ECG Foundation Flashcards by Connor Hancock

Einthoven’s triangle: green electrode:
Blue electrode:
Red electrode:

= neutral/ground
= Negative
= Positive

How well did you know this?

Not at all

Perfectly

Einthoven’s triangle: Lead 1 & view:
Lead 2 & view:
Lead 3 & view:

= negative RA → positive LA (Left lateral camera view)
= negative RA→ positive LL (Inferior camera view)
= negative LA→ positive LL (slight lateral Inferior camera view)

How well did you know this?

Not at all

Perfectly

(Coronary) left coronary artery supplies:

Left coronary artery 2 major branches are:

= L-ventricle, Intraventricular septum, part of R-ventricle & lower conductive system
= anterior descending artery and the circumflex artery

How well did you know this?

Not at all

Perfectly

(T wave) Limb leads Amplitude:
Precordial “chest” leads amplitude:

= <5mm in LL
= <10mm in precordial

How well did you know this?

Not at all

Perfectly

1 cause of death when having a MI

is from a lethal dysarrhythmia

How well did you know this?

Not at all

Perfectly

12/15 Lead ECG Kev Approach) 1st.
2nd.

3rd.
4th.

5th.
6th.

7th.

8th

1st} Is there a clear isoelectric baseline? (Skin prep correctly)
2nd} Are QRSs upright leads I, II & III (Check attachment correctly)
3rd} good R wave progression? (Check lead placement)
4th} Is the monitor in the correct mode(diagnostic)? (0.05 to either 40 or 150 Hz)
5th} Is the axis normal? Any axis deviation present?
6th} Is there any ST elevation present? If yes, do you see it in 2 or more contiguous leads?
7th} Is there any ST depression? If yes, do you see it in 2 or
more contiguous leads?
8th} any pathological Q waves present? Yesterday’s news!

How well did you know this?

Not at all

Perfectly

A Lateral Wall high view:
B Left Lateral low view:
C Inferior wall view:
D Septal wall view:
E L-Anterior view:

A= Lead I & aVL= LA
B= Lead 1, aVL, V5 & V6: views LCX & LAD
C= 2,3,aVF: LL most common block(RCA) Lots of blockages/infarcs
D= V1 & V2: Along sternal borders blockages from LAD commonly
E= V3 & V4: left anterior wall : LAD & LMCA blocks

How well did you know this?

Not at all

Perfectly

3 Is of cardiac) Ischemia:
“Infarct” Injury:
Infarction:

= Ischemia: ST depres/, Hyperacute T waves>5chest avf >10 precordial
= “Infarct” Injury: ST elevation 50%,
= Infarction: old MI; >25% Q or QRS >1SB

How well did you know this?

Not at all

Perfectly

3 I’S of cardiac) Pathologic Q

Infarction

How well did you know this?

Not at all

Perfectly

3 I’S of cardiac) ST Elevation:

Injury

How well did you know this?

Not at all

Perfectly

3 I’S of cardiac) ST Elevation:

Injury

How well did you know this?

Not at all

Perfectly

A blockage of which of the following would result in the entire left ventricle not receiving blood supply?

Left Main Coronary Artery (LMCA)

How well did you know this?

Not at all

Perfectly

ECG Camera views) Anterior

Lead V3 V4

How well did you know this?

Not at all

Perfectly

Leads V3 & V4 view
Leads V1 & V2 view
Leads 2,3, & aVF view
Leads 1, aVL, V5, V6 view

= Anterior
= Septal
= Inferior
= Lateral

How well did you know this?

Not at all

Perfectly

ARTsclerosis:
ATersclerosis:

= harding of arternia
= tunica media plaque build up in layers of media & intima pushing & narrowing lumen size,

How well did you know this?

Not at all

Perfectly

Heart blocks are

blocks in AV node partial or complete
“Putting a rock or pebble on a cable”

How well did you know this?

Not at all

Perfectly

Bundle Branch A&P) Fascicle of the conduction system:
Bundle branch blocks:

= Facilitates syncytium
= ventricles out of sync

How well did you know this?

Not at all

Perfectly

Congitual:
Reciprocal changes:
Spodicks sign:

= same view leads
= mirrored effect in oppisute/corresponding leads for sure MI
= pericarditis PR slopes down aka STEMI imposter

How well did you know this?

