

Wide complex tachycardia and fusion beats are diagnostic for?

Answer 8

Sustained monomorphic ventricular tachycardia.

Question 9

PVCs

Answer 9

Widened QRS complexes, bizzare morpholology, compensatory pause

Question 10

What is electrical alternans and when is it seen?

Answer 10

When the amplitude of QRS complexes vary from beat to beat on EKG. Seen with pericardial effusion. Thought to be a result of the heart swinging back an forth within an increased quantity of pericardial fluid.

Question 11

Atrial premature beats

Answer 11

Due to depolarization of atria originating in focus outside the SA node. Seen on EKG as P wave of abnormal morphology, often occuring earlier in the cardiac cyle than a normal P wave.

Question 12

Afib EKG findings

Answer 12

Irregularly irregular rhythm, varying R-R intervals, no clearly discernible P waves (often replaced by tiny fibrillatory waves), narrow QRS complexes.

Question 13

Rapid ventricular response (RVR)

Answer 13

Narrow complex tachycardias (narrow QRS complexes) - I made this up by looking at the EKG on UW

Question 14

Wolf Parkinson White pre-excitation syndrome EKG findings

Answer 14

Slurred upsloping R waves (delta waves), short PR interval (

Question 15

Acute pericarditis

Answer 15

Diffuse ST segment elevations with PR depressions (but uremic pericarditis doesn’t usually present this way).

Question 16

Coarctation of the aorta

Answer 16

High voltage QRS complexes, ST and T wave changes in left precordial leads.

Question 17

Pericardial effusion

Answer 17

1) Electrical alternans with sinus tachycardia 2) low voltage QRS complexes (large pericardial effusions)

Question 18

Inferior wall MI EKG findings

Answer 18

ST segment elevations in leads II, III, AvF

Question 19

Posterior wall MI EKG findings

Answer 19

ST segment depression in in leads V1 and V2