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<3 > Clinical Cases And ECG MIs > Flashcards

Clinical Cases And ECG MIs Flashcards

1
Q

What could sinus tachycardia be due to?

What is it normal in?

A

Normal if pregnant, emotional

Could also be response to:

  • drugs
  • hyperthyroid
  • fever
  • anemia
  • CHF
  • hypovolemia
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2
Q

What could cause sinus Bradycardia?

A 
‣ Vagal response sleep apnea
		‣ Meds
		‣ MI
		‣ Increased ICP 
		‣ Hypothyroid
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3
Q

When does a premature beat occur?

A

When an irritable focus spontaneously fires a single stimulus

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4
Q

What is premature atrial contraction associated w/ ?

A 
Stress
Alcohol
Tobacco
Coffee
Copd
Cad
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5
Q

Wha will a Premature Ventricular contraction present w/ on an ECG?

A

Wide QRS

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6
Q

What do multiple PVCs indicate on an ECG?

A

Ventricular Tachycardia

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7
Q

What can cause VTACH?

A 
CAd
Heart failure
Hypertrophic cardiomyopathy
Congenital HD
Electrolyte abnormalities
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8
Q

How is a Supraventricular Tachycardia represented on an ECG?

A

Narrow QRS complex, fast HR

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9
Q

What are the causes of Supraventricular Tachycardia?

A

Thyroid disease
Caffeine
Medications w/ stimulants
Stress

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10
Q

Why is Atrial Fibrillation particularly dangerous?

A

Can develop clots from this

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11
Q

What are the causes of atrial fibrillation?

A 
‣ Hypertensive heart disease
		‣ Valvular heart disease
		‣ CHF
		‣ CAD
		‣ Obesity
		‣ DM
		‣ Metabolic syndrome
		‣ Chronic Kidney disease
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12
Q

How is AFIB seen on an ECG?

A

Undulating baseline

No discernible P waves

Irregular QRS complex

Irregularly irregular ventricular rhythm

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13
Q

How does a First degree AV block present on an ECG?

A

Prolonged PR interval (over .2 sec - or bigger than 1 big block)

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14
Q

What are the limb leads of an ECG and what do they show?

A

Show depolarizatio of heart in frontal/coronal plane

AVR, aVL, aVF, I, II, III

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15
Q

What are the precordial leads of an ECG and what do they show?

A

V1-V6

Show depolarization of heart in horiz. Plane

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16
Q

What is a normal axis on an ECG? How do you determine this?

A

Normal= 0-+90

Determined by looking at leads 1 and aVF

17
Q

How common is Coronary heart disease (CHD)?

A

1/6 adults in us

18
Q

What is the common Hx and Sxs seen with CHD?

A

Chest discomfort

Sxs of nausea, vomiting, diaphoresis, dyspnea

19
Q

What is the pathophys of CHD?

A

Narrowing of coronary arteries secondary to erosion, fissure or rupture of plaque, thrombus

20
Q

If there is partial occlusion of the coronary arteries, what can occur?

A

Unstable angina or NSTEMI

21
Q

If coronary flow is completely occluded, what can occur?

A

STEMI

22
Q

What does STEMI stand for?

A

ST elevation MI

23
Q

What are most MIs caused by?

A

Atherosclerosis

24
Q

What is the progression of CAD?

A

Normal heart —> stable angina —> unstable angina —> NSTEMI —> STEMI

25
Q

What will myocardial ischemia present with on an ECG?

Why?

A

Change in T wave

  • inverted
  • tall, upright
  • depressed

Bc deficient blood supply; Impaired REpolarization (t-wave)

26
Q

What will myocardial injury present with on an ECG?

Why?

A

ST elevation

bc inability to fully polarize back to baseline

27
Q

How will a myocardial infarcton/necrosis present on an ECG?

Why?

A

Change in Q waves

Bc dead tissue cant DEpolarize

28
Q

What are the cardiac bio markers of necrosis?

When will these show up? Peak?

A

-elevated Troponin I or T

  • show up 1-4 hours after AMI onset
  • peak at 10-24 hours
29
Q

What can cause a false positive elevation in troponin T?

A

Renal failure

30
Q

What does an NSTEMI present with?

A

Elevated troponin, CK, and CK/MB

  • no st elevation
  • usually st depression or t wave inversion
31
Q

How does a STEMI present on an ECG?

A

W/ a fireman’s hat

-ST elevation that is 2 mm or more higher than baseline when measured at J point

32
Q

What is an Acute MI?

A

Complete interruption of blood flow *usually bc coronary occlusion

33
Q

What vessels are supplied by the Left Anterior descending a. (Ant. Interventricular a.) ?

What MI is assoc.w/ occlusion of LAD?

A

V1-V7
V3 and V4

Anterior wall infarction

34
Q

What vessels are supplied by the Right Coronary a.?

What MI is assoc.w/ occlusion of RCA?

A

II, III, aVF

V3R-V6R

Inferior wall infarction (RV)

35
Q

What vessels are supplied by the circumflex a.?

What MI is assoc.w/ occlusion of Circ. A.?

A

I, aVL

V5-V6

Lateral Wall infarction

36
Q

What vessels are supplied by the Posterior Desc. A.?

What MI is assoc.w/ occlusion of Post. Desc. A.?

How can you see this on an ECG?

A

V1-V3

Look for sharp R wave- then, turn ECG upside down to see fireman’s hat

Posterior wall infarction

(Most missed one)

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