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EKG Flashcards

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1
Q

What indicates right atrial enlargement (RAE) in lead II?

A

P waves taller than 0.25 mV (2.5 mm)

Right atrial enlargement is assessed by the height of the P waves in lead II.

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2
Q

What indicates left atrial enlargement (LAE)?

A

P waves longer than 120 ms (3 little boxes)

Left atrial enlargement is assessed by the duration of the P waves.

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3
Q

What are the criteria for right ventricular hypertrophy (RVH)?

A

Right axis deviation, early R wave progression

RVH is identified through changes in the axis and R wave progression.

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4
Q

What are the criteria for left ventricular hypertrophy (LVH)?

A

Either:
* Height of the deepest S in V1 or V2 + tallest R in V5 or V6 >= 35 mm
* R in aVL > 11 mm

These criteria help in diagnosing left ventricular hypertrophy.

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5
Q

What is sinus arrhythmia?

A

Meets all criteria for normal sinus rhythm except varying R–R interval

Sinus arrhythmia is characterized by changes in the heart rate with breathing.

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6
Q

What indicates a bundle branch block?

A

QRS width >120 ms
* RSR´ in right-sided leads (RBBB)
* RSR´ in left-sided leads (LBBB)

Bundle branch blocks affect the width of the QRS complex and the morphology in specific leads.

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7
Q

What is the PR interval for first-degree AV nodal block?

A

PR interval >200 ms (5 lil boxes)

This is the defining characteristic of a first-degree AV block.

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8
Q

What characterizes Mobitz type II?

A

PR stays the same with random QRS drops

This type is more dangerous than type I as it can lead to complete heart block.

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9
Q

What is the hallmark of third-degree AV block?

A

P–P interval consistent, R–R interval consistent, but they are at separate rates

This is also known as complete heart block.

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10
Q

What are the sources of ectopic beats?

A

Atrial: P waves, narrow QRS
Junctional: no P wave, narrow QRS
Ventricular: no P wave, wide QRS

Ectopic beats can arise from different locations in the heart, affecting the morphology of the ECG.

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11
Q

What defines paroxysmal atrial tachycardia?

A

Rate >100 bpm, identical P wave morphologies from a single focus, p wave is upside down in lead II

It can be mistaken for sinus tachycardia if P waves appear normal.

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12
Q

What characterizes multifocal atrial tachycardia (MAT)?

A

Three or more different P wave morphologies, irregularly irregular R-R intervals, rate >100 bpm

If the rate is <100 bpm, it is called wandering atrial pacemaker.

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13
Q

What indicates junctional tachycardia/AVNRT?

A

No P waves, narrow complex QRS, rate >100 bpm

AVNRT may show retrograde P waves after the QRS complex.

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14
Q

What are the key features of atrial fibrillation?

A

No discernible P waves, irregularly irregular R-R interval

Atrial fibrillation is characterized by chaotic electrical activity in the atria.

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15
Q

What defines ventricular tachycardia?

A

4+ PVCs in a row
* Duration <30 sec: non-sustained
* Duration >30 sec: sustained

It can be monomorphic (single morphology) or polymorphic (multiple morphologies).

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16
Q

What are the criteria for STEMI?

A

1+ mm elevation between J point and baseline, elevations in 2+ contiguous leads

(2mm in anterior leads)

Specific lead groupings help localize the area of myocardial infarction.

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17
Q

What do hyperkalemia findings include?

A

Tall, narrow T waves, P flattening, PR lengthening, QRS widening, sinusoidal pattern

These changes reflect increasing potassium levels in the blood.

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18
Q

What indicates Wolf-Parkinson-White syndrome?

A

Short PR interval (<120 ms), presence of a ‘delta wave’

This syndrome can lead to reentrant tachycardias.

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19
Q

What are the features of pericarditis?

A

Diffuse ST elevations, PR depression may be seen

These findings indicate inflammation of the pericardium.

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20
Q

What indicates a paced rhythm?

A

Presence of pacemaker ‘spike’:
* Atrial pacemaker: spike before P wave
* Ventricular pacemaker: spike before wide QRS complex

Ventricular pacemakers can cause anterior ST elevations similar to LBBB.

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21
Q

The standard QRS duration is ___ms.

A

<120ms (3 lil boxes)

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22
Q

What is the standard QT interval in box # and ms?

A

350 - 450 ms (

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23
Q

Multiple choice: Which of the following is the correct range for the PR interval? A) <120 ms B) 120-250 ms C) 100 - 300 ms

A

B) 120-250 ms

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24
Q

What is the standard PR interval duration in milliseconds and boxes?

