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Cardio Exam 2 > Lec 2-3 EKG Images > Flashcards

Lec 2-3 EKG Images Flashcards

1
Q

What type of rhythm is this?

A

Sinus arrhythmia = non-pathological variation with respiration = looks irregular in bunches

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2
Q

What type of rhythm is this?

A

premature atrial contraction = early QRS complex originated by abnormal P wave followed by compensatory pause; but QRS complex itself looks normal

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3
Q

What type of rhythm is this?

A

premature ventricular contraction

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4
Q

Is this sinus rhythm? What is it?

A

No! because P waves present and regular but not upright in I/II

since P wave = problem is not with atria,
must be problem with where focus is [atrial rhythm/tachycardia with focus coming from somewhere else], or heart just not where its supposed to be [dextrocardia] OR you put leads in the wrong dir [inverted right and left]

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5
Q

What causes this rhythm?

A

dextrocardia

inverted P wave in I, decreasing amplitude from V1 to V6 [opposite what you’d expect = muscle mass decreasing toward left]

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6
Q

What causes this rhythm?

A

p wave inverted 1, 2 but normal progression of QRS so unlikely to be dextrocardia

III + aVF = good; aVL should have been upright but its not; aVR should have been negative but its not

–> you accidentally switched L and R

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7
Q

Sinus or non-sinus? Normal, brady, or tachy?

A

sinus bradycardia

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8
Q

What rate? Sinus or non? Normal brady or tachy?

A

sinus tachycardia

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9
Q

What axis?

A

right axis deviation à V1 negative, AVF positive

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10
Q

What axis?

A

left axis deviation à V1 positive, AVF negative

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11
Q

What axis?

A

left axis deviation

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12
Q

What causes this type of axis?

A

left anterior fascicular block

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13
Q

What causes this?

A

left bundle branch block = broad QRS, looking down in V1

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14
Q

What causes this?

A

right bundle branch block = broad QRS, looking up in V1

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15
Q

What causes this?

A

right bundle branch block = broad QRS, looking up in V1

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16
Q

What causes this?

A

left bundle branch block = broad QRS, looking down in V1

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17
Q

What rhythm is this?

A

right BBB à broad QRS, rabbit ears, upright V1

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18
Q

What rhythm is this?

A

WPW à short PR, delta wave on upstroke of QRS, broad QRS

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19
Q

What rhythm is this?

A

posterior wall infarct –> huge positive R in V1, prominent Q waves in leads II and III [inferior leads]

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20
Q

What rhythm?

A

LVH

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21
Q

What rhythm?

A

RVH with right axis deviation

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22
Q

What rhythm is this?

A

Wolf parkinson white = WPW

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23
Q

What rhythm is this?

A

wolf parkinson white = WPW

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24
Q

What rhythm is this?

