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Flashcards in ECG Deck (45)
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1
Q

List the 3 ventricular arrhythmias.

A

1) PVC
2) ventricular tachycardia
3) ventricular fibrillation

2
Q

List the 3 atrial arrhythmias.

A

1) atrial flutter
2) atrial fibrillation
3) PAC

3
Q

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

A

PVC

4
Q

What is ventricular tachycardia?

A

3 or more PVCs in sequence with HR >100bpm

5
Q

What does ventricular fibrillation look like?

A

chaotic electric activity with no clear P, QRS, or T

- just a bunch of small bumps up and down everywhere

6
Q

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

A
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
Q

What is a mobitz type I (Wenckebach) block?

A

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

8
Q

What is a mobitz type II block?

A

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

often occurs with wide QRS

9
Q

The mobitz blocks are what form of dysrhythmia?

A

second degree AV blocks

10
Q

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

A

second degree, mobitz type IIf

11
Q

Describe what a 3rd degree AV block looks like.

A

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

12
Q

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

A

BBB’s: RBBB and LBBB

13
Q

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?

A

RBBB

14
Q

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

A

LBBB

15
Q

Describe LBBB vs RBBB

A

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
Q

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

A

in the septal fascicle, L ant or L post

17
Q

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

A

L ant = LAD

L post = RAD

18
Q

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

A

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

19
Q

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

A

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

20
Q

What does a L ant hemiblock look like?

A

LAD with larger S waves in inferior leads

21
Q

What does a L post hemiblock look like?

A

RAD with larger S waves in lateral leads

22
Q

Larger S waves in inferior leads may indicate what dysrhythmia?

A

L ant hemiblock

23
Q

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

A

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
Q

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

A

RAD

25
Q

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

A

LAD

26
Q

What dysrhythmia encompasses the following traits:

- RAD
- R>S in V1
- S>R in 1
A

R ventricular hypertrophy

27
Q

What dysrhythmia encompasses the following traits:

 - LAD
 - great deflection of S in V1
 - great deflection of R in V5
A

L ventricular hypertrophy

28
Q

A tall P wave in lead II could indicate what?

A

R atrial hypertrophy

29
Q

What indicates L atrial hypertrophy?

A

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

30
Q

Describe the difference between L and R atrial hypertrophy.

A

L atrial hypert = greater neg deflection of P in V1

R atrial hypert = tall p-wave in lead II

31
Q

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

A

false, t wave inversion in AVR is normal

32
Q

What does depressed ST interval indicate?

A

ischemia

33
Q

Elevated ST interval indicates what?

A

myocardial injury

34
Q

What does acute myocardial infarction look like?

A

acute ST elevation, almost 4 small boxes

35
Q

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

A

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

36
Q

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

A

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

37
Q

What are the hallmarks of an MI?

A

inverted T, elevated ST interval

  • inverted T occurs on day 1-2 and then days later
  • elevated ST occurs acutely
38
Q

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

A

RCA

39
Q

What lead areas does the RCA supply?

A

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

40
Q

L anterior descending artery supplies what lead areas?

A

antero septal leads (V1-2)

41
Q

What artery supplies the antero lateral leads?

A

circumflex L branch

I, AVL, V5-6 = anterolateral

42
Q

What leads does the L ant descending artery supply?

A

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
Q

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

A

L ant descending (apical = distal branch)

44
Q

What supplies the inferior and posterior leads of the heart?

A

RCA

45
Q

What supplies the anterolateral leads of the heart?

A

circumflex