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Block 3 > FPC: EKG interpretation > Flashcards

FPC: EKG interpretation Flashcards

1
Q

What is the general naming system for arrhythmia?

A

The first word is the location and the second is the type of arrhythmia

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2
Q

In sinus arrhythmia, what effect does inspiration have on heart rate?

A

Increases it

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3
Q

What effect does expiration have on heart rate?

A

Decreases it

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4
Q

Describe sinus arrhythmia.

A

The diaphragm contracts, negative intrathoracic pressure pulls air into the lungs, lowering arterial pressure, activating baroreceptors, and decreasing vagal input to the SA node

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5
Q

What does a Valsalva maneuver do?

A

Activates the vagus nerve to slow heart rate and break up tachyarrhythmia

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6
Q

What is a benefit of sinus arrhythmia?

A

It maximizes blood flow during maximum oxygenation

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7
Q

What arrhythmia is common in young athletes?

A

Sinus arrhythmia

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8
Q

What extra heart sound can occur with hypertension?

A

S4

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9
Q

What will the P wave look like in the right atrium in an instance of hypertrophy/enlargement?

A

Greater than 2.5 mm tall in lead II

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10
Q

What will the P wave look like in the left atrium in an instance of hypertrophy/enlargement?

A

Terminal negativity in lead V1 or -mitral in lead II

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11
Q

What will the QRS look like in left ventricular hypertrophy?

A

S in V1 + R in V5 or V6 is greater than 35 (or 25 if single lead)

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12
Q

What will the QRS look like in right ventricular hypertrophy?

A

V1 R wave bigger than S wave

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13
Q

What is a premature atrial contraction?

A

Premature p wave followed by a narrow QRS

Premature atrial contractions (PACs) are early heartbeats originating in the atria.

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14
Q

What characterizes a premature ventricular contraction?

A

Wide QRS due to lack of conduction system use, typically not preceded by a p wave

Premature ventricular contractions (PVCs) can disrupt the normal heart rhythm.

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15
Q

What is a non-compensatory pause?

A

The RR interval will be less than normal due to the SA node being reset

This can occur in PACs.

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16
Q

What is a compensatory pause?

A

The RR remains the same due to SA node firing when it has to

This can be seen in PVCs.

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17
Q

What is syncope?

A

Transient complete loss of blood flow to the brain

Syncope can result from various cardiovascular issues.

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18
Q

A heart rate over 150 could be indicative of what?

A

SVT (AVNRT)

Supraventricular tachycardia (SVT) is often associated with elevated heart rates.

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19
Q

What does an irregular heart rate indicate?

A

Atrial fibrillation (a-fib)

A-fib is characterized by a lack of consistent P waves.

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20
Q

What is indicated by a wide and regular heart rate?

A

Ventricular tachycardia (VT)

VT can be life-threatening and requires immediate attention.

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21
Q

What type of tachycardia has a P wave before the QRS complex?

A

Sinus tachycardia

This indicates that the heart’s natural pacemaker is functioning properly.

22
Q

If you see 3 P waves during tachycardia, what is it called?

A

Multifocal atrial tachycardia (MAT)

MAT is characterized by varying P wave morphology.

23
Q

What are the requirements for atrial fibrillation (a-fib)?

A

Requires a trigger and a susceptible substrate (left atrial dilation)

Inflammation near the atrium can also cause a-fib.

24
Q

What characterizes atrial flutter?

A

200-300 in atrium, 100-150 in ventricle, narrow QRS, sawtooth pattern

Atrial flutter typically originates in the right atrium.

25
Q

Which leads are looked at for atrial flutter?

A

Leads II and III

These leads help identify the characteristic patterns of atrial flutter.

26
Q

What is a 1st degree AV block?

A

PR interval is larger but RR interval is the same

This indicates a delay in conduction through the AV node.

27
Q

What is a 2nd degree AV block?