A

The standard PR interval duration is less than 120-250 ms (3-5 lil boxes).

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25
True or False: The normal QRS duration is typically less than 120 milliseconds.
True.
26
what is the standard voltage of a p wave
<.25 V (2.5 lil boxes)
27
what are the different morphologies for Q, R, and S waves
28
What are the different waves and durations in a standard EKG wave
29
how does the 300 rule work for calculating heart rate
300/# big boxes between each R wave
30
what is the axis
indeterminate
31
what is the axis
normal
32
what are the changes expected in the V1-V6 leads with right axis deviation
V1 and V2 are positive or isoelectric
33
what are the changes expected in the V1-V6 leads with left axis deviation
the R wave transition point is in V5 or V6
34
what are the requirements for NSR
p wave before every QRS QRS after every P P waves "identical" and "normal" rate 60 to 100 bpm R-R interval is constant
35
What is the rhythm
1st degree heart block
36
what is the rhythm
2nd deg heart block Mobitz type I (Wenckebach)
37
what is the rhythm
2nd deg heart block Mobitz type II
38
what is the rhythm
3rd deg heart block
39
what is this
RBBB if in V1 or V2 LBBB if in V5 or V6
40
Which BBB is this
RBBB
41
which BBB is this
LBBB note anterior (V1-V4) St elevations
42
which BBB is this
LBBB
43
how do QRS and P waves correspond to tell you where an arrhythmic is coming from
44
what is this depicting
"short long pattern" this is a PAC because it has a p wave and the QRS is narrow
45
what is this depicting
atrial escape rhythm. longer than normal R-R interval (60-80)
46
what is this depicting
premature junctional complex. no p wave narrow QRS
47
what is this depicting
junctional tachycardia/ AVNRT
48
what is this depicting
junctional escape rhythm
49
what is this rhythm
NSR with a premature atrial complex
50
what is this rhythm
paroxysmal atrial tachycardia (120 HR, inverted p waves)
51
what is this rhythm
Multifocal atrial tachycardia (150 HR)
52
what is this rhythm
afib
53
what is this rhythm
AVNRT (there's a little inverted p-wave that looks like an s wave also not pictured on the strip but in V1 there's a little p wave)
54
what is this rhythm
sinus arrhythmia. there are inverted p-waves on V1
55
What is this rhythm
NSR with PVC
56
what is this rhythm
V fib/flutter
57
Which EKG leads are primarily associated with anterior myocardial infarction (MI)?
Leads V1 to V4.
58
True or False: Leads I, aVL, V5, and V6 are associated with lateral MI.
True.
59
Fill in the blank: Inferior MI is typically indicated by changes in leads _____ and _____.
II, III, aVF.
60
What leads are indicative of anterolateral MI?
Leads V3 to V6 and I, aVL.
61
Multiple Choice: Which of the following leads are associated with inferolateral MI? A) V1, B) V2, C) II, III, aVF, V5, V6, D) I, aVL
C) II, III, aVF, V5, V6.
62
how can you tell the difference between hyper-acute T waves and peaked T waves from hyperkalemia
the hyper-acute T waves will only be in the leads for the MI territory (ie. II, III, aVF)
63
what is the major finding
anteriolateral STEMI (leads I, AVL, V2-V6) depressions in inferiolateral leads
64
what is the major finding
inferior STEMI (II, II AvF)
65
what is the major finding
WPW
66
what is the major finding
junctional escape rhythm, slow narrow rhythm with no p waves hypokalemia, u wave in aV2 and V3
67
what is the major finding
hyperkalemia, peaked pointy t waves in V2-V6
68
what is the major finding
hyperkalemia, flattening of t wave and widening of QRS
69
what is the major finding
hyperkalemia sinusoidal pattern
70
what is the major finding
junctional escape rhythm, no p waves narrow QRS and slow pt has hypothermia so weird wave after QRS
71
what is the major finding
sinus tachycardia no enlargements S1Q3T3 but not on test so...
72
what is the major finding
NSR (HR 90) pericarditis (diffuse concave ST elevations and electrical alternans)
73
what is the major finding
paced ventricular rhythm (line in lead III)
74
what is this
Wandering atrial pacemaker. Note the differing morphologies of the P waves, as each is coming from a different focus, and the resultant varying PR intervals. This causes the irregularly irregular rhythm. As the overall rate is less than 100 bpm, it is not MAT
75
what is the rhythm
Junctional escape rhythm. Note the rate is slow (about 50 bpm), the QRS complex is narrow, and there are no P waves preceding the QRS complexes.
