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ECG Basics > From Skillstat > Flashcards

From Skillstat Flashcards

1
Q

Characteristics of Normal Sinus Rhythm

A
  • Rate between 60-100
  • Narrow QRS
  • Upright P waves in II
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2
Q

Characteristics of Sinus Bradycardia?

A
  • Rate under 50 bpm
  • Narrow QRS
  • Upright P waves in II
  • Can be normal baseline for jacked bros.
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3
Q

Characteristics of Sinus Tachycardia?

A
  • Rate above 100, usually under 150
  • Narrow QRS
  • Often due to sympathetic stimulation, eg pain, fever, increased O2 demand, hypovolemia)
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4
Q

Sinus Arrhythmia?

A
  • Irregular rhythm which fluctuates with inspiration (HR increases) and expiration (HR decreases).
  • Narrow QRS and upright P waves
  • Common in children
  • Usually benign
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5
Q

Sinus Exit Block

A
  • P wave absent
  • Mostly flat line in II between complexes
  • Pause is equal to a multiple of previous P-P intervals
  • P cells in sinus node are firing on schedule; surrounding T (transmission) cells are not.
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6
Q

Sinus Arrest? Aka Sinus Pause?

A
  • Pause in electrical activity that is not equal to a multiple of P-P intervals
  • Failure of SA node to fire
  • An escape pacemaker such as AV junction will provide impulse
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7
Q

NSR with Premature Atrial Complexes?

A
  • Atria initiate an impulse earlier than expected from SA node
  • Narrow QRS
  • Flattened, noticed, peaked, or biphasic P waves for the PAC
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8
Q

Characteristics of Supraventricular Tachycardia?

A
  • Rhythm between 170-230/minute.
  • Narrow QRS
  • Regular, rapid pattern.
  • When at rest, narrow QRS tachycardia over 150/minute are most often SVT
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9
Q

Characteristics of atrial fibrillation?

A
  • Chaotic baseline with recognizable QRS complexes.
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10
Q

Characteristics of atrial flutter?

A
  • Sawtooth pattern on the baseline.
  • QRS complex every 2nd or fourth impulse (former is 150/min, latter is 75/min).
  • Caused by a recently circuit within the atria generating a loop.
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11
Q

Characteristics of Paced Atrial rhythm?

A
  • vertical spike before the P wave
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12
Q

Characteristics of NSR with 1 degree AV Block?

A
  • Prolonged PR interval, greater than .20 seconds.
  • Underlying rhythm should be identified, and then “with a first degree AV block” is added to the end.
  • Results from a prolonged transmission of electrical impulse through AV junction (AV node and the bundle of His).
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13
Q

What is a Wenckebach block otherwise known as?

A

Mobitz Type I Second Degree AV Block.

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14
Q

Characteristics of a Second Degree AV Block Type I

A
  • cyclical lengthening of the PR interval followed by a dropped QRS
  • QRS complexes yield an irregular rhythm
  • Caused by cyclical and progressive delay through AV junction
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15
Q

Characteristics of a Second Degree AV Block Type II?

A
  • One or more QRS complexes are dropped
  • PR intervals do not change (fixed PR intervals)
  • Caused by an intermittent block below the AV node
  • Low cardiac output when there are multiple dropped QRS complexes
  • Can progress to 3rd degree AVB.
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16
Q

Characteristics of Second Degree AV Block with 2:1 Conduction?

A
  • Each alternative P wave is NOT paired with a QRS complex.
  • PR interval is constant.
  • Can be associated with low cardiac output, can progress to a 3rd degree AV block.
17
Q

Characteristics of a 3rd degree AV block?

A
  • Lonely P waves (P wave without an accompanied QRS complex)
  • Chaotic PR intervals.
  • Narrow QRS denotes a higher junction at block
  • Wide QRS points toward a sub oval block high in bundle branches.
18
Q

Characteristics of Normal Sinus Rhythm with Premature Junctional Complex?

A
  • Absent or inverted P wave in lead II
  • shortened PR interval (less than .12 seconds)
  • complex comes early or premature
  • Occurs due to an irritable focus within the AV junction.
19
Q

Characteristics of a Junctional Rhythm?