A

Wenckebach (mobitz I): progressive lengthening of PR with dropped QRS

Mobitz II: fixed PR with dropped QRS and wide QRS

These blocks indicate varying degrees of AV node dysfunction.

28
Q

What is a 3rd degree AV block?

A

Complete dissociation of P and QRS; they occur independently

This is a severe form of heart block requiring immediate medical intervention.

29
Q

What is a 3rd degree AV block?

A

Complete dissociation of P and QRS; they both happen but not in relationship to each other

This condition indicates a complete block in the electrical conduction from the atria to the ventricles.

30
Q

Which heart blocks need a pace maker?

A

Mobitz II and 3rd degree

These blocks are significant enough to require pacing to maintain adequate heart function.

31
Q

What does a long QT interval indicate risk for?

A

Ventricular tachycardia

A prolonged QT interval can lead to dangerous arrhythmias.

32
Q

What will hypokalemia show on EKG?

A

Long QT interval

Low potassium levels can affect the heart’s electrical activity.

33
Q

What will hyperkalemia do on EKG?

A

Peaked (taller) T wave

High potassium levels can lead to characteristic changes in the EKG.

34
Q

What happens to the ST segment during a heart attack?

A

Elevation

ST elevation is a key indicator of myocardial infarction.

35
Q

What happens to the ST segment during ischemia?

A

Depression

ST depression indicates that the heart muscle is not receiving enough oxygen.

36
Q

What will happen to ST during ischemia?

A

Depression

This indicates a lack of blood flow to the heart muscle.

37
Q

What causes subendocardial ischemia?

A

An oxygen supply/demand mismatch not specific to a single blocked coronary artery

This type of ischemia can occur in various conditions affecting the heart.

38
Q

Describe ventricular fibrillation.

A

No clear QRS or other repeating pattern

This is a life-threatening arrhythmia requiring immediate intervention.

39
Q

What are the characteristics of Ventricular Tachycardia (V-tach)?

A

Fast, wide, and regular

V-tach can be monomorphic or polymorphic and often requires urgent treatment.

40
Q

What is Torsade de Pointes?

A

Pleomorphic V-tach with twisting of the points

This arrhythmia is characterized by a distinctive EKG pattern and can lead to sudden cardiac arrest.

41
Q

What are the underlying causes of Ventricular Tachycardia?

A
  • Ischemia
  • Infarct
  • Irritation of myocardium
  • Dilated cardiomyopathy

These conditions can lead to instability in the heart’s rhythm.

42
Q

What is the heart rate in Ventricular Tachycardia?

A

Rate > 100 bpm

This indicates a rapid heart rhythm originating from the ventricles.

43
Q

What is the characteristic shape of the QRS complex in monomorphic V-tach?

A

All same shape (in each lead)

This homogeneity in shape differentiates it from other forms of tachycardia.

44
Q

True or False: Carotid massage can break up Ventricular Tachycardia.

A

False

Carotid massage is not effective in terminating V-tach.

45
Q

Give the run-through for tachycardiaa

A
  1. How fast is the RR
  2. Regular vs irregular
  3. Wide vs narrow
  4. P wave?
  5. 3 different P waves??
  6. Flutter?
46
Q

Give the steps for determining Brady/blocks

A
  1. Regular or irregular QRS
  2. P wave relationship
  3. PR interval
47
Q

Give the criteria and vessel for an anterior MI

A

ST elevation V1-V4; LAD

48
Q

Give the criteria and vessel for a lateral MI

A

ST elevation V5-V6 or I and AVL; circumflex

49
Q

Give the criteria and vessel for an inferior MI

A

II, II, AVF; RCA

50
Q

Give the criteria and vessel for a posterior MI

A

ST depression V2 or V3; PDA

51
Q

Describe EKG findings of pericarditis

A

ST elevation, PR depression, spodicks sign, no reciprocal changes, and a concave QT shape

Block 3 (52 decks)

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