ECGs

Question 1

Bradycardia

Answer 1

<60 BPM

Question 2

when is intervention needed for those with bradycardia?

Answer 2

when it is severe =< 30 bpm as it will likely compromise cardiac output

Question 3

summary of ECG finding for bradycardia
regularity?

Answer 3

regular

Question 4

summary of ECG finding for bradycardia
p wave?

Answer 4

uniform shape
one wave in front of every QRS complex

Question 5

summary of ECG finding for bradycardia
QRS?

Answer 5

one following each p wave
QRS complexes appear normal

Question 6

sinus tachycardia

Answer 6

rhythm originating from SA node; rate is too fast
>100 bpm, <160 bpm

Question 7

summary of ECG finding for tachycardia
QRS?

Answer 7

one following p wave
less than 0.12s (3 squares wide)

Question 8

summary of ECG finding for tachycardia
t wave?

Answer 8

one following the QRS complex

Question 9

summary of ECG finding for tachycardia
regularity?

Answer 9

regular

Question 10

immediate notification is needed if the rate is over ____ or less than ____.

Answer 10

over 180 bpm, less than 30 bpm

Question 11

atrial tachycardia

Answer 11

single ectopic focus in atria over the SA node regulating heart rate leading to fast regular rhythm but not enough time for vents to fill properly

Question 12

summary of ECG finding for atrial tachycardia
QRS?

Answer 12

less than 0.12s (3 squares)

Question 13

summary of ECG finding for atrial tachycardia
rate?

Answer 13

150-250 bpm

Question 14

summary of ECG finding for atrial tachycardia
p wave?

Answer 14

abnormal shape; one in front of every QRS complex – but sometimes can be hidden in t-wave

Question 15

atrial fibrillation

Answer 15

multiple foci generating electrical impulses in atria
atria is no longer beating but rather just quivering.

Question 16

is atrial fib dangerous?

Answer 16

not if ventricles are still functioning ok.
if there is blood pooling at atria and clotting occurs, then it can be life threatening.

Question 17

summary of ECG finding for atrial fibrillation
QRS?

Answer 17

normal when occurs

Question 18

summary of ECG finding for atrial fibrillation
regularity?

Answer 18

very irregular

Question 19

summary of ECG finding for atrial fibrillation
rate?

Answer 19

> 350 bpm

Question 20

summary of ECG finding for atrial fibrillation
p wave?

Answer 20

no discernible p waves just fibrillatory waves

Question 21

atrioventricular block

Answer 21

conduction disturbances within AV node

Question 22

three types of heart blocks

Answer 22

1. first degree
2. second degree
3. third degree

Question 23

blocks resulting in delay in conduction of impulse from atria to ventricles

Answer 23

1st and 2nd

Question 24

blocks resulting in the impulse no longer travelling from atria to ventricles

Answer 24

3rd = complete heart block

Question 25

characteristics of first degree block

Answer 25

- increased PR interval (0.12s to 0.20s)

Question 26

characteristics of second degree block

Answer 26

- few missed QRS complexes

Question 27

characteristics of third degree block

Answer 27

- p wave without corresponding QRS complex

Question 28

if a patient has LBBB, why can we not do stressing with dobutamine?

Answer 28

it can lead to false positive septal defect

Question 29

what does a notched p wave indicate?

Answer 29

left atrial enlargement

Question 30

PVC on an ECG

Answer 30

wide QRS complex with T wave in opposite direction

Question 31

when are PVCs significant?

Answer 31

when there is five or more per minute or three or more in a row or PVC falling on T wave that ends up triggering ventricular tachy

Question 32

ventricular tachycardia

Answer 32

series of PVCs causes the ventricles to become irritable and it overtakes the normal pacemaker of the heart

Question 33

why do myocardial infarcts occur?

Answer 33

due to occlusion or blockage of the coronary arteries causes deprivation of oxygen and nutrients which will eventually cause tissue death

Question 34

3 components to diagnosis MI

Answer 34

1. hx and physical examination 2. troponins I and T 3. ECGs

Question 35

trops will be elevated in ___ hours after cellular damage.

Answer 35

6 hours!

Question 36

ECG changes following acute myocardial infarction T wave

Answer 36

onset: t waves = tall and narrow, peaking few hours after: t waves = invert

Question 37

ECG changes following acute myocardial infarction ST segment

Answer 37

onset: segment elevated later: returns to baseline within few hours

Question 38

ECG changes following acute myocardial infarction Q wave

Answer 38

new Q waves = MI appears from hours to several days and can persists for the life of the patient

Question 39

significant q wave

Answer 39

indicative of infarction for duration greater than 0.04 secs 1/3 height of R wave

Question 40

ST segment depression indicate ...

Answer 40

myocardial ischemia

Question 41

myocardial ischemia

Answer 41

lack of blood flow to myocardium to meet the myocardial physiological requirements

Question 42

ventricular pacemaker on ECG

Answer 42

pacemaker spike followed by wide QRS (shows R vent depolarization then L vent depolarization)

Question 43

atrial pacemaker on ECG

Answer 43

spike followed by P wave and normal QRS

Question 44

atrial and ventricular pacemaker

Answer 44

spike - p wave - spike - normal QRS

Question 45

beta 1 receptors

Answer 45

responsible for heart rate and strength

Question 46

beta 2

Answer 46

function of smooth muscles (muscles we have no control over)

Question 47

selective beta blockers

Answer 47

block beta 1 receptors more than beta 2

Question 48

non-selective beta blockers

Answer 48

block both beta 1 and beta 2 receptors