ECGS

Question 1

What does an ectopic beat result in?

Answer 1

Irregular heart rhythm

Question 2

What is a PVC?

Answer 2

Ventricles contract before atria and cannot be filled optimally

Question 3

What are the ECG characteristics of PVCs?

Answer 3

No P waves, wide QRS complex followed by a long pause

Question 4

What are the characteristics of ventricular bigeminy?

Answer 4

Every other beat is a PVC (1 normal, 1 PVC, 1 normal, 1 PVC)

Question 5

What are the characteristics of ventricular trigeminy?

Answer 5

Every 3rd beat is a PVC (2 normal, 1 PVC, 2 normal, 1 PVC)

Question 6

What is ventricular tachycardia?

Answer 6

Run of 3 or more PVCs sequentially; very rapid (100-250 bpm)

Question 7

What are the characteristics of ventricular tachycardia?

Answer 7

No P waves, wide and bizarre QRS complex

Question 8

Is ventricular tachycardia an emergency?

Answer 8

Yes, activate EMS

Question 9

What are the characteristics of ventricular fibrillation?

Answer 9

P waves and QRS complex cannot be discerned

Question 10

Is ventricular fibrillation an emergency?

Answer 10

Yes, call 911 -> CPR and defibrillator

Question 11

What are the characteristics of supraventricular tachycardia?

Answer 11

No P waves, narrow QRS complex

Question 12

Is supraventricular tachycardia an emergency?

Answer 12

No

Question 13

How do you reduce HR in patients experiencing supraventricular tachycardia?

Answer 13

Carotid massage and coughing/breath holding techniques with Valsalva maneuver

Question 14

What are the characteristics of premature atrial contractions (PACs)?

Answer 14

Early beat P-waves are buried under the T-wave. QRS complexes of the early beat and the normal beat should look similar

Question 15

Do premature atrial contractions (PACs) compromise CO?

Answer 15

No. PACs are not an emergency and patients can continue to exercise

Question 16

What is atrial tachycardia?

Answer 16

Rapid increased HR (100-250 bpm)

Question 17

What are the characteristics of atrial tachycardias?

Answer 17

3 or more PACs in a row, shortened PR interval

Question 18

Are atrial tachycardias an emergency?

Answer 18

No, just monitor

Question 19

What are the characteristics of atrial flutter?

Answer 19

“Sawtooth” appearance of P waves, 250-350 bpm

Question 20

Are atrial flutters an emergency?

Answer 20

No, but stop exercise and refer to physician

Question 21

When should medical treatment be initiated for atrial flutters?

Answer 21

If HR is >100 at rest

Question 22

What are the characteristics of atrial fibrillations?

Answer 22

No true P waves, rapid irregular P waves

Question 23

Are atrial fibrillations an emergency?

Answer 23

No, but stop exercise and refer patient to a physician (not 911)

Question 24

What are the characteristics of AV blocks?

Answer 24

Increase in PR interval to >0.2 seconds (or 1 large box).

Question 25

Are AV blocks an emergency?

Answer 25

No, can be normal in athletes with increased vagal tone and usually benign

Question 26

What are the characteristics of second-degree type I AV blocks?

Answer 26

Progressive delayed PR intervals and missed QRS complex

Question 27

What are the characteristics of second-degree type II AV blocks?

Answer 27

No delayed PR interval and randomly missed QRS complex. Unexpected drop of QRS complex with no warning

Question 28

What should you do in the presence of second degree type II AV blocks?

Answer 28

Stop exercise

Question 29

What are the characteristics of third degree AV blocks?

Answer 29

No relationship between P waves and QRS complex on the ECG. PR interval constantly changing, and QRS complex is usually wide and bizarre

Question 30

What should you do in the presence of type III AV blocks?

Answer 30

Stop immediately and refer patient for emergency help. Requires atropine and pacemaker