EKG, Echo, Cath Flashcards
1
Q
Describe the findings
A
- NSR ( +1 )
- ST and/or T wave abnormalities suggesting electrolyte disturbances ( +1 )
- Prolonged QT ( +2 )
-
Hypocalcemia ( +4 )
- prolonged QT = long ST segment + normal duration T wave
- characteristic of LQT-3 subtype
- Ical = 2.7 in this patient
2
Q
Describe the findings
A
- NSR ( +1 )
- Dual-chamber pacemaker (DDD), normal functioning ( +2 )
-
Bi-V pacing / cardiac resynchronization ( +4 )
- RA lead is appropriately sensing the underlying SR and therefore triggering the RV lead to fire
- dual V-pacing spkes occurring just after each other (best seen in V2)
- upright (RBBB morphology) QRS complex in V1 –> suggests Bi-V
3
Q
Describe the findings
A
- NSR ( +1 )
- AV block, 1st degree ( +1 )
- subtle P-waves with prolonged PR in V2-V4 –> NSR with 1st degree AV block
- IVCD, nonspecific ( +1 )
- ST and/or T wave abnormalities suggesting electrolyte disturbances ( +2 )
-
Hyperkalemia ( +4 )
- K = 9.2; marked QRS widening
4
Q
Describe the findings
A
- SB ( +1 )
- Borderline normal EKG or normal variant ( +1 )
- Normal variant, early repolarization ( +4 )
5
Q
Describe the findings:
A
RCA dissection
- mid-RCA:
- small, linear cleft indicative of a vessel dissection
- IVUS confirmed dissection
6
Q
Describe the findings:
A
- MR ( +4 )
- LV aneurysm ( +2 )
- MV, systolic anterior motion ( +1 )
*****Dx: HCM with prior apical MI –> LV apical aneurysm
******mid-cavity obliteration during systole –> LVOTO
*******mechanism of MR in this setting –> systolic anterior motion of anterior MV
7
Q
Describe the findings
A
- RV
-
Pulmonary valve stenosis ( +4 )
- post-stenotic dilation of the pulmonary artery on RV gram will confirm the diagnosis
8
Q
Describe the findings
A
- Severe MS ( +6 )
- Rheumatic mitral valve disease ( +2 )
- LAE ( +1 )
9
Q
Describe the findings
A
- Aortic dissection, Type A ( +6 )
- Aortic enlargement or aneurysm ( +2 )
- Mild-moderate AR ( +1 )
- Mild-moderate MR ( +1 )
10
Q
Describe the findings
A
- Atrial myxoma ( +6 )
- Mild-moderate MS ( +2 )
11
Q
Describe the findings
A
-
RCA fistula ( +4 )
- SA node coming off proximal RCA –> large atrial myxoma
- Severe RCA stenosis ( > 75%) ( +4 )
12
Q
Describe the findings:
A
-
Coarctation of Aorta ( +4 )
- known history of coarctation
- underwent surgery at age of 10
- follow up revealed 25 mmHg residual pressure gradient across the coarctation
- Aortic aneurysm ( +4 )
13
Q
Describe the findings
A
- NSR ( +1 )
- LAE ( +1 )
- RAD ( +1 )
- IVCD, nonspecific type ( +2 )
- criteria for LBBB are not met due to lack of slurred R-waves in the lateral limb leads
- PPM malfunction - failure to capture ( +4 )
-
PPM malfunction - failure to sense ( +4 )
- atrial pacing exists, but there is a failure of the atrial spikes to capture (spikes without any evidence of conduction)
- atrial spike seen just after the second QRS complex of the tracing that is clearly occuring too son after the previous P-wave ( < 240 ms) –> atrial lead is failing to appropriately sense the intrinsic P-wave
14
Q
Describe the findings
A
- VT ( +4 )
15
Q
Describe the findings
A
-
Membranous VSD ( +6 )
- perimembranous VSD near the LVOT
- patient with history of Down Syndrome (Trisomy 21)
- presented with a murmur and was found to have a small, hemodynamically insignificant VSD
16
Q
Describe the findings:
A
-
Anomalous LCx ( +4 )
- benign anomaly, LCx will always course posterior to the aorta and never between the great vessels
17
Q
Describe the findings
A
- NSR ( +1 )
- LAD ( +1 )
- LVH ( +4 )
- ST and/or T wave abnormalities ( +1 )
- HCM ( +4 )
18
Q
Describe the findings
A
- Atrial flutter ( +4 )
- Nonspecific ST and/or T wave abnormalities ( +1 )
19
Q
Describe the findings
A
- NSR ( +1 )
- LAE ( +1 )
- 2nd degree AV block, Mobitz II ( +4 )
- Nonspecific ST and/or T wave abnormalities ( +1 )
20
Q
Describe the findings
A
- A-fib ( +1 )
- AV junctional rhythm/tachycardia ( +1 )
- 3rd degree AV block ( +1 )
- Anterior or anteroseptal, age indeterminant or probably old ( +1 )
- Prominent U waves ( +1 )
- Digitalis toxicity ( +4 )
21
Q
Describe the findings
A
- Mitral valve prolapse
- Normal
- LV size
- Wall thickness
22
Q
Describe the findings of M mode:
A
- E - early opening
- F - floating closed mid-diastole
- A - atrial opening
- C - closure
- D - end diastole, just before MV opens
23
Q
Describe the findings:
A
- SAM
- Hypertrophic cardiomyopathy
- Asymmetric septal hypertrophy
24
Q
Describe the findings
A
- Asymmetric septal hypertrophy
- HCM
- Normal to hyperdynamic LV function (EF > 50%)
- SAM
- Mild-moderate MR
25
Q
Describe the findings
A
- Rheumatic
- Severe MS
26
Q
Describe the findings:
- 28-year old male with A-fib and Edema
A
- Ebstein’s Anomaly
- Tricuspid Valve:
- fails to coapt
- severe TR
- RV function
- enlarged RV
- global hypokinesis
- Atria
- enlarged RA
27
Q
Describe the findings:
A
Muscular VSD
28
Q
Describe the findings:
A
Supracristal (Outlet) VSD
29
Q
Describe the findings:
A
30
Q
What is the differential?
How can you differentiate?
A
- VSD
- Membranous
- Supracristal (Outflow)
- Short Axis
- Membranous →
- 10 oclock
- TV
- Supracristal (Outlet)
- 2 oclock
- PV
- Membranous →
31
Q
Describe the findings:
A
- “Complete AV Canal Defect”
- Primum ASD
- Membranous VSD
- Enlarged RV
- Enlarged LA, RA
- Severe MR
- Severe TR
32
Q
Describe the findings
A
- Apical HCM
- Normal/Hyperdynamic EF
33
Q
Differentiate - Thickened Apex
A
- Apical HCM
- contrast fills apex
- HES / Loefflers’
- clot filled apex (contrast does not fill)
