ECG Review Flashcards
1
Q
determining HR
A
- 300 / # big boxes
- 300, 150, 100, 75, 60, 50
2
Q
determining limb lead axis
A
- lead I and aVF + = normal (0 to +90)
- lead I and II + = normal (-30 to +90)
- find isoelectric lead; axis = 90˚ of that lead
3
Q
precordial lead axis
A
- QRS predominantly negative in V1 and positive in V6
- isoelectric transition point around V3 or V4
4
Q
normal intervals:
- PR interval
- QRS interval
- QT interval
- Q wave
A
- 3-5 small boxes
- ≤ 2 small boxes
- 2 large boxes, less than half of RR interval
- 1 small box wide or deep (except aVR)
5
Q
sinus tachycardia
A
- positive p wave before QRS (I, II, aVF) [normal]
- HR > 100
6
Q
sinus bradycardia
A
- positive p wave before QRS (I, II, aVF) [normal]
- HR < 60
7
Q
atrial fibrillation
A
- no positive p wave before QRS
- irregularly irregular narrow QRS intervals
- lumpy bumpy baseline
8
Q
atrial flutter
A
- no positive p wave before QRS
- sawtooth pattern
- narrow but regular QRS
- 2:1 block -> HR~140
- 4:1 block -> HR~70
9
Q
supraventricular tachycardia
A
- no positive p wave before QRS
- regular narrow QRS
10
Q
SVT due to AVNRT
A
- baseline ECG in sinus rhythm shows narrow QRS and normal PR
11
Q
SVT due to AVRT
A
- baseline ECG in sinus rhythm has delta wave and short PR
12
Q
ventricular tachycardia
A
- no positive p wave before QRS
- wide QRS tachycardia
13
Q
monomorphic VT
A
- QRS complex same shape
- reentry arrhythmia from area of ventricle
14
Q
polymorphic VT
A
- multiple QRS shapes
- acute ischemia, meds prolonging QT
- Torsades de Pointes
15
Q
atrial fibrillation treatment
A
- structurally normal heart: type IC a-a
- structurally abnormal: type III a-a
- ablation procedure (pulmonary vein)
16
Q
atrial flutter treatment
A
- very responsive to ablation (cavo-tricuspid isthmus)
17
Q
AVNRT treatment
A
- adenosine slows AV node conduction
- AV node blockers
- slow pathway ablation
18
Q
AVRT (WPW) treatment
A
- bypass tract ablation
- *AVOID AV node blockers
19
Q
LBBB
A
- wide QRS at sinus rhythm, p wave present
- V1 goes down
20
Q
RBBB
A
- wide QRS at sinus rhythm, p wave present
- V1 goes up, rabbit ears
21
Q
1˚ AV block
A
- p wave always followed by QRS
- PR interval > 5 small squares
- delay usually at AV node
22
Q
2˚ AV block type I/Mobitz I/Wenckebach
A
- lengthening PR intervals before blocked P wave
- PR interval following blocked wave is shorter than PR interval before
- block high in AV node
23
Q
2˚ AV block type II/Mobitz II
A
- fixed prolonged PR intervals before/after blocked P wave
- block on his-purkinje system
- can progress to AV block
24
Q
3˚ AV block
A
- all P waves blocked
- P wave rate different than QRS rate (distance variable)
- QRS narrow = high block
- QRS wide = low block
25
NSTEMI
- acute: ST depression and/or T wave inversion
| - weeks later: normal ST and T; NO Q waves
26
STEMI
- acute: ST elevation
- hours: ST elevation, decreased R wave, Q wave
- 1-2 days: T wave inversion, deeper Q wave
- more days: ST normal, T wave inversion
- weeks: ST/T normal, Q wave persists
27
anterior STEMI
- ST elevation in leads I, aVL, V2, V3, V4
- LAD artery
- may sig reduce LV systolic function -> HF
28
inferior STEMI
- ST elevation in leads II, III, aVF
- PDA (90% RCA)
- GI symptoms common, nitro induced hypo, bradycardia from vagus
- proximal RCA occlusion can cause RV infarction
29
LVH
- increased QRS amplitude in V1 + V5, aVL, or I
| - caused by: AS, HTN, HCM
30
low voltage
- caused by anything that reduces electrical impulse conduction
- amyloid
31
types of bradycardia
- sinus pauses (treatment > 3 sec)
| - sinus bradycardia (HR < 60; pathologic and physiologic)
32
bigeminy
- alternating normal and premature beat
33
premature atrial contraction
- supraventricular
- preceded by p wave
- narrow QRS
- may not conduct to ventricle
- resets SA node
34
premature ventricular contraction
- ventricular
- no p wave
- wide QRS
- may not conduct to atrium
- no effect on SA node
