Cardiology Flashcards
(35 cards)
how to use aVR to distinguish between SVT with aberrancy and VTach
SVT will have a primary qS in aVR and a primary R wave in V6
VTach will be opposite.
should you treat a bifiscicular block with a sodium channel blocker
no
-it will cause a blockage of the 3rd fascicle causing a complete heart block.
-no amiodarone, lidocaine, or procainamide
what is Sgarbossa criteria
looking for MI criteria in a LBBB
-concordant STE >= 1mm is 5 points
-STD >=1mm in V1-V3 is 3 points
-Discordant STE >=5mm is 2 points
need a total of 3 points to meet MI criteria
how to determine left anterior fascicular block
Left axis deviation
qR complex in lead I,aVL
RS complex in lead aVF, III
how to determine left posterior fascicular block
Right axis deviation
-RS complex in lead I
-qR complex in lead II, III
if you are not able to determine if there is a fascicular block in wide complex tachycardia how should you treat it.
you should synchronize cardiovert them
what is a trifascicular block.
a bifascicular block plus a 1st degree heart block.
will typically be a complete heart block
how to determine a bifascicular block
RBBB plus a left anterior fascicular block or left posterior fascicular block
how many fascicles are on the heart
3
-left anterior fascicle
-left posterior fascicle
-Right fascicle
what is a common visual of benign early repolarization
ST segment “fish hook” appearance
what leads is benign early repolarization seen.
seen primarily in R wave leads
II, III, aVF, V4, V5, V6
how do you determine LVH
-S wave height in V1
plus
R wave height in V5 or V6
if greater than 35 mm it is LVH
- aVL has an R wave >11mm
-aVF has an R wave >20mm
-only need 1 of the 3 criteria
What are the imitators of OMI/ACS
-LVH
-BBB (sgarbossa criteria)
-ventricular beats
-pericarditis
-early repolarization
how can aVR be used as a diagnostic tool when there is anterior depression
-STE indicates left main disease
-use to diagnose SVT w/ aberrant conduction vs VTach
-aVR is elevated along with V1 and aVR is greater than V1 with global depression is considered left main insufficiency. 3 vessel occlusion of 97% or greater
how can aVR be used for a diagnostic tool when there is anterior ST elevation
elevation is aVR and V1 is highly suggestive and diagnostic for proximal LAD obstruction
can you use aVR as a diagnostic tool on 12 EKG
yes
what lead is aVL a twin with. the reciprocal change will mirror it.
lead III
what artery feeds the anterior wall of the heart
left main
left ascending
what artery feeds the lateral wall of the heart
-High lateral- left circumflex
-low lateral- left circumflex, left marginal, left diagonal.
what artery feeds the inferior wall of the heart
-90% of the population is the RCA
-10% is the LAD
when are the coronary arteries perfused
during the diastolic phase.
stroke volume is made up of what 3 things
-preload
-afterload
-contractility
what is the normal ejection fraction
50-70%
why is diastolic filling so important
it is 2/3 of your MAP
