QRS Syndromes

Question 1

Wolf Parkinson-White Syndrome

Answer 1

Short PR interval: PR 0.12 s
Delta wave = slurred QRS onset
*unreliable for other diagnosis

Question 2

Wide QRS
PR > 0.12 s
Terminal R w ave in V1

Answer 2

Right Bundle Branch Block

Question 3

Wide QRS

Mid-QRS notching in leads with tall R waves

Answer 3

Left Bundle Branch Block

*stop analysis if present

Question 4

Intraventricular conduction defect

Answer 4

If neither LBBB or RBBB w/ wide QRS

Question 5

Pathologic Q wave seen in leads (3) or (5) indicate ___

Answer 5

1, 2, aVF
V2, V3, V4, V5 or V6
MI

Question 6

Q wave in V2 and/or V3

Answer 6

Septal, anteroseptal/ anterior MI

Question 7

Q wave in V5 and/or V6

Answer 7

Lateral MI

Question 8

Q wave in lead 1

Answer 8

High lateral MI

Question 9

Q wave in aVF

Answer 9

Inferior wall MI

Q amplitude > 1/3 - 1/4 of R amplitude in aVF

Question 10

Large R wave in V1 if Q wave indicative of inferior wall MI (aVF)

Answer 10

True posterior MI

Question 11

Right ventricular hypertrophy

Answer 11

RAD + large R or R’ in V1

Question 12

Left ventricular hypertrophy

Answer 12

S or Q wave in V1 or V2 (+) R wave in V5 or V6 (>) 35 mm

Question 13

Pericarditis

Answer 13

Abnormal ST elevation in inferolateral (V5 and V6) and anterior leads (V2 and V3) but NOT in V1 (not always) and aVL

Question 14

Localized abnormal ST elevation to 1 area supplied by single coronary artery

Answer 14

Acute epicardial injury

Question 15

ST segment depression

Answer 15

Ischemia