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EKG > Lecture 8 > Flashcards

Lecture 8 Flashcards

1
Q

inflammation of pericardium

A

pericarditis

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2
Q

EKG changes in pericarditis

A
  • T wave initially upright and elevated but inverts during recovery phase
  • elevated ST segment (flat or concave)
  • ST changes diffuse
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3
Q

low voltage seen in all leads

A

pericardial effusions

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4
Q

electrical alterans

A

manifested by changing aamplitude of the QRS complex (seen with large pericardial effusions because the heart may rotate freely)

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5
Q

acute occlusions of the pulmonary artery

A

pulmonary embolism

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6
Q

what rhythm is commonly seen with pulmonary embolism?

A

sinus tachycardia (esp. if embolism is small)

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7
Q

EKG pattern seen with massive PE

A

S1 Q3 T3

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8
Q

axis deviation with PE

A

right axis

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9
Q

other EKG changes with PE

A

signs of RAE, RBBB, inverted T waves in precordial leads

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10
Q

congenital condition with delayed repolarization following depolarization

A

long QT syndrome

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11
Q

long QT syndrome is a/w which ventricular dysrhthmias

A

V. fib and torsafes

-usually a/w exercise

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12
Q

short QT syndrome is a/w?

A

syncope, ventricular arrhythmias, risk of sudden cardiac death

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13
Q

represents depolarization and repolarization but it is corrected for the heart rate

A

QTc interval

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14
Q

signs of hyperkalemia

A
  • tall, peaked T waves
  • flattened p waves
  • 1st degree AV block
  • wide QRS complexes
  • sine wave pattern (K>7.0)
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15
Q

signs of hypokalemia

A
  • flattened T waves
  • appearance of U waves**
  • ST segment depression
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16
Q

hypercalcemia will result in ____ (increased, decreased) automaticity with _____(faster, slowed) conduction

A

decreased; slowed

17
Q

QT interval for hypercalcemia

A

shorter!

-short refractory period

18
Q

QT interval for hypocalcemia

A

longer!

19
Q

hypocalcemia can precipitate what?

A

V. tach or torsades

20
Q

what ions does digoxin affect the movement of?

A

sodium and calcium

  • slows influx of sodium
  • increases influx of calcium
21
Q

what is the primary biomechanical mechanism of action of digoxin?

A

inhibition of the Na/K ATPase of the cell membrane

22
Q

effect of digoxin on contractility and heart rate?

A

increases contractility and slows heart rate/AV conduction

23
Q

digoxin effect

A

expected EKG changes and do not indicate a need to d/c the drug

  • seen in therapeutic drug levels
  • slows SA node and conduction through the AV node
24
Q

digoxin therapeutic drug levels

A

0.8-2.0 ng/ml

25
Q

toxic blood levels of digoxin

A

> 2.4 ng/ml

26
Q

EKG findings a/w toxic blood levels of digoxin

A

conduction blocks or tachy-dysrhythmias

27
Q

increased risks a/w toxic blood levels

A

renal disease, hypokalemia, and aging(?)

28
Q

Specific EKG changes with therapeutic digoxin levels

A
  • shortened QT interval
  • flattened T waves
  • asymmetric ST depression and T wave inversion in leads with tall R waves (gradual downslope of ST segment)
29
Q

most characteristic rhythm disturbance of toxic digoxin levels

A

PAT (paroxysmal atrial tachycardia)

30
Q

drugs that put pt at risk for V. tach and torsades

A

anti-arrhythmics, TCA, phenothiazines, erythromycin

31
Q

effect of quinidine

A

prolonged QT interval

-also widened QRS

32
Q

when should you d/c quinidine

A

QTI >25% prolongation

33
Q

where do you seen osborne waves

A

hypothermia

34
Q

all intervals with hypothermia are _____ (prolonged or shortened)

A

prolonged

35
Q

what is an osborne wave

A

ST segment elevation with an abrupt ascent at the J point, then plunge back to baseline

36
Q

most common arrhythmias a/w hypothermia

A

sinus bradycardia and slow a fib

37
Q

what is brugade syndrome

A

EKG abnormalities which cause sudden death due to V. fib

-3 different EKG patterns with variable ST segment elevation abnl.

38
Q

treatment for brugade syndrome

A

ICD (implantable cardioverter-defibrillator)

EKG (5 decks)

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