A
  • Expected rate is 40-60 BPM
  • Inverted or absent P waves in lead II.
  • Originates from AV junction (between AV node and Bundle of His)
  • Absent P wave in junctional rhythm is associated with loss of atrial kick.
20
Q

What are the characteristics of an accelerated junctional rhythm?

A
  • Rate between 60-100/minute
  • Inverted or absent P waves in lead II
  • Shortened PR interval
  • Narrow QRS complexes
  • Due to increased automaticity, increased sympathetic system activity, or ischemia.
21
Q

Characteristics of a Junctional Tachycardia Rhythm?

A
  • Rate over 100 BPM
  • Inverted or absent P waves in lead II
  • Shortened PR interval
  • QRS complexes that are usually narrow
  • One presentation includes an inverted P wave buried in each QRS complex
22
Q

Characteristics of a wandering pacemaker?

A
  • Rhythm with 3 or more different P wave morphology (absent counts as one).
  • Narrow QRS complex
23
Q

Characteristics of Normal Sinus Rhythm with Premature Ventricular Complex?

A
  • Complex arrives earlier than expected
  • Complex is usually wide (.12 seconds or more)
  • T wave often points in opposite direction from QRS complex.
  • often represent increased ventricular automaticity or re-entry phenomenon.
    PVC every second complex is called ventricular bigeminy, every third is ventricular trigeminy
24
Q

Characteristics of Idioventricular Rhythm?

A
  • Anticipated rate of 20-40/minute
  • Occurs when SA and AV nodes are not firing or are slower than the ventricular pacemaker rate.
  • Rate is often not sufficient to sustain an adequate cardiac output.
25
Q

Characteristics of an Accelerated Idioventricular Rhythm?

A
  • Rate between 41-100 beats per minute
  • Wide complexes
  • Can progress rapidly to asystole or VTach.
  • Due to hypoxia or excessive sympathetic stimulation
26
Q

Characteristics of Ventricular Tachycardia?

A
  • Looks like big waves
  • Non-sustained VT (a group of 3 or more PVCs) is a run of VT)
  • Can be caused by myocardial ischemia, a PVC landing on a T-wave (R-on-T), cardiac drug toxicity, or electrolyte imbalance.
27
Q

Characteristics of Ventricular Fibrillation?

A
  • Chaotic electrical activity originating in ventricles
  • Coarse VFib has amplitude equal to our greater than 3 mm, Fine VFib is less than 3mm in height, and suggests less electrical energy in myocardium (less opportunity for defibrillation success)
  • No cardiac output with this rhythm.
28
Q

Characteristics of Paced Ventricular Rate?

A
  • Vertical spike before the QRS complex.
29
Q

What effect do sodium imbalances have on ECG?

A

Sodium imbalances are not apparent on ECG.

30
Q

How does Hypercalcemia prevent on an ECG?

A
  • Shortened QT interval
  • Widened QRS Complex
  • Possible bradycardia
31
Q

How does hypocalcemia present on an ECG?

A
  • Lengthened QT interval

- Shortened QRS duration

32
Q

How does Hyperkalemia present on an ECG?

A 
Mild Hyper K
- Pointed T-waves, most pronounced in precordial leads.
- Patients with LVH may instead display normalization of T-wave inversions in V5, V6, aVL, I)
Moderate Hyper K
- Exacerbation of Mild Hyper K changes
- Widening, lower amplitude P waves
- Prolonged PR interval
- Possible loss of delta wave in WPW patients
- ST elevation in V1-V3 possible
Severe HyperK
- Exacerbation of previous changes
- Widening QRS complex.
33
Q

ECQ changes due to Hypokalemia?

A
  • T waves become wider with lower amplitudes
  • T wave inversion may occur in severe HypoK
  • ST segment depression develops
  • P wave amplitude, P wave duration, and PR interval may all increase
  • U waves emerge, best seen in V2&V3.
34
Q

How would Hypermagnesmia (rare) present on an ECG?

A
  • May cause atrioventricular and intraventricular conduction disturbances.
  • May culminate in 3rd degree AV block or asystole

ECG Basics (1 decks)

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