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EKGS Flashcards

1
Q
A

sinus pause, sinus pacemarker not working

Rate

Varies

Rhythm

Irregular

P waves

Present except in areas of pause / arrest, P:QRS ratio 1:1

PR interval

3-5 little squares (0.12 – 0.20 seconds), constant

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

Yes

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2
Q
A

Sinoatrial Block, Nonconductedbeat fromthe normal pacemaker.

Rate

Varies

Rhythm

Irregular

P waves

Present except in areas of pause / arrest, P:QRS ratio 1:1

PR interval

3-5 little squares (0.12 – 0.20 seconds), constant

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

Yes

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3
Q
A

Premature Atrial Contraction (PAC)

Rate

Depends upon the underlying sinus rate

Rhythm

Irregular overall; regular before/after the early beat

P waves

Present; morphology for the PAC may be different; P:QRS ratio 1:1

PR interval

May vary with the PAC

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

No

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4
Q
A

Ectopic Atrial Tachycardia

Rate

100-180 bpm

Rhythm

Regular

P waves

Present; morphology of the ectopic focus is different; P:QRS ratio 1:1

PR interval

Ectopic focus has a different interval

QRS complex

Normal – can be aberrant at times

Dropped beats

No

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5
Q
A

Wandering Atrial Pacemaker (WAP), The impulse “wanders” around the atria

Rate

60 – 100 bpm

Rhythm

Irregularly irregular

P waves

Present; at least 3 different morphologies are required; P:QRS ratio 1:1

PR interval

Variable depending on the focus

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

No

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6
Q
A

Multifocal Atrial Tachycardia (MAT)

Rate

> 100 bpm

Rhythm

Irregularly irregular

P waves

Present; at least 3 different morphologies are required; P:QRS ratio 1:1

PR interval

Variable depending on the focus

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

No

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7
Q
A

Atrial Flutter

Rate

Atrial rate commonly 250-350 bpm; ventricular rate commonly 125 – 175 bpm

Rhythm

Usually regular

P waves

Saw toothed appearance; P:QRS ratio variable but commonly 2:1

PR interval

Variable

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

No

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8
Q
A

atrial fibirillation

Rate

Variable; ventricular response can be fast or slow

Rhythm

Irregularly irregular

P waves

None; chaotic atrial activity; P:QRS ratio is not defined

PR interval

None

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

No

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9
Q
A

Premature Junctional Contraction (PJC)

Rate

Depends upon the underlying rhythm

Rhythm

Irregular; regular before/after the early beat

P waves

For the early beat: may be inverted, hidden (buried in QRS) or after QRS in ST segment

PR interval

3-5 little squares, constant; early beat will be shortened or absent

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

No

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10
Q
A

Junctional Escape Beat

Rate

Depends upon the underlying rhythm

Rhythm

Irregular; regular before/after the early beat

P waves

For the escaped beat: may be inverted, hidden (buried in QRS) or after QRS in ST segment

PR interval

3-5 little squares, constant; escaped beat will be shortened or absent

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

No

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11
Q
A

Junctional thythm

Rate

40 – 60 bpm

Rhythm

Regular

P waves

Variable; P:QRS ratio; none or 1:1

PR interval

None or shortened

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

No

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12
Q
A

Accelerated Junctional Rhythm

Rate

60 – 100 bpm

Rhythm

Regular

P waves

Variable; P:QRS ratio; none or 1:1

PR interval

None or shortened

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

No

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13
Q
A

Premature Ventricular Contraction (PVC)

Rate

Depends upon the underlying rhythm

Rhythm

Irregular; regular before/after the early beat

P waves

Not present for the PVC; P:QRS ratio otherwise 1:1

PR interval

None for the premature beat

QRS complex

Wide (> 3 little squares) bizarre appearance for the premature beat; otherwise < 3 little squares (0.12 seconds)

Dropped beats

No

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14
Q
A

Ventricular Escape Beat

Rate

Depends upon the underlying rhythm

Rhythm

Irregular; regular before/after the early beat

P waves

Not present for the PVC; P:QRS ratio otherwise 1:1

PR interval

None for the escape beat

QRS complex

Wide (> 3 little squares) bizarre appearance for the premature beat; otherwise < 3 little squares (0.12 seconds)

