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Flashcards in ECG Deck (45):
1

List the 3 ventricular arrhythmias.

1) PVC
2) ventricular tachycardia
3) ventricular fibrillation

2

List the 3 atrial arrhythmias.

1) atrial flutter
2) atrial fibrillation
3) PAC

3

A tall and wide QRS complex with a T wave opposite deflection of R can indicate what dysrhythmia?

PVC

4

What is ventricular tachycardia?

3 or more PVCs in sequence with HR >100bpm

5

What does ventricular fibrillation look like?

chaotic electric activity with no clear P, QRS, or T
- just a bunch of small bumps up and down everywhere

6

What is the difference between a 1st degree AV block and a second degree?

1st = PR interval is longer than normal (>5 small boxes)
2nd = PR interval progressively lengthens until atrial impulse isnt conducted to ventricle (dropped QRS)

7

What is a mobitz type I (Wenckebach) block?

a type second degree AV block (PR gets smaller and smaller until QRS is dropped)

8

What is a mobitz type II block?

PR interval constant, atrial conduction is intermittent (signified by dropped QRS's)

often occurs with wide QRS

9

The mobitz blocks are what form of dysrhythmia?

second degree AV blocks

10

In which AV block is the PR interval constant, but intermittent atrial conduction is present?

second degree, mobitz type IIf

11

Describe what a 3rd degree AV block looks like.

PP and RR intervals regular, no relationship between P and R waves

12

What diagnosis will have R and R' on chest leads?

BBB's: RBBB and LBBB

13

With an EKG that shows a large S wave in the left leads, R/R' in V1 and V2, as well as long QRS and opposite T-wave, what is the abnormality?

RBBB

14

A notched or broad QRS on V5-6 could indicate what?

LBBB

15

Describe LBBB vs RBBB

LBBB: notched/broad QRS on V5-6, deep S on V1-2, opposite T

RBBB: R/R' on V1-2, deep S on V5-6, opposite T

16

When there's a hemiblock, where is the block occuring?

in the septal fascicle, L ant or L post

17

L ant hemiblock usually has what kind of axis deviation? L post?

L ant = LAD

L post = RAD

18

Which is more common, L ant hemiblock or L post hemiblock?

L anterior, seen in normal and diseased hearts (L post seen more in diseased hearts)

19

T/F: QRS looks different for hemiblocks than normal.

false, no change in QRS complex in hemiblocks, or ST/T

20

What does a L ant hemiblock look like?

LAD with larger S waves in inferior leads

21

What does a L post hemiblock look like?

RAD with larger S waves in lateral leads

22

Larger S waves in inferior leads may indicate what dysrhythmia?

L ant hemiblock

23

What are the different types of blocks that can occur in the heart?

1) AV block (1-3rd degree, mobitz type I-II for 2nd degree)
- looking at PR intervals and dropped QRS

2) BBB (LBBB and RBBB)
- looking at R/R' on V1-2 for RBBB, V5-6 for LBBB
- notched/broad QRS on V5-6 for LBBB
- deep S waves on opposite chest leads

3) hemiblock (L ant or L post)
- looking at RAD and deep S's on lateral leads = post
- looking at LAD and deep S's on inferior leads = ant

24

To have R ventricular hypertrophy, what deviated axis should be occuring?

RAD

25

To have L ventricular hypertrophy, what does the axis look like?

LAD

26

What dysrhythmia encompasses the following traits:
- RAD
- R>S in V1
- S>R in 1

R ventricular hypertrophy

27

What dysrhythmia encompasses the following traits:
- LAD
- great deflection of S in V1
- great deflection of R in V5

L ventricular hypertrophy

28

A tall P wave in lead II could indicate what?

R atrial hypertrophy

29

What indicates L atrial hypertrophy?

greater neg deflection of P than positive in the biphasic p wave in V1

30

Describe the difference between L and R atrial hypertrophy.

L atrial hypert = greater neg deflection of P in V1

R atrial hypert = tall p-wave in lead II

31

T/F: T wave inversion in aVR is abnormal and indicates MI.

false, t wave inversion in AVR is normal

32

What does depressed ST interval indicate?

ischemia

33

Elevated ST interval indicates what?

myocardial injury

34

What does acute myocardial infarction look like?

acute ST elevation, almost 4 small boxes

35

T/F: MI can present with ST elevation with OR without an inverted T wave

true, T wave can be inverted or normal for MI to happen (with ST elevation present)

36

What does it mean if a Q-wave is significant?

either 1 box wide or it's 1/3 the height of the QRS complex

37

What are the hallmarks of an MI?

inverted T, elevated ST interval
- inverted T occurs on day 1-2 and then days later
- elevated ST occurs acutely

38

If significant Q waves are found in inferior leads, which coronary artery is responsible?

RCA

39

What lead areas does the RCA supply?

inferior (II,III, AVF) and posterior (V1-2) leads

40

L anterior descending artery supplies what lead areas?

antero septal leads (V1-2)

41

What artery supplies the antero lateral leads?

circumflex L branch

**I, AVL, V5-6 = anterolateral**

42

What leads does the L ant descending artery supply?

anteroseptal (V1-2)
- look for abnormal Q waves in V1-2 to see if L ant descending is at fault

The distal LAD supplies the antero apical leads (V3-4)

43

What artery supplies the anteroapical and anteroseptal leads of the heart?

L ant descending (apical = distal branch)

44

What supplies the inferior and posterior leads of the heart?

RCA

45

What supplies the anterolateral leads of the heart?

circumflex