Reading an EKG

Question 1

How long is each little box on an EKG?

Answer 1

.04 seconds (40ms)

Question 2

How long is each big box on an EKG?

Answer 2

5 little boxes

.2 seconds (200ms)

Question 3

How is the PR interval measured?

Answer 3

From onset of P wave to onset of QRS

Question 4

How long is a normal PR interval?

Answer 4

120-200ms

3-4 boxes

Question 5

How long is a normal QRS complex?

Answer 5

80-120ms

2-3 boxes

Question 6

What would a narrow QRS indicate?

Answer 6

Atrial or junctional arrhythmias

Question 7

What would a wide QRS indicate?

Answer 7

Ventricular

Question 8

What does an elevated ST segment indicate?

Answer 8

Myocardial Ischemia

Question 9

What does a depressed ST segment indicate?

Answer 9

Subendocardial infarction

Question 10

What does an upside T wave indicate?

Answer 10

Acute Ischemia

Question 11

What is a normal sinus rhythm?

Answer 11

P wave before each QRS

QRS after each P wave

Question 12

What does a long PR interval indicate?

Answer 12

1st degree AV block

Question 13

What is a bigeminal pattern? Trigeminal?

Answer 13

Two quick beats then a rest

Three quick beats then a rest

Question 14

What would atrial flutter look like?

Answer 14

A regular set P wave:QRS complex ratio

P waves are same monomorphic

Question 15

What would A fib look like?

Answer 15

An irregular heart rate
Random polymorphic P waves
There DOES NOT have to be lots of P waves

Question 16

What would have wide upside-down complexes?

Answer 16

V Tach

Question 17

What would V fib look like?

Answer 17

Irregular rate and rhythm

No set pattern (unlike torsades)

Question 18

What are random wide QRS complexes called?

Answer 18

PVCs

Question 19

What would an irregular junctional rhythm look like?

Answer 19

Bradycardia

P wave after a narrow complex

Question 20

What is a flatline called?

Answer 20

Asystole

Question 21

What has progressively longer PR intervals and eventually has a P without a QRS complex?

Answer 21

2nd degree AV block type 1; AKA

Mobitz 1 or Wenckebach

Question 22

What is a Mobitz 2 or 2nd degree AV block type 2?

Answer 22

Randomly does not conduct

Question 23

What has rhythmic P waves, rhythmic R waves, but non-synchronized P/QRS?

Answer 23

3rd degree conduction block

Question 24

What do the QRS complexes look like with a 3rd degree block?

Answer 24

Wide

Upside down

Question 25

What is a V tach preceded by a prolonged QT that has a sinusoidal amplitude?

Answer 25

Torsades de pointes

Question 26

What is the axis of a patient with a positive I and a positive aVF?

Answer 26

Normal

Question 27

What is needed for a patient with a positive I and a negative aVF to be considered normal?

Answer 27

A positive II

Question 28

A patient has a positive I, negative II, and negative aVF?

Answer 28

Left Axial Deviation (LAD)

Question 29

What is needed for a Right Axial Deviation (RAD)?

Answer 29

Negative I

Positive aVF

Question 30

What is looked at when considering atrial hypertrophy?

Answer 30

P waves

Question 31

What does the v1 R wave > S wave tell us?

Answer 31

Right Ventricular Hypertrophy (RVH)

Normally minimal R wave with deep S wave

Question 32

What does a v6 R wave + v1 S wave > 35mm indicate? Or v5 R wave + v2 S wave > 35mm

Answer 32

Left Ventricular Hypertrophy (LVH)

Question 33

What is a difference between Left Atrial Enlargement (LAE) and Right Atrial Enlargement (RAE)?

Answer 33

LAE has a long P wave duration

RAE has a tall/peaked P wave

Question 34

How does an acute/recent infarct present?

Answer 34

ST elevation with significant (pathologic) Q waves

Question 35

Inferior wall ischemia has elevated ST segments in which leads?

Answer 35

II
III
aVF

Question 36

Elevated ST segments in V1 and V2 indicates an ischemia where?

Answer 36

Anterior septum

Question 37

Elevated ST segments in V5 and V6 indicates an ischemia where?

Answer 37

Lateral wall