Diagnostic features of EKG - disorders Flashcards Preview

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Flashcards in Diagnostic features of EKG - disorders Deck (35):
1

EKG findings of LV hypertrophy

1. Bigger R waves in Left-sided Leads (due to larger muscle mass)
→ I, aVL, V5, V6

2. T wave can be inverted

2

EKG findings of Right Ventricular Hypertrophy

Big R waves in Right-sided Leads
→ V1,V2

3

EKG findings of Myocardial ischemia

ST depression

T wave inversion - sometimes

4

EKG findings of ischemia during acute coronary syndrome

T wave inversion

5

What is transmural injury and what are the
EKG findings of transmural injury

ST elevation

Note: Transmural injury: death of myocardial tissue that extends from the endocardium to the epicardium as a result of a myocardial infarction.

6

Coronary artery most responsible for MI seen in inferior Leads

inferior Leads are II, III, av1

RCA

7

Coronary artery most responsible for MI seen in anteroseptal leads

anteroseptal: V1-V2

LAD

8

Coronary artery most responsible for MI seen in anteroapical leads

V3-V4

LAD (distal)

9

Coronary artery most responsible for MI seen in anterolateral leads?

V5, V6, I, aVl

CFX

10

Coronary artery most responsible for MI seen in posterior leads

V1-V2

RCA

(note: V1-V2 is also anteroseptal and responsible for LAD)

11

EKG findings of myocardial injury/infarction

Pathological/sizable Q waves
(>1 small box)

- Q waves in inferior leads (II,III, aVF) are due to inferior infarcts.

- Q waves in anterior leads (V1-V4) are due to anterior wall infarcts.

12

Can Q waves differentiate between acute MI and one that happened years ago?

No, but ST elevation along with Q wave can

ST elevation can.
-Acute: see ST elevation
-Hours: see ST elevation AND ↓ R wave and Q deeper waves
- Weeks: normal ST and persistent Q waves

(note: Q waves are usually the last ECG findings to develop)

13

What the the giant upright t waves called that are rarely seen in MI?

Hyperacute/peaked T waves
- lasts only a few minutes and rarely caught bc usually people dont have an MI while they are hooked up to an EKG

14

ECG findings in MI in:
Transmural MI
Subendocardial MI

transmural:
- ST elevation
- With Q waves

Subendocardial:
- ST depression (lasting 2/3 days)
- no Q waves

(note: ST depression may reflect transient ischemia w/o necrosis)

15

Difference between Stenosis and regurge sounds:

Stenosis: hear the sound before the closing of valves
Regurge: hear the sound after closing of the valves

16

How can you tell if you have a prolonged QT interval? Why is this important?

If you look peak to peak, divide in half = if you don’t see the T wave, you have a prolonged QT interval

- When the QT interval is altered susceptibilities to arrhythmias increase - especially likely with QT prolongation.

17

Causes of prolonged QT interval

hypocalcemia
hypokalemai
hypomagnesemia
hypothermia
Class 1A or 3 anti-arrythmic drugs
Congenital Long QT syndrome

18

How do calcium levels affect the QT intervals?

Hypercalcemia shortens the QT interval.
§ The commonest cause is hyperparathyroidism.

Hypocalcemia lengthens the QT interval (is more common)
§ Has many causes (life threatening ventricular arrhythmias)

19

EKG findings of hypokalemia
- what can this cause?

Prolonged QT

T wave merging with U wave

- Hypokalemia is a common cause of arrhythmias.

20

Common causes of hypokalemia?

overuse of diuretics and vomiting or diarrhea

21

EKG findings in:
mild hyperkalemia (5.5-7.5)

increased T wave voltages with a distinctive peaked, symmetrical appearance.

22

EKG findings in:
highish hyperkalemia (7.5-9.0)

P waves may flatten and the QRS & T waves widen.

A broad S wave often appears.

23

EKG findings in:
highhh hyperkalemia (>9.0)

sinusoidal pattern appears without P or R waves.

24

most common cause of hyperkalemia?

renal failure

If unrecognized hyperkalemia often causes fatal arrhythmias (and cardiac arrests)

25

sinus arrest

Failure of sinus node discharge;
absent atrial depolarization and periods of ventricular asystole

26

Intermittent episodes of slow and fast rates from SA node or atria

Bradycardia-Tachycardia Syndrome

27

Inability to mount age-appropriate HR with exercise

Chronotropic Incompetence

28

First-Degree AV block
how long is the PR interval?

AV conduction is delayed, and the PR interval is prolonged (> 200 ms)

29

Mobitz I (Wenckebach)
- how is the QRS duration?

Progressive prolongation of PR interval until a VENTRICULAR (QRS) beat is dropped;
QRS duration is normal

- AV node is affected

30

Infranodal diseases

Mobitz II 2nd degree AV block

3rd degree AV block = complete heart block

31

Mobitz II

2nd degree AV block

intermittently dropped ventricular beats (QRS) preceded by constant PR intervals

32

Irregular supraventricular tachycardias (SVT)

i. Atrial fibrillation (no discrete Ps, and irregularly irregular)

ii. Multifocal atrial tachycardia (3 or more P waves)

iii. Atrial flutter with variable conduction (flutter waves, sawtooth)

*note: supraventricular (above the ventricles)

33

5 C's of Atrial Fibrillation

1. Cause: Reverse
2. Control Rate
3. antiCoagulation
4. Control Rhythm
5. Cure: ablation

34

medications that control rate

1. betablockers
2. digoxin
3. verapamil
4. diltiazem
5. Amiodarone

35

EKG findings of cardiac tamponade

caused by: rapidly accumulating moderate sized or large effusions (can be caused by pericardial effusion)- Heart is unable to fill (sim to restrictive CM)

1. Low voltage with sinus tachycardia
2. Electrical alternans with sinus tachycardia

Note: Heart is in a Sea of fluid that causes changes with each beat