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ECG Patterns Flashcards

1
Q

Cycle length variation (irregular vent rhythm)
P waves shape variation
Rate within normal range

A

Wandering Pacemaker

- P waves change shape as pacemaking center moves

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2
Q 
Cycle length variation (irregular vent rhythm)
P wave shape varies 
Pts have COPD 
HR >100bpm
Also digitalis toxicity in CVD pt
A

Mulifocal Atrial Tachycardia

- P wave shape changes due to 3 or more atrial foci

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3
Q

Continuous chaotic atrial spikes (no discernible P waves)
Irregular ventricular rhythm
(No single impulse depolarizes atria completely so random QRS rhythm)

A

Atrial Fibrillation

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4
Q

Irregular rhythm that varies with respiration

All identical P waves

A

Sinus Arrhythmia

- Considered normal

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5
Q

Normal sinus rhythm followed by normal rhythm at 60-80bpm

A

Atrial Escape Rhythm

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6
Q

Normal sinus rhythm followed by normal rhythm at 40-60 bpm

A

Junctional Escape Rhythm

Idiojunctional rhythm

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7
Q

Inverted P wave before each QRS
Inverted P wave after each QRS
Inverted P wave buried in QRS

A

Junctional Automaticity with Retrograde Atrial Depolarization

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8
Q

Fairly normal rhythm at 20-40bpm

A

Ventricular Escape Rhythm

“Idioventricular rhythm”

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9
Q

Normal sinus rhythm followed by a pause and an irregular P wave

A

Atrial Escape Beat

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10
Q

Normal sinus rhythm followed by a pause and inverted P wave

A

Junctional Escape Beat

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11
Q

Normal sinus rhythm followed by a pause and a large, widened QRS complex

A

Ventricular Escape Beat

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12
Q

Junctional and Atrial Irritability causation

A 
Epinephrine release 
Increased SNS 
Caffeine, amphetamines, cocaine
Excess digitalis, ethanol 
Hyperthyroidism 
Stretch (low O2)
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13
Q

Normal sinus rhythm followed by an early P wave with characteristic downslope immediately afterwards (sideways Z) followed by normal sinus rhythm

A

Premature Atrial Beat

- Sideways Z is the SA node resetting

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14
Q

Normal sinus rhythm followed by an early P wave with characteristic downslope immediately afterwards (sideways Z) followed by normal sinus rhythm with initial widened QRS

A

Premature Atrial Beat with aberrant ventricular conduction

- One Bundle Branch not completely repolarized leads to widened QRS

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15
Q

Normal sinus rhythm beat followed by closely coupled premature atrial beat with different morphologic P wave and normal QRS complex

A

Atrial Bigeminy/Trigeminy

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16
Q

Normal sinus rhythm beat closely followed by a widened QRS complex

A

Premature Junctional Beat

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17
Q

Normal sinus rhythm beat coupled closely to an inverted P wave and QRS complex

A

(AV) Junctional Bigeminy/Trigeminy

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18
Q

Normal sinus rhythm closely followed by a widened QRS complex (usually opposes polarity of normal QRS) followed by a compensatory pause

A

Premature Ventricular Contraction (PVC)

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19
Q

Normal sinus rhythm closely followed by a widened QRS complex (usually opposes polarity of normal QRS) followed by a compensatory pause
- When coupled to a normal beat

A

Ventricular Bigeminy/Trigeminy

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20
Q

Normal sinus rhythm with interspersed larger QRS complexes

PVC’s coupled to normal sinus rhythm

A

Ventricular Parasystole

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21
Q

Various shaped QRS complexes in close proximity interrupting a apparently normal sinus rhythm

A

Multifocal PVC’s

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22
Q

Normal sinus rhythm followed by sudden tachycardia with rate 150-250/min
Normal looking P waves and QRST cycle, P waves different than sinus rhythm P