A

Wolf Parkinson White = WPW

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25
What rhythm is this?
Right bundle branch block
26
What does this rhythm suggest?
posterior infarct
27
What does this rhythm suggest?
left ventricular hypertrophy
28
What does this rhythm suggest?
right ventricular hypertrophy
29
Which leads correspond to inferior wall? septal wall? anterior wall? anteroseptal wall? lateral wall?
inferior = leads II, III, aVF septal = V1 and V2 anterior = V3 and V4 anteroseptal = V1, V2, V3, V4 lateral = I, aVL, V5, V6 [I/aVL = high lateral; V5/V6 = anterolateral]
30
What does this rhythm show?
diffuse subendocardial ischemia = ST depressions and T wave inversions
31
What does this rhythm show? Which specific leads/signs?
anterolateral and inferior ischemia T inversion and ST depression on II, III, aVF --\> inferior ischemia ST depression on V4, V5, V6 --\> anterolateral ischemia
32
What stage of MI is this? [hyperacute, fully resolved, resolution, or chronic stabilized]
resolution phase because you see: - Q wave - inverted T wave - no ST elevation
33
What stage of MI is this? [hyperacute, fully resolved, resolution, or chronic stabilized]
chronic stabilized because you see - Q wave - upright T wave - no ST elevation
34
What stage MI is this? [hyperacute, fully resolved, resolution, or chronic stabilized]
hyperacute phase this is because: - huge ST elevation - hyperacute tall T wave - no Q wave yet
35
What stage MI is this? [hyperacute, fully resolved, resolution, or chronic stabilized]
fully evolved phase this is because: - ST elevation - start to see Q wave formation - start to see T wave inversion
36
What pathology does this rhythm show? what phase?
anterior wall MI hyperacute phase since T waves and STs still up ST elevation in V3, V4, V5, V6
37
What does this EKG show? If a patient presents with new onset of this type of EKG and chest pain what is the diagnosis?
this shows LBBB = wide QRS, QRS down in V1, rabbit ears notched/slurred in V5, V6 pt with new onset LBBB and acute chest pain = acute STEMI MI this is an acute anterior wall MI
38
What does this EKG show?
Inferior wall MI ST elevation in V2, V3, aVF hyperacute phase reciprocal ST depression/T wave inversion in 1 and aVL substantiate STEMI
39
What does this EKG show?
inferior and RV infarction --\> RCA infarct ST elevation in 2, 3, aVF [hyperacute] and in V4%, V5R, V6R
40
What does this EKG show?
inferior wall/posterior MI II, III, aVF ST elevation = inferior wall MI I and aVL ST depression = reciprocal changes V1/V2 ST depression --\> mirror image of posterior wall -\> may signify posterior wall MI
41
What does this EKG show?
age-indeterminant inferior wall MI - III, avF show Q wave = inferior infarction
42
What does this EKG show?
atrial fibrillation - irregularly irregular R-R interval b/c some P waves transmitted down and some aren't - fibrillatory waves rather than discrete P waves
43
What does this EKG show?
multifocal atrial tachycardia - atrial tachycardia with 3 or more different P wave morphologies - irregularly irregular rhythm
44
What does this EKG show?
multifocal atrial tachycardia - atrial tachycardia with \> 3 different P wave morphologies - irregularly irregular rhythm - rate \> 100 bpm
45
What does this EKG show? How should you treat?
supraventricular tachycardia Give adenosine
46
What type of rhythm is this?
supraventricular tachycardia = SVT
47
What type of rhythm is this?
sinus tachycardia P before every WRS and upright in 1 and 2 and inverted in aVR
48
What type of rhythm does this EKG show?
typical atrial flutter - sometimes 1 or 2 or 3 p waves between each QRS - irregularly irregular QRS - saw tooth pattern P-waves - typical means upright in II, III, aVF - distinguish from AFib: clear p wave activity
49
What type of rhythm does this EKG show?
typical atrial flutter - fast sawtooth p waves - a few P waves for each QRS - typical b/c upright in II, III, aVF
50
What type of rhythm does this EKG show?
atypical atrial flutter - sawtooth p waves - very distinctive p waves - atypical = down in II, III, aVF
51
Match each of the following rhythm strips with the following types of rhythms: - multi-focal atrial tachycardia [MAT] - atrial fibrillation - atrial flutter - atrial tachycardia - AVNRT/AVRT [SVT] - sinus tachycardia
1 = sinus tachycardia 2 = AVNRT/AVRT = SVT 3 = atrial fibrillation 4 = atrial flutter 5 = atrial tachycardia 6 = multi-focal atrial tacycardia [MAT]
52
What type of rhythm is this? Treatment?
ventricular tachycardia = fast wide QRS complexes Treat: synchronized cardioversion
53
What is this rhythm?
ventricular tachycardia with fusion and capture beats mean VT AV dissociation = no real association betwen P and QRS capture beat = in middle of VT a p wave able to capture a narrow normal QRS fusion beat = QRS in between supraventricular and ventricular beats
54
What rhythm is this? How do you treat?
Ventricular fibrillation - chaotic irregular deflections - no P waves or QRS or T treat by defibrillations [not cardioversion]
55
What rhythm is this? How should you treat?
This is a fake fibrillation = an artifact on exam Not fib because its regular [in fib = irregular] not flutter b/c don't have classic sawtooth pattern in II, III, aVF don't do fibrillation!!
56
What rhythm is this? How should you treat?
This is torsade de pointes treat with IV magnesium
57
What rhythm is this? How do you treat?
WPW with AFib - broad complex tachycardia - irregularly irregular means not VT or VF --\> must be AFib - broad coming down accessory path - WPW since broad QRS + delta complex pre-excitation = slurred QRS upstroke Treat = procainamide or pronesta and synchronize cardiovert
58
What does this EKG show?
first degree AV block - prolonged PR - each P followed by QRS - usually constant PR interval
59
What does this EKG show?
Mobitz type I 2nd degree EKG block [wenkebach] - lots of p waves and irregularly irregular QRS = "group" beating - progressive prolongation of PR until P fails to conduct
60
What does this EKG show?
second degree AV block mobitz type 2 more dangerous than type 1 lots of extra P waves 3 or more extra p waves for every QRS no group beating like in wenkebach
61
What does this EKG show?
complete heart block p waves show no relation to the QRS complexes
62
What does this EKG show?
sinus pause = longer than 2 seconds of no sinus activity = 10 big boxes
63
What does this EKG show?
electronic pacemaker spikes = artificially induced electronic stimuli that pace pts rhythm cause a blip or spike on the waveform
64
What is this patient's most likely K level A)4.5 B)5.0 C)5.5 D)6.5 E)8.5
mostly likely has 6.5 - peaked T waves mean K . 5.5 - loss of p waves mean K \> 6.5 - but if 8.5 would have had wider QRS
65
Identify 3 ECG findings inidicative of possible hyperkalemia? Give what med?
- peaked T waves - first degree AV block - wide QRS give IV calcium
66
What caused this EKG pattern?
hypokalemia = promiment U waves in V2/V3
67
What likely caused this EKG pattern?
acute pericarditis = diffuse ST elevation, concave upwards, PR depression in V3 - may be tachycardic
68
What EKG finding is this?
electrical alternans = QRS axis or amplitude alternates between beats may be due to pericarditis or tamponade with fluid surrounding heart
69
What caused this EKG finding
Pulmonary embolism S1Q3T3 pattern - prominent S wave in lead I - Q wave and inverted T wave in lead III - sinus tachycardia - T wave inversion in V1-V3
70
What caused this EKG finding?
digoxin effect = reverse tick/check sign = sagging ST
71
What kind of rhythm is this? What is dysfunctioning here?
sinus bradycardia represents dysfunction at SA node
72
What kind of rhythm is this? What is dysfunctioning?
Sinus tachycardia this is dysfunctional SA node
73
What kind of rhythm is this? What causes this?
Supraventricular tachycardia narrow QRS, fast, P waves not super distinct reflects reentry through AV node
74
What does this rhythm show?
premature ventricular contractions wide QRS from ventricles; two different shaped PVC means multiple ectopic foci
75

Cardio Exam 2 (19 decks)

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