Heart Rhythms

Question 1

Normal Sinus Rhythm

Answer 1

Regular-60-100 BPM
QRS Normal
P-Wave visible before QRS
P-R Interval Normal less than 5 small boxes (anything above 5 small boxes wouldbe 1 HB)

Question 2

Sinus Brady

Answer 2

Regular - less than 60 BPM
QRS Normal
P-Wave vuisible before QRS
P-R interval is normal
Usually benign often caused by BB

Question 3

Sinus Tach

Answer 3

Regular 100+ BPM
QRS Normal
P-Wave Visible before QRS
Exercise

Question 4

SVT-supraventricular tachycardia

Answer 4

Regular 140-220 BPM
QRS is usually normal
P-Wave is buried in the preceding T-wave
P-R depends on the site of supraventricular pace maker
Impulses stimulating the heart are not beginning in the SA node

Question 5

A-Fib

Answer 5

Irregularly irregular - 100-160 BPM(can be slower on meds)
QRS-usually normal
P-Wave-not distinguishable as artria are firing all over
P-R interval Not measurable

Question 6

A-Flutter

Answer 6

Regular- around 110 BPM
QRS-ususally normal
P-Wave replaces w/ saw tooth flutter waves usually @ 2:1 ratio but can be 3:1
P-R interval-not measurable

Question 7

1st Degree Heart Block

Answer 7

Regular rhythm and rate (60-100)
QRS- Normal
P-Wave ratio is 1:1 P to QRS
P-R Interval-Prolonged MORE than 5 small boxes
Delay of conduction through the AV node can be seen in healthy athletes

Question 8

2nd Degree Type 1 (Wenckebach)

Answer 8

Regularly irregular
Rate can be Normal or Slow
QRS is Normal
P-Wav Ratio is 1:1 for 2,3 or 4 cycles then 1:0
P wave rate is normal but faster than QRS
P-R Interval Progressively legnthening P-R interval until a QRS complex is dropped
Conduction block of some but not all atrial beats getting through to the ventricle.

Question 9

2nd Degree Type II

Answer 9

Regular
Rate is normal or slow
QRS -prolonged
P-Wave Ration 2:1 or 3:1
P-Wave rate Normal but faster than QRS rate
P-R Interval-normal or prolonged but constant
Electrical excitation fails to pass through the A-V node or bundle of HIS. Atrial contraction are not always followed by a QRS

Question 10

3rd Degree Block/Complete Heart Block

Answer 10

Regular
Rate is slow
QRS is Prolonged, p-wave is unrelated 
P-R interval -Chaotic
Complete AV(NODE) block, No atrial impulse passes through the AV node and the ventricles generate their own rhythm

Question 11

Bundle Branch Block

Answer 11

Regular Rhythm and Rate
QRS IS PROOOLONGED
P-Wave Ration is 1:1
P-Wave rate is normal and same as QRS rate
P-R Interval- Normal-less than 5 small boxes
Abnormal conduction thru the bundle branches will cause depolarization delay thru the ventricle causing an wide QRS

Question 12

Right Bundle branch block

Answer 12

Means that there is a problem/s with the right side of the heart

Question 13

Left Bundle Branch Block

Answer 13

is an indication of heart disease and further interpretation of the ekg cannot be carried out

Question 14

Prematur Ventricular Complexes/Contractions

Answer 14

Regular rate and rhythm
QRS-Normal
P-Wave 1:1
P-Wave Rate Normal and same as QRS rate
P-R Interval- Normal
can be unifocal(look like a regular PVC) or Multifocal which can be one weird looking and one normal looking or all weird looking
PVC-caused by heart depolarizing earlier than it should

Question 15

Junctional Rhythm

Answer 15

Regular
Rate 40-60 (AV node speed…juntional)
P-Wave Ratio is 1:1 if p-wave can be seen
P-wave is inverted in Lead II
P-Wave Rate-same as QRS
P-R interval- Variable
SA node does not control the heart rhythm. Block in conduction system along the way, when this happens AV node takes over. Don’t for get about ACCELERATED JUNCTIONAL which is faster than 60 BPM