Normal ECG

Question 1

In which leads is the P wave positive?

In which leads is the P wave inverted?

P wave will be up or down in which leads?

Answer 1

1, 2, V4, V5, V6 and aVF

aVR

3, aVL, other chest leads

Question 2

What is the acceptable range for the P-R interval?

Answer 2

.12 to .20 seconds

Question 3

What is the acceptable range for the QRS interval?

What is the acceptable range for a Q wave?

Answer 3

.05 to .10 seconds

no more than .03 sec and 1-2mm tall in 1, aVL, aVF, V5 and V6

Question 4

What is the acceptable elevation for the ST segment?

What is the acceptable depression for the ST segment?

Answer 4

No more than 1mm in standard leads

No more than 2mm in chest leads

No more than 1/2mm

Question 5

In which leads is the T wave positive?

In which leads is the T wave inverted?

In which leads is the T wave variable?

Answer 5

1, 2, V3-V6

aVR

3, aVL, aVF, V1-2

Question 6

What is the acceptable range for height of the T wave?

Answer 6

5mm in standard leads

10mm in precordial leads

Question 7

What might an elongated QRS interval signify?

Answer 7

Bundle branch block

Question 8

What are the “official” values for tachycardia and bradycardia?

Answer 8

Tachycardia = >100 bmp

Bradycardia = <60 bpm

Question 9

What may an ST depression indicate?

What may an ST elevation indicate?

Answer 9

subendoardial ischemia

subepicardial or transmural injury or ischemia

Question 10

What is the concern associated with inverted T waves?

With tall upright T waves?

Answer 10

ischemia

hyperkalemia

Question 11

What is the concern associated with ST elevation?

What is the concern associated with a Q wave/QS complex?

Answer 11

pattern of injury (ischmia)

pattern of necrosis or infarct

Question 12

Exaggerated upright T waves in a pt without chest pain or hx concerning for CAD and without s/s of hyperkalemia can be said to be

Answer 12

a normal variant

Question 13

abnormal, notched P waves taller in lead I than in lead 3 are associated with what?

Flat P in lead I that gets tall and point in lead 2-3 is assocaited with what?

Inverted P in leads 2-3 with short PR interval is associated with what?

Answer 13

P-mitrale (mitral dz, p wave kinda looks like an “m”)

P-pulmonale, pulmonary valve dz

AV junctional rhythm

Question 14

What is associated with a R-S-R’-S’ reading?

What is associated with a very prominent Q wave?

Answer 14

bundle branch block

Old infarction

Question 15

What does it mean if you see ST depression after 2 min of exercise?

Answer 15

impending CAD/infarct

Question 16

What makes up a “Normal Sinus Rhythm”?

Answer 16

P:QRS = 1

with P wave preceding QRS

other dz can have this pattern (ectopic atrial, MAT -lung dz, wandering atrial pacemaker, etc)

Question 17

What are the possible concerns associated with a P wave that follows the QRS?

Answer 17

SVT (AV nodal re-entry tachycardia)

Junctional Rhythm

Question 18

What are some of the concerns associated with No P waves?

Answer 18

Atrial fibrillation

atrial flutter

junctional or ventricular escape rhythms

junctional tachycardia

VT

Question 19

what can cause a LAD?

What can cause a RAD?

Answer 19

pregnancy, tymor, ascites, etc

lung dz

Question 20

Easy way to determine axis

Answer 20

normal-positive deflection in leads I and aVF

LAD=positive in lead I and neg in aVF

RAD=neg in lead I and pos in aVF

Question 21

What are the perpendicular leads?

Answer 21

I - aVF

II-aVL

III-aVR

Question 22

How to find axis (my words, tell me if I’m wrong)

Answer 22

look to see if Lead I and aVF are both positive or if one is negative (determines left or right or normal) then look at smallest QRS complex on EKG and go to whatever lead is perpendicular to that. Use that to determine the value (-30, -60, -90, -180,30, 60, 90, etc.)

I think…..

Question 23

Know how to find rate by counting R waves

Answer 23

From R wave to R wave count 300-150-100-75-60-50 and guestimate rate