Not at all

Perfectly

De Winter’s T Waves:

V2 V3 most commonly but can happen any lead
ST depression at the J-point & upsloping ST-segments w/ tall, symmetrical T- waves in the precordial leads (LMCA or LAD occlusion)
“Hyper T w/ STD”

How well did you know this?

Not at all

Perfectly

ECG Camera views) Left Lateral

Lead I, aVL, V4, V5

How well did you know this?

Not at all

Perfectly

ECG Camera views) Septal

Lead V1 V2

How well did you know this?

Not at all

Perfectly

ECG Camera views) LMCA - 3 vessel disease

Lead aVR

How well did you know this?

Not at all

Perfectly

ECG Camera views) Posterior

Lead V5 V6

How well did you know this?

Not at all

Perfectly

ECG Camera views) Right

Lead V4R

How well did you know this?

Not at all

Perfectly

ECG Heart waves – P wave: QRS complex: T wave:

= Atrial depolarization = Ventricular depolarization = Repolarization of ventricles

ECG Lead coronary arteries) Anterior

(LAD) Left Anterior Descending

ECG Lead coronary arteries) Inferior

(RCA) Right Coronary Artery

ECG Lead coronary arteries) Posterior

(RCA) Right Coronary Artery &/or (LCX)

ECG Lead coronary arteries) Right

(RCA)

ECG Lead coronary arteries) Lateral

(LCX) Left Circumflex

ECG Lead views) Lead aVR

LMCA - 3 vessel disease

ECG Lead views) Lead V5 V6

Lateral

ECG Lead views) Lead V3 V4

ECG Lead views) Lead V1 V2

Septal

ECG Lead views) Lead I, aVL, V4, V5

Left Lateral

ECG Lead views) Lead V4R

Right

ECG Lead views) Lead aVR

LMCA - 3 vessel disease

ECG Lead views) Lead V8 V9

Posterior

ECG Lead views) Lead V3 V4

ECG Lead views) Lead V1 V2

Septal

ECG Lead views) Lead V4R

Right

Horizontal Boxes: Each small box ?secs: 5 small boxes equal: Each large box is ?secs:

= 0.04 sec = 1 large box = 0.20 sec

Isoelectric line: Used for:

= Down 1mV of calibration bar/ line (bottom of cal) = ST seg depress/elevation, Hypertrophy, amplitude

LBBB Definer Turn criteria

Down deflection before J point "turning left"

STE leads criteria) Lead aVR, aVL, aVF

≥ 1mm

STE leads criteria) Lead V1 Lead V2-3

Lead V1 ≥ 1mm Lead V2-3}≥ 2mm M>40, 2.5mm M<40 1.5 all women

STE leads criteria) Lead V4-6

≥ 1mm

STE leads criteria) Lead V4-6

≥ 1mm

15 leads views) Lead V4 Lead V5 Lead V6

Lead V4 Lead V5 Lead V6

STE leads criteria) Lead V4R Lead V8-9

Lead V4R ≥ 1mm Lead V8-9 ≥ 0.5mm

STE leads criteria) Lead V4R Lead V8-9

Lead V4R ≥ 1mm Lead V8-9 ≥ 0.5mm

STE leads criteria) Lead V4R Lead V8 Lead V8

Lead V4R Lead V8 Lead V8

15 leads views) Lead V4R Lead V8 Lead V8

Lead V4R Lead V8 Lead V8

Leads 2, 3, aVF reciprocal leads

leads 1, aVL, V1-6

Leads 1, aVL, V1-6 reciprocal leads

2, 3, aVF reciprocal leads

Leads II, III and aVF look at what part of the heart?

Inferior wall (most common blockacke(RCA)

Leads V1 and V2 look at what part of the heart?

Septal (blockages from LAD commonly)

Leads 1, aVL, V5, V6 look at what part of heart:

L-Lateral (low view : views LCX & LAD)

Leads V1 and V2 look at what part of the heart?

Septal (blockages from LAD commonly)

Leads 1, aVL, V5, V6 look at what part of heart:

L-Lateral (low view : views LCX & LAD)

Leads V3 and V4 look at what part of the heart?

