Everything ECG Flashcards
Leads I, II, III are referred to as what?
Standard limb leads
which waves are the marker of myocardial infarction?
Q waves
is it more likely or less likely for someone to be having a MI if the initial deflection in the QRS complex is up?
less likely
Which leads are septal leads?
V1 and V2
Which leads are the anterior leads?
V2, V3, V4
which leads are the lateral precordial leads?
V4, V5, V6
Which leads are the inferior leads
II, III, AvF
A “J” point is a common feature of a normal variant in the hearts electrical system known as what?
Early repolarization
What do you compare the ST elevation level too?
The PR segment baseline
What 5 things should you examine each ECG for?
- Rate
- Rhythm
- Axis
- Hypertrophy
- Infarct
How many seconds in one small box?
0.04 seconds
How many seconds is one full box (5 small box’s)
.20 seconds
When trying to determine the rhythm what 4 questions should you ask yourself?
- Are there P waves
- is the QRS wide or narrow
- is it regular or irregular
- is the P wave related to the QRS
an upward P wave in lead II, regular rhythm and rate between 60-100 is considered what?
NSR
What interval does the AV node make the heart beat at?
40-60 bpm
What is the ventricular escape rate?
30-40 bpm
If an electrical impulse is being generated above the av node or from the av node will the QRS be wide or narrow?
QRS will be narrow as in supraventricular rhythms
In what condition would you see a wide QRS complex even though the impulse was generated from the SA node (supraventricular)
if there is a bundle branch block
If the electrical conduction is being started from the AV node would the P wave be positive or negative in lead II?
It would be negative because the electrical current is going up ward toward the SA node so away from the lead creating a negative deflection.
If the conduction from the AV node toward the atria is faster than the conduction to the ventricle will you see an inverted P wave before or after the QRS?
before
If the conduction from the AV node toward the atria is slower than the conduction to the ventricle will you see an inverted P wave before or after the QRS?
after
If the conduction from the AV node toward the atria is the same speed as the conduction to the ventricle will you see an inverted P wave before or after the QRS?
neither, it will be hidden in the QRS so no p wave will be seen
would you expect an indoventricular escape rhythm to have a wide or narrow QRS?
wide
What are some common causes of reentry tachy?
Myocardial ischemia, and presence of an accessory pathway
If someone has an increase in serum potassium would it cause brady or tachy?
brady
Low potassium can cause the heart to become fast or slow?
fast
What usually causes WAP to occur?
increased vagal effect slowing down the SA node and allowing another pacemaker site to take control
What kind of disorders is multifocal atrial tachy seen?
COPD/ lung disorders
What can you treat PAC’s with?
beta blockers, CCB’s and sometimes anitanxiety meds
a run of three or more consecutive beats is considered what?
PAT
What rate does PAT usually occur within
140-250
If someone has been in aflutter less than 48 hours is it ok to cardiovert without coagulation?
according to this book yes
90% of patients with afib were found to have PAC’s in what ventricle?
The left
what is the difference between the PR interval of a PAC and PJC?
PAC will be normal, PJC will be short like less than .10ms
What is the most common cause of PJC?
digitalis toxicity causing enhanced automaticity of the AV junction
what are some conditions that can cause PJCs?
- ingestion of substances i.e caffeine, alcohol/tobacco
- electrolyte imbalance
- hypoxia
- CHF
- CAD
When the HR of the SA node becomes less than that of the AV node what type of rhythm can occur?
a junctional rhythm
In what kind of patients can you see a junctional rhythm?
those with
- increased parasympthetic tone
- inferior MI
- disease of the SA node
- hypoxia
- CCB’s and beta blockers
Tx for junctional rhythm?
follows same protocols for bradycardia
- Atropine
- Pacing
- Vasopressors
Mobitz II is most commonly associated with an MI to what part of the heart?
anterior wall
along with myocarditis
Mobitz I with a 2:1 conduction ratio can look like mobitz II, what two things should you look for?
a Wider QRS complex and wenckebach pattern