Dropped beats

No

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15
Q
A

Idioventricular Rhythm

Rate

20 – 40 bpm

Rhythm

Regular

P waves

None

PR interval

None

QRS complex

Wide (> 3 little squares) bizarre appearance

Dropped beats

No

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16
Q
A

Accelerated Idioventricular Rhythm

Rate

40 – 100 bpm

Rhythm

Regular

P waves

None

PR interval

None

QRS complex

Wide (> 3 little squares) bizarre appearance

Dropped beats

No

17
Q
A

VTach – Torsade de Pointes

Rate

200 – 250 bpm

Rhythm

Irregular

P waves

None

PR interval

None

QRS complex

Variable

Grouping

Variable sinusoidal pattern

18
Q
A

Ventricular Flutter

Rate

200 – 300 bpm

Rhythm

Regular

P waves

None

PR interval

None

QRS complex

Wide, bizarre

Grouping

None

19
Q
A

Ventricular Fibrillation (VFib)

Rate

Indeterminate

Rhythm

Chaotic Rhythm

P waves

None

PR interval

None

QRS complex

None

Grouping

None

20
Q
A

1stDegree AV Block

Rate

Depends on underlying rhythm

Rhythm

Regular

P waves

Upright, all the same, P:QRS ratio 1:1

PR interval

Prolonged > 5 little squares (> 0.20 seconds), constant

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

No

21
Q
A

2ndDegree AV Block – Mobitz I (Wenckebach)

Rate

Depends on underlying rhythm

Rhythm

Regularly irregular

P waves

Upright, all the same, P:QRS ratio is variable

PR interval

Variable – progressively longer until QRS complex is dropped.

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

Yes

22
Q
A

2ndDegree AV Block –Mobitz II

Rate

Depends on underlying rhythm

Rhythm

Regularly irregular

P waves

Upright, all the same, P:QRS ratio is variable

PR interval

3-5 little squares (0.12 – 0.20 seconds), constant

QRS complex

< 3 little squares (0.12 seconds)

Dropped beats

Yes

23
Q
A

3rdDegree AV Block (Complete Heart Block)

Rate

Separate, dissociated, rates for sinus rhythm and escape rhythm

Rhythm

Regular, but P rate and QRS rate are different

P waves

Upright, all the same, P:QRS ratio not measurable

PR interval

Not measurable

QRS complex

Normal or wide based upon the origin of the escape rhythm

Dropped beats

No*

24
Q
A

Normal Sinus Rhythm (NSR)

Rate

60 – 100 bpm

Rhythm

Regular

P waves

Upright, all the same, 1 P for every QRS

PR interval

3-5 little squares (0.12 – 0.20 seconds), constant

QRS complex

< 3 little squares (0.12 seconds)

25
Sinus Arrhythmia ## Footnote Rate 60 – 100 bpm Rhythm Varies with respiration P waves Upright, all the same, 1 P for every QRS PR interval 3-5 little squares (0.12 – 0.20 seconds), constant QRS complex \< 3 little squares (0.12 seconds)
26
Sinus Bradycardia- Canbe caused by vagal stimulation, certain medical conditions (hypothyroidism), medications (beta blockers), can also be normally found in well conditioned athletes. ## Footnote Rhythm Regular P waves Upright, all the same, 1 P for every QRS PR interval \*3-5 little squares (0.12 – 0.20 seconds), constant QRS complex \*\< 3 little squares (0.12 seconds)
27
Sinus Tachycardia ## Footnote Can be caused by medications or conditions that require increased cardiac output such as exercise,hypovolemia, hyperthyroidism and fever. Rate \> 100 bpm Rhythm Regular P waves Upright, all the same, 1 P for every QRS PR interval \*3-5 little squares (0.12 – 0.20 seconds), constant QRS complex \*\< 3 little squares (0.12 seconds)
28
why might we see Sinus Arrhythmia
Thisrhythm represents the normal respiratory variation, becoming slower during exhalation and faster upon inhalation. This occurs because inhalation increases venous return by lowering intrathoracic pressure. Note that the PR intervals are the same, only the TP intervals vary with the respirations.

Diagnostic medicine (9 decks)

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