A

Paroxysmal Atrial Tachycardia

Supraventricular Tachy

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23
Q

Rate of 150-250/min with a 2:1 ratio of P spikes to QRS complexes

A

PAT with AV block

- AV node blocks every other atrial stimulus

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24
Q

Inverted P waves before/after/buried

Rate of 150-250 bpm

A

Paroxysmal Junctional Tachycardia

Supraventricular Tachy

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25
Widened QRS complexes | Rate of 150-250bpm
Paroxysmal Ventricular Tachycardia
26
``` Lengthened QT segment Progressively larger then smaller Caused by low K, K channel blockers Rate of 250-350bpm Increased risk with U wave ```
Torsades de Pointes
27
Identical back to back atrial depolarization waves (1 of 3 usually leads to QRS) "Sawtooth" Rate of 250-350bpm
Atrial Flutter
28
Rapid series of smooth sine-waves of similar amplitude | Rate of 250-350 bpm
Ventricular Flutter
29
Wavy baseline w/o identifiable P waves QRS not regular (Erratic rhythm) Rate of 350-450bpm
Atrial Fibrillation
30
Erratic rhythm (no regularity) No identifiable waves Rate of 350-450bpm
Ventricular Fibrillation
31
Delta wave before QRS | Appearance of shortened PR and lengthened QRS --> upsloping of QRS complex
Wolff-Parkinson-White Syndrome | Due to accessory AV conduction pathway: Bundle of Kent
32
Prolonged PR interval of a consistent length
Primary AV Block
33
PR interval length
Less than 1 large box | From beginning of P wave to beginning of QRS complex
34
QRS wave length
Less than 3 little boxes
35
T wave length
Less than 2 big boxes
36
Progressively prolonged PR intervals with subsequent lone P wave (usually fixed rhythm/ratio)
Secondary AV Block Wenckebach | Type 1
37
Multiple P waves per QRS (2:1/3:1) Widened QRS Series repeats P wave not premature
Secondary AV Block | Mobitz (Type 2)
38
Complete atrial and ventricular dissociation (P waves irregular relationship to QRS complex) P wave at fast rate superimposed over slower QRS rate
Complete Tertiary AV Block
39
Widened QRS | Rabbit ears in V1/V2
Right Bundle Branch Block
40
Widened QRS Rabbit ears in V5/V6 (more sloped btw R peaks)
Left Bundle Branch Block
41
Biphasic P wave more +
Right Atrial Hypertrophy
42
Biphasic P wave more -
Left Atrial Hypertrophy
43
Large R wave in V1
Right Ventricular Hypertrophy
44
Large S wave V1 and R in V5
Left Ventricular Hypertrophy
45
Symmetrically inverted T waves | ST segment depression
Ischemia
46
ST segment elevation with reciprocal ST segment depression
Acute Injury
47
Q waves | Significant if..
Old Injury Necrosis At least 1 small square wide (.04 sec)
48
ST segment elevation in leads II, III, AVF with Q wave | Caused by occlusion of...
Inferior MI | - Either LCA/RCA depending on dominant supply
49
ST segment elevation in leads V1-V4 with Q wave | Caused by occlusion of...
Anterior MI | - Anterior descending branch of LCA
50
ST segment elevation in leads I, AVL, V5-6 with Q wave | Caused by occlusion of...
Lateral MI | - Circumflex branch of LCA
51
Leads V1, V2, tall R wave and ST depression | Caused by occlusion of...
Posterior MI | - RCA
52
When can ECG not be a diagnostic tool for Acute MI?
LBBB
53
Pattern of RBB and persistent ST elevation in V1-V3 | ST segment "saddle-like" especially in V1/V2
Brugada Syndrome | - Results in sudden cardiac arrest in absence of coronary obstruction
54
Flat elevated ST segment T wave elevated off baseline Present in all leads PR segment depression
Pericarditis
55
Minimal bimodal presentation of QRS complexes | Blunting of all electrical activity
Pericardial Effusion
56
QT Interval longer than half of cardiac cycle
Long QT Syndrome | - Predisposed to ventricular arrhythmias
57
Large S wave in 1 ST depression in 2 Large Q wave in 3 with T wave inversion (in leads V1-V4) Afib common
Pulmonary Embolism
58
Peaked T waves in all leads Wide QRS Flat/widened P waves
Hyperkalemia
59
Flattened T waves in all leads Prominent U waves Non-monomorphic baseline
Hypokalemia
60
Shortened QT interval | Widened T waves
Hypercalcemia
61
Prolonged QT interval | Flattened T waves
Hypocalcemia
62
Gradual downward curve of ST segment - lowest portion being below the baseline
Digitalis effect | Dali stash
63
``` Severe bradycardia Prolonged PR interval Widened QRS Prolonged QT Osborn wave ```
Hypothermia | (Osborn wave is extra deflection at end of QRS)
64
Normal but everything is reversed
Dextrocardia
65
Spike before P wave
Atrial paced rhythm
66
Spike after P wave but before QRS complex
Ventricle paced rhythm
67
Spike before P wave and before QRS complex
Atrial and ventricle paced rhythm

CV II (5 decks)

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