Ischemia/infarction lecture

Question 1

ST segment depression- slop and depth

T wave changes- inversion

Answer 1

EKG criteria for ischemia

Question 2

ST depression greater or equal to 1 mm, think…?

Answer 2

Myocardial ischemia

Question 3

Greater than 1 mm ST segment depression that is horizontal or downsloping in one or more leads and persists for more than .08 seconds beyond the J point is highly suggestive of…

Answer 3

Myocardial ichemia

Question 4

Pts with LVH, LBBB, digoxin and Wolf-Parkinson-White abnormality.

Answer 4

ISCHEMIA CAN NOT BE READ ON EKG OF THESE PATIENTS

Question 5

1. symptoms that are highly suspicious (significant chest pain!)
2. EKG changes
3. release of cardiac biomarkers

all 3 required for what dx?

Answer 5

MI

Question 6

Other causes of ST segment depression include metabolic abnormalities (hypokalemia, etc.), drug effects (digoxin, others) and more. ST segment depression of

Answer 6

“non specific” ST changes

Question 7

First EKG change seen (within minutes) of an MI

Answer 7

hyper acute T waves

myocardial cells injure, which release potassium and causes a peaked T wave

Question 8

Normal R wave, peaked ST segment and T wave

Answer 8

onset and first several hours

Question 9

Peaked T waves will invert after….

Answer 9

6-48 hours

Question 10

New ST segment elevation at the J point (often merging into peaked T waves) in…

Answer 10

2 or more contiguous leads

Question 11

Limb leads: ST segment elevation of __ mm or more.

Answer 11

1 mm

Question 12

Precordial leads: ST segment elevation of _ mm or more.

Answer 12

1 mm

Question 13

Leads at a distance from those showing ST segment elevation may show changes that are opposite those in the infarct leads: ST segment depression and T wave inversion.

Answer 13

Reciprocal changes with STEMI

Question 14

With anterior wall STEMI, reciprocal changes may occur in leads

Answer 14

II, III, aVF

Question 15

With inferior wall STEMI, reciprocal changes may occur in leads…

Answer 15

I and aVL

Question 16

If reciprocal changes are seen in V1-V3, consider..

Answer 16

Posterior infarction

Question 17

Q waves during a STEMI are greater than _____ seconds in duration

Answer 17

0.04

Question 18

During a STEMI….

If Q wave is followed by an R wave, the Q wave must be at least _____ the height of the R wave in the same QRS complex.

Answer 18

1/3

Question 19

Do all MIs produce Q waves?

Answer 19

NO

Question 20

The presence of the following EKG abnormalities invalidate reading STEMI via EKG:

Answer 20

• Left Ventricular Hypertrophy
• Left Bundle Branch Block
• Wolf-Parkinson-White abnormality/syndrome