Rapid EKG V Flashcards
bundle branch block
conduction block in right or left bundle branches
- see two QRS out of phase
- looks widened
R and R’ (second delayed)
widened QRS greater than 0.12s
bundle branch block
right BBB
sharp S wave downward
- R’ right ventricle
- R/R’ in V1 and V2
left BBB
rounded S wave downward
- R left ventricle
- R/R’ in V5 and V6
right chest leads
V1 and V2
left chest leads
V5 and V6
left bundle branch
has two subdivisions
- fascicles
- hemiblocks
hemiblocks
fascicles of left bundle branch
intermittent mobitz
occasional dropped QRS due to permanent BBB one side with intermittent BBB other side
- one sided BBB with intermittent dropped QRS
- momentary complete AV block
imitators of intermittent mobitz
dropped QRS end of wenckebach
-tell bc of progressive lengthened PR intervals
non-conducted PAB - see P’ with no QRS
tansient sinus block- missing entire P-QRS-T
normal P wave with no QRS
second degree AV block
P’ with no QRS
non-conducted PAB
missing P-QRS-T
sinus block
normal mean QRS vector
tail - AV node
- advancing wave of Na ions
- 0 > + 90 degrees
lateral limb lead
I and AVL
inferior limb leads
II, III, and AVF
most isoelectric lead in frontal plane
can give you the correct angle of deviation - mean QRS vector
-bc signal is perpendicular to vector
chest lead V2
4th ics - left of sternum
-normally negative
posterior/anterior infarction of left ventricle
seen on V2
transitional zone
V3 and V4
axis deviation
frontal plane
axis rotation
horizontal plane
chest lead V1
4th ICS - right of sternum
-info about atria
diphasic P wave in V1
atrial enlargement
right atrial enlargement
initial component of diphasic P wave is larger (in V1)
left atrial enlargement
second component of diphasic P wave larger (in V2)
height of P wave in any limb lead greater than 2.5mm
suspect right atrial enlargement
QRS in lead V1
S normally larger than R
-overall downward deflection
right ventricular hypertrophy
will see mainly positive V1
-larger R wave than S
progressively smaller R wave from V1 > V4
also RAD in frontal plane
left ventricular hypertrophy
V1 very deep S wave
- LAD in frontal plane
- also large R in V5
-also may see inverted T wave in left chest leads (V5 and V6)
math for left ventricular hypertrophy
mm of V1 + mm of V5
-more than 35mm - there is LVH
V1 depth (S) + V5 height (R)
strain pattern
with ventricular hypertrophy
-ST segment depressed and humped
strain pattern in V1
right ventricular hypertrophy
strain pattern in V5
left ventricular hypertrophy
R atria, L atria, R ventricle hypertrophy
look at V1
L ventricle hypertrophy
look at V1 and V5
