Diagnostic Features of ECG Flashcards

1
Q

Associate each of the waves on ECG with what’s going on in the heart:
P wave
QRS complex
T wave

A

P wave = atrial depolarization
QRS complex = ventricular depolarization
T wave = ventricular repolarization

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2
Q

If your QRS takes up 3 heavy lines, what is your HR?

A

100 bpm

HR = 300 / # heavy lines between 2 QRS's
HR = 1500 / # mm between 2 QRS's
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3
Q

EKG leads measure:

A
  1. Two different points on body (bipolar)

2. One point on the body and a virtual reference point with 0 potential in the center of heart (unipolar)

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4
Q

Depolarization moving ___ a positive electrode produces a ___ deflection

A

Toward a positive electrode produces a positive deflection

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5
Q

V1 & V2 are what type of leads?

A

R-sided chest leads, measuring R ventricle

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6
Q

V5 & V6 are what type of leads?

A

L-sided chest leads, measuring L ventricle

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7
Q

If have LV hypertrophy, expect to see large R waves on which leads?

A

L-sided leads: V5 & V6, sometimes I, aVL

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8
Q

More muscle = more volts = greater amplitude can be seen in which cardiomyopathy?

A

Ventricular hypertrophy

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9
Q

If have RV hypertrophy, expect to see large R waves on which leads?

A

R-sided leads: V1 & V2

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10
Q

How does demand ischemia change the EKG?

A

Depression of ST segment

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11
Q

How does acute coronary artery obstruction change EKG?

A

T wave inversion

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12
Q

How do demand ischemia and acute coronary obstruction differ?

A

Demand - normal ECG @ rest

Obstruction - abnormal even at rest

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13
Q

Transmural infarcts produce which kinds of waves?

A

Q - waves;

Absence of normal transmural vector produces a negative deflection in leads over infarcted myocardium

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14
Q

What rules can you use to determine if you can associate infarct with a Q wave?

A
  1. Is > 1/4 of the amplitude of the R wave
  2. Is one small box (0.04) seconds wide
  3. Is usually in at least 2 leads reflecting the same region of the LV
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15
Q

Transmural vs subendocardial infarct as seen by ECG

A

Transmural: ST elevation with Q waves
Subendocardial: ST depression without Q wave

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16
Q

Why are we worried about prolonged QT interval? What is normal?

A

Increases susceptibility to arrhythmias
Normally: < 1/2 of total difference of 1 QRS to the next
Bad if > 1/2

17
Q

What acquired things prolong QT interval?

A

Hypokalemia, Hypomagnesemia, Class 1A or 3 anti-arrhythmic drugs, Hypothermia

18
Q

How does hypercalcemia affect ECG?

A

Shortened QT interval