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EKG Commonly Forgotten > Yellow Belt MedMastery > Flashcards

Yellow Belt MedMastery Flashcards

1
Q

What is the criteria for pathologic Q waves?

A
  1. > 1/4 the size of the R-wave in the same lead
  2. > 0.04 secs
  3. Any Q waves in V1-V3 are considered abnormal
  4. Needs to be present in two contiguous leads
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2
Q

Mirror images of leads II, III, aVF

A

V1, V2, V3

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3
Q

Describe the difference between STEMI vs. NSTEMI vs. Unstable Angina

A

STEMI - CP sxs + ST segment is elevated + Troponins

NSTEMI - CP sxs + Troponins

Unstable Angina - CP sxs

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4
Q

Explain the phases of myocardial ischemia through the changes seen in STEMI.

A
  1. Acute – ST elevation, Q waves can appear.
  2. ST segment resolution - ST segment moves towards baseline and T waves become inverted.
  3. Subacute - ST segment is back to the isoelectric line and T waves are still inverted.
  4. Chronic - T waves become positive again, ST segments stays at the isoelectric line, Q waves are present.
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5
Q

Describe the different ST segment shapes between STEMI vs. Perimyocarditis.

A

Focus on where the ST segment originates and the shape of it.

STEMI - Originates from the descending segment + Convex

Perimyocarditis - Originates from the a sending segment + Concave

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6
Q

Describe the setting of Vagotonia and how it relates to having an ST segment elevation.

A
  1. Elevated ST segment up to 0.2 mV
  2. Tall peaked T waves
  3. HR <60 BPM
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7
Q

According to MedMastery, where are the three main times when the Cardiac Axis matters?

A
  1. Left anterior fascicular block
  2. RVH - RSS criteria + R. Axis increases likelihood of RVH
  3. LVH + R. Axis suggests Biventricular Hypertrophy
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8
Q

If you are suspecting Right Atrial Enlargement, where should you focus your attention on the EKG?

A

P wave > 2.5 mV in Lead II

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9
Q

If you are suspecting Left Atrial Enlargement, where should you focus your attention on the EKG?

A
  1. > 0.04 seconds negative P wave in V1

2. >0.12 seconds P wave in Lead II

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10
Q

What is the criteria for Right Ventricular Hypertrophy?

A
  1. > 0.5 mV R wave in V1
  2. R > S in V1
  3. > 0.5 mV S wave in V5
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11
Q

What is the EKG criteria for Right Bundle Branch Blocks?

A
  1. M wave in V1 (>0.12 seconds)

2. Broad S wave over the Left Ventricle (V5 & V6)

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12
Q

What is the precordial lead location of V1, V2, V3 in the transverse plane of the Heart?

A

Right Ventricle

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13
Q

What is the precordial lead location of V2 & V3 in the transverse plane of the Heart?

A

Basal Septum

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14
Q

What is the precordial lead location of V2, V3, V4 in the transverse plane of the Heart?

A

Anterior Left Ventricle

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15
Q

What is the precordial lead location of V5 & V6 in the transverse plane of the Heart?

A

Lateral Left Ventricle

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16
Q

What is the precordial lead location of V7 & V8 in the transverse plane of the Heart?

A

Posterior Left Ventricle

17
Q

List the five different shapes of ST segment depressions.

A
  1. Descending
  2. Sagging
  3. Horizontal
  4. Ascending
  5. Deep horizontal
18
Q

After becoming familiar with the different shapes of ST segment depression, explain what is meant by each individual shape.

A
  1. Descending - Ventricular Hypertrophy
  2. Sagging - Digoxin, Hypokalemia, Coronary Insufficiency
  3. Horizontal - Coronary Insufficiency
  4. Ascending - Increased Sympathetic tone, Coronary Insufficiency
  5. Deep horizontal - Severe Ischemia
19
Q

What size should a normal T-wave be?

A

T waves should be at least 1/8 the size of the corresponding R Wave.

20
Q

List the 3 different shapes of T wave inversions.

A
  1. Asymmetrical
  2. Symmetrical
  3. Biphasic
21
Q

After becoming comfortable with T-wave inversions, explain what can be inferred after seeing them on the EKG.

A
  1. Asymmetrical - LVH (over V4 - V6) or RVH (over V1 - V3)
  2. Symmetrical - Myocardial ischemia or myocarditis
  3. Biphasic - Terminal negativity has a high specificity for coronary artery disease.

EKG Commonly Forgotten (1 decks)

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