L-Anteriorwall (LAD & LMCA blocks)

Mirror Criteria

V1&2 leads (v2 most sensitive w/ R): ST depression w/ big R wave (accompany 15-20% inferior or lateral STEMI)

Most common reason for MI & Stroke

ARTHsclerosis: Scab of artery can break open from intima, Body constricts, hemostasis, blocks blood flow (Asprin biggest helper antiplatelet) (R side of heart only) L side Lungs filters clots)

Orthodromic Re-entry loop: Antidromic Re-entry loop

= Clockwise rentry conduction loop >narrow QRS = counterclockwise reentry conduction loop > wide QRS

Posterior MI w/o post leads

V1 V2leads Mirror test

Precordial Posterior Lead Placement) V8(5) V9(6):

= Mid-Scapular = ½ way in-between the Scapula & Spine

PRI: ST segment: P-T is: RR:

= AV holding impulse for sync = ventricular contraction = 1 full cardiac cycle = gives rate & rhythm

Printz metal angina

Coronary artery spasm usually w/ stimulant (cocaine) & then occlusion arteries

QRS complex: T wave: U wave: QT segment:

= ventricular depolarization = ventricular depolarization = “late bloomer = all ventricle’s action

RBBB Definer turn criteria

Up defelection before J point "turning right"

Re-entry loops

= stuck in nascar loop in a chambers pathway causing commonly SVT / no P waves

Reciprocal leads:

Right BBB can produce: LBBB can produce a

a classic rsR’ (r prime) R prime “2nd version of wave”, NO BUNNY EARS QRS complex Discordis (oppisite)

RPM: LAC:

RPM: Posterior & Marginal LAC: anterior descending circumflex

Rs 6sec strip method: big box method: Small box method: Triplicate method:

= # of Rs x 10 = 1R to R BB#s then 300/BB# = 1R-R SB#s then 1500/ SB# = descend W/ SB 300, 150, 100, 75, 50, 43, 38

SA node rate: AV node rate: Purjunkie rate:

=100-60BPM =60-40BPM =40-15BPM

Spodicks sign:

sloping down P wave into QRS (evidence of pericarditis)

3 I’S of cardiac) ST depression, Hyperacute or flipped T Wave:

Ischemia

STE leads criteria) Lead I-III

≥ 1mm

STE leads criteria) Lead I-III

≥ 1mm

Systematic approach

1. rate, 2. rhythm, 3. P waves, 4. PRI, 5. QRS

Coronary) Right coronary artery (RCA) supplies: Right Coronary arteries' 2 major branches:

= part R-atrium & ventricle, upper part conduction system = posterior descending artery & marginal artery

Coronary) Right coronary artery (RCA) supplies: Right Coronary arteries' 2 major branches:

= part R-atrium & ventricle, upper part conduction system = posterior descending artery & marginal artery

Unipolar Limb Leads: aVR: aVL: aVF:

= Augmented by the cardiac monitor = Right Arm positive (inferior) = Left Arm positive (lateral ) = Left Leg positive (inferior)

V1 & V2

V1 V2 leads view:

Septum

V3 & V4

V3 V4 leads look at

Left lateral wall

V5 & V6

V5 V6 leads look at

Inferior

V8 & V9 STEMI criteria:

0.5mm or greater

Vertical Boxes Each small box is: Each small box also equals: 5 small boxes equal: Each large box is: 2 large boxes equal: 1 mV

= 0.1mV = 1 mm = 1 large box = 0.5 mV = 1 mV

Wellen’s wave type A:

Biphasic T waves in V2 or V3, min STE <1mm (V2 usually biggest shower Highly specific for for a critical blockage of the LAD

Wellen’s wave type B:

DEEP inverted T waves V2 or V3,

When obtaining a 12 lead ECG, where do you place V2? When obtaining a 12 lead ECG, where do you place V5? When obtaining a 12 lead ECG, where do you place V6? When obtaining a 12 lead ECG, where do you place V3? When obtaining a 12 lead ECG, where do you place V1? When obtaining a 12 lead ECG, where do you place V4? When obtaining a 15 lead ECG, where do you place V4R?

= 4th ICS just left of Sternum = Left 5th ICS anterior of auxiliary = 5th ICS midaxillary = ½ in between V2 & V4 = Right of Sternum 4th ICS = 5th ICS left Midclavicular = Right ICS midclavicular

Which coronary artery feeds the inferior wall of the heart?

Right Coronary Artery (RCA)

Which coronary artery feeds the left lateral wall of the heart?

Left Circumflex (LCX)

ECG change represents active myocardial injury:

ST-Segment Elevation

Which of the following ECG changes represents myocardial ischemia:

Hyperacute T-Waves

ECG Foundation Flashcards

(99 cards)