SF3 1 EKG Flashcards
Second-Degree AV Block, Mobitz Type 1
* Progressive increase in PR Interval from beat to beat until single QRS absent
* PR interval goes back to initial length and cycles
* Usually benign
Stage of STEMI
Days Later
* ST Normalized
* T Wave inverted
Hypercalcemia
* Shortened QT Interval
Orthodromic Atrioventricular Reentrant Tachycardia
* Can be triggered by Atrial Premature beat in WPW
* No delta wave
* Conduction via AV node with reentry from accessory pathway
* QRS normal
Junctional Escape Rhythm
* No P Wave (impulse from below atria)
* Normal QRS
* Beat 40-60 bpm
Second-Degree AV Block, Mobitz Type II
* Sudden intermitten loss of AV conduction without gradual lengthening
* Block may persist two or more beats
* QRS often widened
* Conduction block beyond AV node
* Severe disease
Left Ventricular Hypertrophy
* Deep S in V1
* Elevated R in V5/V6
Sinus Bradycardia
* Normal P
* Normal QRS
* Slowed Heart Rate
Sinus Rhythm (WPW)
* Short PR Interval (<0.12 s)
* Slurred QRS “Delta Wave”
* “Fusion” (synced) AV and Accessory (Bundle of Kent) conduction
* QRS widened
Severe Hyperkalemia
* Flattened P
* Widened QRS
Third-Degree AV Block
* Complete heart block
* no relationship between P and QRS
* QRS width/rate dependent on whether AV node or His/Purkinje providing pacemaking
***In graph, second and fourth P wave superimposed on T wave
Right Bundle Branch Block
* Widened QRS
*RSR’ in V1 (Rabbit Ears)
* Prominent S in V6
Ventricular Premature Beat
* Ectopic ventricular focus fires AP
* Widened QRS (slow cell-to-cell conduction)
* Ectopic beat unrelated to preceding P wave
* T wave opposite polarity of QRS
First Degree AV Block
* PR Interval Lengthened (>0.2 s)
* Benign/Asymptomatic
Stage of STEMI
Acute
* ST Elevation
Stage of STEMI
Hours into it
* ST Elevation
* Depressed R Wave
* Q Wave Begins
Polymorphic Ventricular Tachycardia
* Example of “Torsades de Pointes” (waxing and waning pattern)
* QRS continually changes shape
* Rate varies
* Multiple ectopic foci or continually changing reentry circuit
* QT prolonged (LQTS)
* Abnormality of cardiac ion channel or calcium handling usually
Digoxin Therapy
* ST “Scooped” depression
* Mild PR Prolongation
Atrial Premature Beats
* Originate from Atrial focus outside of SA Node
* earlier-than-expected P Wave with abnormal shape
* QRS Normal
Stage of STEMI
Days 1-2
* T wave inversion
* Q wave deeper
Hyperkalemia
* Tall “peaked” T Wave
Sinus Tachycardia
Everything normal, SA node discharge > 100 bpm (typically 100-180 bpm)
Stage of STEMI
Weeks Later
* ST / T Normal
* Q Wave Persists
Atrial Flutter
* Rapid regular atrial activity at 180-350 bpm
* Many reach AV node during refractory period
* two or more beats of atria per ventricle
* usually caused by reentry over large Anatomically-Fixed Circuit
Monomorphic Ventricular Tachycardia
* QRS complex wide (>0.12 s)
* Rate of 100-200 bpm
* Rate regular
* QRS identical to one another
* Usually structural abnormality supporting reentry circuit (myocardial infarction or cardiomyopathy)
Right Ventricular Hypertrophy
* R > S in Lead V1
* Right Axis Deviation
Ventricular Escape Rhythms
* No P Wave
* Widened QRS Complex (distinguish from Junctional)
* Rate 15-40 bpm
Hypocalcemia
* Prolonged QT Interval
Hypokalemia
* ST Depression
* Flattened T
* Prominent U Wave
Atrioventricular Nodal Reentrant Tachycardia
* Normal QRS
* regular tachycardia
* P wave hidden/retrograde
Ventricular Fibrillation
* Disordered rapid stimulation of ventricles with no coordinated contraction
* chaotic irregular appearance, no QRS
Atrial Fibrillation
* chaotic rhythm with very high atrial rate (350-600 discharge/min)
* No P waves OR high frequency “noise”
* QRS-T normal but timing irregular
* Multiple Wandering Reentrant Circuits within Atria
Antidromic AVRT
* Wide QRS Complex
* Ventricles stimulated by anterograde conduction via accessory pathway
* reentry through AV node
Pathological Q wave. Typical of Myocardial infarction
(remember, must see grouping not single lead)
Left Bundle Branch Block
* Widened QRS
* Broad, notched R in V6
* Absent R and Prominent S in V1
