Lead Groups Flashcards
Septal Leads
These are the two chest leads that are center on the chest
V1, V2
Lateral Leads
Looking at the left side of the heart
I, aVL, V5, V6
Inferior Leads
From the Left foot the view is looking up (inferior-below)
II, III, aVF
Anterior Leads
This is also a view on the left side of the heart
V3, V4
These groupings are anatomically contiguous leads
An ST elevation in two or more leads in these groups on a 12 lead EKG indicates
Infarction II, III, aVF - Inferior S Septal V1, V2 A Anterior V3, V4 L Lateral V5, V6
Cardiac Causes of Chest Pain
MI, angina, CHF, Pericarditis, tamponade, cardiac contusion
Non Cardiac Causes of Chest Pain
Pulmonary embolism, cholecystitis, pancreatitis, indigestion, gastritis, ulcer, irritation of chest muscle or cartilage, respiratory, AAA, drug abuse, esophageal spasms, trauma
Basics of CHF
Heart is unable to pump blood to the body
Blood backs up, causing fluid to back up into the lungs, liver, GI tract,
arms and legs
Causes of CHF
Coronary Artery Disease - most common Heart Attack (MI) Hypertension Valvular disease Emphysema Infections (cardiomyopathy)
Symptoms of CHF
Shortness of breath, Coughing, Swelling of the lower extremities (ankles/feet) Swelling of the abdomen, Weight gain, Irregular or rapid pules, Palpitations, difficulty sleeping, fatigue, weakness, faintness, loss of apppetite
Right Heart Failure
Fluid backs up into the systemic circulation
EDEMA in the PERIPHERY
Left Heart Failure
Fluid backs up into the lungs
EDEMA in the LUNGS
Treatment of CHF
ACE inhibitors to open up blood vessels
Diuretics to decrease blood volume (by increasing urine output)
Betablockers to slow down heart, better contractility
CPAP
Pacemakers, AICDs, LVADs
Normal Heart Sounds
S1 Caused by AV valves closing
Ventricles are in systole
S2 Caused by Semilunar valves closing
Atria are in systole
LUB-DUB
Abnormal Heart Sounds
S3 Can be heard in young adults, healthy children
May be first sign of CHF
Lub-dub-dee (Kentucky)
Abnormal Heart Sounds
S4 Never heard in a normal heart
Caused by over filled atria
Dee-lub-dub (Tennessee)
Dysrhythmia is
the most common complication of myocardial infarction
In hospital Management of ACS
Thrombolytics, angiography//angioplasty//stents
Coronary Artery Bypass Graft (CABG)
3 Lead EKG
Range 1.0-30 Hz
Filters out all but the QRS complex
Use to determine rate and rhythm
Monitor quality ONLY!
12-Lead EKG
Range 0.05-150 Hz
QRS complex, ST segment and baseline are all visible
More sensitive to artifacts
Diagnostic quality
A 12 Lead EKG must have all of the following
Negative aVR One complete cardiac cycle in each lead Diagnostic frequency response Proper calibration Appropriate speed (25 mm/sec)
Precordial Lead Placement
V1 4th intercostal space, right of sternum
V2 4th intercostal space, left of sternum
V3 Between V2 and V4
V4 5th intercostal space, left mid clavicular line
V5 Between V4 and V6
V6 5th intercostal space, left mid-axillary line
