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DMS EKG > Lecture 2 > Flashcards

Lecture 2 Flashcards

1
Q

What are the 3 stages of EKG evolution during an acute MI?

A
  1. T wave peaking followed by T wave inversion.
  2. ST segment elevation
  3. Appearance of new Q waves
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2
Q

The 3 stages of EKG evolution during an acute MI should be seen in _____ leads.

A

2 or more

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3
Q

T or F
T wave peaking followed by T wave inversion, ST segment elevation, or the appearance of Q waves can be present without any of the others.

A

True

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4
Q

T waves that become tall and narrow at the onset of the MI

A

hyperacute T waves

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5
Q

hyperacute T waves occur

A

a few hours after the T waves invert

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6
Q

T wave changes reflect _____

A

ischemia

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7
Q

lack of adequate blood flow to the myocardium

A

ischemia

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8
Q

Is ischemia reversible?

A

yes - if blood flow is restored or oxygen demands of the heart are lessened the T waves will normalize.

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9
Q

What happens to the T wave if infarction occurs?

A

T wave inversion will persist for months to years

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10
Q

actual myocardial cell death

A

infarction

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11
Q

ST segment elevation signifies…

A

injury - cellular damage beyond ischemia

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12
Q

Is cellular damage reversible?

A

yes

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13
Q

ST segment elevations is a reliable sign…

A

an MI has occurred and immediate and aggressive intervention is required.

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14
Q

Significant ST elevation

A

at least 1 mm of ST elevation in two contiguous leads.

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15
Q

ST segments usually return to normal post acute MI…

A

within a few hours

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16
Q

Persistent ST segment elevation indicates…

A

the formation of a ventricular aneurysm.

17
Q

aneurysm

A

a weakening and bulging of the ventricular wall

18
Q

What is the difference between an MI ST elevation and a Joint elevation?

A

MI- the elevated ST segment is bowed upward and tends to merge with the T wave.

J point - the T wave maintains its independent wave form.

19
Q

Q waves indicate…

A

irreversible cell death has occurred.

20
Q

Q waves are diagnostic of…

A

an MI

21
Q

Q waves appear within ____ of onset of infarction but may take _____ to evolve.

A

several hours

days

22
Q

ST segment usually has __________ when the Q waves appear.

A

returned to baseline

23
Q

Q waves stay for how long?

A

the lifetime of the patient

24
Q

In normal hearts small Q waves can be seen in:

A

left lateral leads : I, aVL, V5, and V6

and sometimes the inferior leads: II and III

25
Q

Q waves in normal hearts are caused by

A

left to right depolarization of the intraventricular system.

26
Q

Lead aVR normally has ______ Q wave and _________ has significant Q waves.

A

a very deep

never

27
Q

Pathologic Q waves are ___________ and ___________ than normal Q waves.

A

wider and deeper

28
Q

Criteria for significant Q waves

A

> 0.04 sec in duration
and
depth must be 1/3 the height of the R wave in the same QRS complex

29
Q

mortality rate for non-Q wave MI

A

These have a lower mortality rate initially but a higher risk for later infarction and mortality than Q wave infarctions.

30
Q

angina that can occur at any time and is usually from coronary artery spasm

A

Prinzmetal’s angina

31
Q

Typical angina is brought on by and is due to:

A

exertions and is due to progressive atheroclerotic heart disease.

32
Q

ST changes that occur during Prinzmental’s angina

A

ST segment may not have the rounded, domed appearance of an MI, and they will return quickly to baseline when given nitroglycerin

33
Q

Prinzmental’s angina occurs in patients with:

A

underlying CAD or normal coronary arteries.

34
Q

Contraindications to stress testing

A 
acute systemic illness
severe aortic stenosis
Uncontrolled CHF
severe HTN
angina at rest
presence of significant arrhythmia
35
Q

How can you test a patient who cannot exercise?

A

Adenosine stress testing

Dobutamine stress testing

DMS EKG (9 decks)

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