76
what is the major finding
Diffuse ST elevations characteristic of pericarditis.
77
what is the major finding
1st degree AV block, LVH
78
what is the major finding
RVH
79
what is the major finding
inferior MI with reciprocal changes
80
major findings
BAE, ant/lat/inf Q waves
81
major findings
inferior MI (Q waves, T changes); posterior MI (R waves only)
82
major findings
complete heart block
83
major findings
1st degree AV block, LVH
84
PACs, LVH, strain pattern
85
anterior MI with QS waves
86
low voltage, a-flutter
87
Vtach
88
PVC, NSVT, RBBB, 3rd degree AV block
89
WPW
90
SVT
91
bradycardia
92
afib with aberrancy (difficult)
93
pericarditis
94
a-fib with ventricular pacer
95
MAT
96
long QT due to hypocalcemia, 1st degree block
97
PAC, RBBB, left anterior fascicular block
98
sinus bradycardia, LVH, old inferior MI
99
ST elevations in LBBB
100
short PR interval
101
dextrocardia
102
LVH
103
RVH (with strain)
104
R axis deviation, RAE
105
3rd degree block
106
sinus arrhythmia, long QT
107
WPW
108
LBBB, lateral MI
109
LVH, RBBB, LAE, Mobitz type II
110
anterolateral infarct
111
junctional rhythm (with P wave buried in ST in V1), anterolateral MI
112
anterior MI with Q wave
113
pericarditis
114
inferior and posterior MI (T and Q waves)
115
Wenckebach
116
tremor masquerading as a-fib, 1st degree block, Left anterior fasicular block
117
LVH
118
what are the options for: tachy irregular QRS>120 (wide) BBB
Afib with BBB MAT with BBB
119
what are the options for: tachy irregular QRS>120 (wide) no BBB
Vfib
120
what are the options for: tachy irregular QRS <120 (narrow) with p waves (identical)
sinus arrhythmia
121
what are the options for: tachy irregular QRS <120 (narrow) with p waves (3 different types)
MAT
122
what are the options for: tachy irregular QRS <120 (narrow) with no p waves
Afib
123
what are the options for: tachy regular QRS <120 (narrow) with p waves (identical)
Sinus tachy
124
what are the options for: tachy regular QRS <120 (narrow) with p waves (sawtooth)
AFlutter
125
what are the options for: tachy regular QRS <120 (narrow) with no p waves
SVT/AVRT
126
what are the options for: tachy regular QRS <120 (narrow) with inverted p waves in lead II
PAT
127
what are the options for: tachy regular QRS >120 (wide) with BBB and p waves
sinus tachy with BBB
128
what are the options for: tachy regular QRS >120 (wide) no p waves
VT
129
what are the options for: brady regular QRS >120 (wide) with p waves and BBB
sinus brady with BBB
130
what are the options for: brady regular QRS >120 (wide) with p waves (not in synch with QRS)
3deg HB with ventricular escape
131
what are the options for: brady regular QRS >120 (wide) with no p waves
ventricular escape
132
what are the options for: brady regular QRS <120 (narrow) with p waves
sinus brady
133
what are the options for: brady regular QRS <120 (narrow) with p waves (not in synch with QRS)
3deg HB with junctional escape rhythm
134
what are the options for: brady regular QRS <120 (narrow) with no p waves
junctional escape rhythm
135
what are the options for: brady irregular QRS <120 (narrow) with p waves (some conducted some not)
2nd deg HB
136
what are the options for: brady irregular QRS <120 (narrow) without p waves
slow afib
137
what are the options for: brady irregular QRS >120 (wide) with BBB no p waves
slow a fib with BBB
138
what are the options for: brady irregular QRS >120 (wide) with BBB with p waves
2nd deg HB with BBB
139
what are the options for: normal rate irregular QRS <120 (narrow) identical p waves
NSR with PAC/PVCs 2nd Deg HB
140
what are the options for: normal rate irregular QRS <120 (narrow) with p waves (3 different types)
WAP
141
what are the options for: normal rate regular QRS <120 (narrow) p waves
NSR
142
what are the options for: normal rate regular QRS >120 (wide) p waves
NSR with BBB
143
which MI have elevations in: I, aVL, V5-6
Lateral MI
144
which MI have elevations in: V1-V4
anterior
145
which MI have elevations in: 1, aVL, V1-V3
anteriolateral could be any combination of any two from V1-V4 any two from I, aVL, V5-V6
146
if there is a LBBB what do we not have to worry about
RVH/LVH or MI
147
if there is a paced rhythm what do we not have to worry about
RVH/LVH or MI
148
if there is LVH what do we not have to worry about
MI
149

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