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Flashcards in 12 lead ECG interpretation Deck (33)
1

Locations on body:
Lead I

Lead II

Lead III

Lead I = + on left and - on right arm

Lead II = + on left leg and - on right arm

Lead III = + on left leg and - on left arm

2

Locations on body
aVR

aVL

aVF

aVR = right arm

aVL = left arm

aVF = left leg

3

Septal infarcts are most evident in which leads

V1 and V2

4

___ is the dominant producer of voltage in heart

left ventricle

5

QRS axis points ____ and ____

QRS axis points left and posterior

6

normal depolarization goes in which direction

down from right arm to left leg

7

which leads appear + and which leads are -

+ = I, II

- = V1, V2, aVR

8

normal QRS axis ranges from ___ to ___

-30 to 90

9

what is LAD angles?

-30 to -90

LAD ALWAYS ABNORMAL

10

what is RAD angles

+90 to +180

CAN ALSO BE FOUND IN CHILDREN/CHEST MALFORMATION

11

RAD is negative in which lead

LAD is negative in which lead

RAD = neg at lead I, pos at lead II

LAD = pos at lead I, neg at lead II

12

thumbs up rule

which ever thumb is positive is the axis
both positive = normal axis

both negative = indeterminate

13

what does RBBB or LBBB or ectopic ventricular beat appear on ecg in common

widened QRS

14

RBBB shows as what on ecg

late R in V1 + T wave inversion in V1

large S in V6/I

15

LBBB shows as what on ecg

no R and large S in V1

late R in V6/1 + T wave inversion in V6

16

Hemiblocks cause ____ without widening the QRS

axis shifts

17

Hemiblocks cause axis shifts without ____

widening the QRS

18

___ causes LAD

blocks in anterior fascicle

19

____ causes RAD

blocks in posterior fascicle

20

What possibilies if P wave abnormalities

1) Tall P (>2.5 mm in inferior lead = R atrial enlargement)

2) Wide notch P wave with late negativity in V1 (L atrial enlargement)

21

what possibilities if QRS wide?

(>0.12 sec = BBB)
RBBB = large late R' in V1 + late S wave in V6

LBBB = wide QS in V1 + wide R wave in V6

22

what possibilities if axis shift

Right axis = RVH or posterior hemiblock

Left axis = LVH or anteiror hemiblock

23

what possibilities if high voltage

ventricular hypertrophy

RVH (R wave in V1 + S wave in V6 > 11mm)

LVH (S wave in V1 + R wave in V6 > 35) + T wave inversion

24

what possibilities if Q waves

infarct if in 2 related leads
(25% of R wave or 0.04 sec wide)

2 contiguous leads = necrosis

25

what possibilities if ST elev?

injury if local

pericarditis if diffuse

26

what possibilities if ST depression?

ischemia

subendocardial infarct

reciprocal signs from MI (with ST elev or old MI)

27

what possibilities if T inversion?

ischemia (early MI)

hypertrophy

BBB

28

what possibilities if Long QT

electrolyte imbalance (low K, Ca2+, Mg2+

type 1A/C, type 3, congenital long QT)

29

late R in V1 + T wave inversion in V1

large S in V6/I

RBBB

30

no R and large S in V1

late R in V6/1 + T wave inversion in V6

LBBB

31

which BBB masks MI

LBBB

32

QRS is wide, think ___

BBB

33

QRS is narrow, think ___

hypertrophy