Section 4 Flashcards
Hyperkalemia
Hyper-K-alemia
High potassium
Caused by renal disease, acidosis, meds
Hyperkalemia EKG Progression
- T waves peak
- Loss of P wave, further T wave peaking
- Sine Wave
Hypokalemia
Hypo-K-alemia
Low potassium
Caused by dietary deficiency, alkalosis, excess mineralocorticoids, meds
Hypokalemia EKG findings
T wave flattening
U wave appears in ONLY the anterior leads (between T and P wave)
Hypocalcemia
Low Calcium
Caused by malabsorption, vit d deficiency, hypoparathyroidism
Hypocalcemia EKG findings
Prolonged QT interval
Short PR interval
T wave flattening
Risk of V Tach
R on T phenomenon
Prolonged QT from hypocalcemia turning into Vtach. T wave encroaches onto the next R wave.
Hypercalcemia
High Calcium
Caused by malignancies, granulomatous diseases, medication induced, primary hyperparathyroidism
Hypercalcemia EKG findings
Shorted QT inervals
Hypothermia
Cold temp
Slows metabolism
Hypothermia EKG Changes
Sinus Brady
Prolonged segments
Distinct ST elevation: J Wave or Osborne Wave
Digitalis Effect
Drug Digoxin causes it
Normal at therapeutic levels
Slows AV node conduction
Digitalis EKG
ST Depression w/ downslope
(Looks like mustache)
T wave flattening or inversion
Digitalis Toxicity
Happens at supratherapeutic levels
Sinus Node suppression
AV Conduction blocks
Tachyarrhythmias
Paroxysmal Atrial Tach
Enhanced automaticity of ectopic atrial focus
Or from re-entrant circuit in atria
Usually looks like SVT, but can have P waves if slow enough
100-200 BPM
Associated with Digitalis Toxicity
PAT
Paroxysmal Atrial Tachycardia
Associated with Dig Toxicity
Usually 2:1 block
Acute Pericarditis
Inflammation of Pericardium
Patient recovering from viral infection
Usually presents with chest pain that improved with then lean forward
Acute Pericarditis EKG
ST elevations, T wave changes, PR depressions
Pericardial Effusion
Heart is rotating freely within fluid
Following an infection
Pericardial Effusion EKG
Low voltage: aka little QRS complexes
Electrical ALternans
Associated with Pericardial Effusions
Amplitude of the waveform is varying beat to beat
Short-tall-short-tall
COPD
Chronic Obstructive Pulmonary Disease
Emphysema
Chronic Bronchitis
Right atrial enlargement common
COPD EKG
Low voltage: Little QRS
Right axis deviation
Poor R wave progression
R atrial enlargement
Acute Pulmonary Embolism EKG
R ventricular hypertrophy
RBBB: Right bundle branch block
S1, Q3, T3
Tachycardia: Sinus Tach or Afib
S1Q3T3
Acute Pulmonary Embolism
S1: Large S in Lead 1
Q3: Deep Q in Lead 3
T3: Inverted T in lead 3
Brugada Syndrome
Inherited trait, more in men
Causes Syncope
Brugada EKG
EKG showing RBBB and ST (can look like bunny ears) elevation V1, V2, V3 Risk of Vtach Pointy ST in V1
Female presenting with chest discomfort that gets worse when lying on back. Just recovered from infuenza virus
Acute Pericarditis
ST elevations in multiple leads, PR depressions
Male with COPD, SOB
Low voltage QRS complexes
Right atrial enlargement: Poor R wave progression and R axis deviation.
Female fell in bathroom was there all night
Hypothermia
Osborne Waves: Distinct T waves
Patient had facial trauma after fall
Syncopal episode w/o warning so was unable to put hands out to stop fall.
Male with CHF on Digoxin
Normal: Digitalis Effect (showing ST depression with T wave flattening)
High levels: Tachy arrhythmias
Female with thyroidectomy, muscle cramping, tingling in fingers
Hypocalcemia: Prolonged QT with T wave flattening. PR interval shortening
Male with Afib on Digoxin, feels fine
Digitalis Effect, normal, Afib with ST depressions
