Electrocardiography Graph Readings

Question 1

What heart condition does this ECG indicate? How do you know?

Answer 1

(Monomorphic) ventricular tachycardia

• fast and regular heart rate (monomorphic).
• long QRS complex indicates abnormal ventricular activation.

Question 2

What heart condition does this ECG indicate? How do you know?

Answer 2

Atrial fibrillation

• Highly disorganized and rapid.
• No P wave indicates no atrial contraction.
• Irregular ventricular rhythm indicates insufficient depolarization to break through.

Question 3

What heart condition does this ECG indicate? How do you know?

Answer 3

AV block 2nd degree; Type 1/Wenckebach

• Ocasional uncoupling of QRS complex indicates a 2nd degree AV block.
• Type 2 / Wenckebach is indicated by progressive lengthening of PR inverval before the block.

Question 4

What heart condition does this ECG indicate? How do you know?

Answer 4

Premature Ventricular Contraction (PVCs

(not clinical since not enough data)

• ventricular contraction occurs faster than the pattern would predict.
• (only w 3 or more is it considered clinical).

Question 5

What heart condition does this ECG indicate? How do you know?

Answer 5

Left Bundle Branch Block (LBBB)

• V1 displays deep and wide negative wave (w long QRS complex).
• V6 displays slurred wave (delayed vent. depolarization creates R’)

Question 6

What heart condition does this ECG indicate? How do you know?

Answer 6

AV block; 1st degree

• consistently lengthened PR interval (>200ms)

Question 7

What heart condition does this ECG indicate? How do you know?

Answer 7

Atrial flutter

• variable ventricular rate.
• rapid, re-enterant tachycardia

Question 8

What heart condition does this ECG indicate? How do you know?

Answer 8

Torsade de pointes (aka polymorphic ventricular
tachycardia)

• twisting ribbon pattern.

Question 9

What heart condition does this ECG indicate? How do you know?

Answer 9

Right Bundle Branch Block (RBBB)

• Displays long QRS complex.
• Displays double peaks in QRS complex (delayed vent. depolarization creates R’)

Question 10

What heart condition does this ECG indicate? How do you know?

Answer 10

AV block 3rd degree

• P wave and QRS complex are completely uncoupled.

Question 11

What heart condition does this ECG indicate? How do you know?

Answer 11

Asystole/dead

…flatlined…duh.

Question 12

What heart condition does this ECG indicate? How do you know?

Answer 12

Ventricular fibrillation

• complete loss of norma waves (P/QRS/T)
• w lack of twisting ribbon pattern.

Question 13

What heart condition does this ECG indicate? How do you know?

Answer 13

Long QT

• QT is long (consistently).

Question 14

What heart condition does this ECG indicate? How do you know?

Answer 14

AV block 2nd degree; Type 2/Mobitz (3:1)

• QRS uncoupling indicates 2nd degree block.
• Type 2/Mobitz is indicated by the PR interval consistency and block regularity.

Question 15

What heart condition does this ECG indicate? How do you know?

Answer 15

Sinus bradycardia, sinus pause, AV escape, sinus resumes

• HR is too slow.
• SA node fails to fire, and AV node steps in.
• HR then resumes (still slow).

Question 16

What heart condition does this ECG indicate? How do you know?

Answer 16

Sinus tachycardia

• heart rate is too fast!

Question 17

What heart condition does this ECG indicate? How do you know?

Answer 17

AV block 1st degree

• PR interval us consistantly too long (>200ms).
• QRS complex always follows.

Question 18

What heart condition does this ECG indicate? How do you know?

Answer 18

Long QT (+ sinus bradycardia 55)

• heart rate is too slow
• QT segment is lengthened.