EKG 4 summary Flashcards
Which has a faster rate, AVNRT or atrial flutter?
Atrial flutter is faster (250-300 bpm)
True or false: Atrial flutter will not be terminated by carotid massage because the issue is above the AV node
True
Will atrial flutter be affected by carotid massage?
Yes (will slow rate, but will not terminate flutter)
What pacemaker runs at 40-60 BPM?
Junctional pacemakers (at or near AV node) ~
What are the 4 questions you need to answer to figure out rhythm?
Are normal P waves present?
Are QRS complexes narrow or wide?
What is the Relationship of P waves & QRS complexes?
Is the rhythm regular or irregular?
What are the 5 types of arrythmias?
1) Sinus arrhythmias
2) Ectopic rhythms
3) Re-entrant rhythms
4) Conduction blocks
5) Preexcitation syndromes
What does a wide QRS complex usually imply?
Depolarization origin from within the ventricle myocardium and not traveling through the conduction system … spreads more slowly
Which 2 questions can help determine the important distinction as to whether an arrhythmia is supraventricular (atrial or junctional) or ventricular in origin?
1) Are NORMAL P-waves present?
2) Are QRS complexes narrow (< 0.12 sec or 3 small boxes) or wide (>0.12 sec)?
What is the origin of the arrhythmia if P waves are present and at a normal axis?
Origin of arrhythmia is atrial, likely at or near Sinus node
What does it indicate if there’s an arrhythmia, a P wave present, but an abnormal axis or appearance?
Origin is atrial other than at or near sinus node, retrograde from junctional or accessory pathway from a ventricular origin
What does it indicate if there’s an arrhythmia and no P wave present?
Then origin is below atria in AV node or ventricles
What size is a normal QRS complex (width)?
<3 small boxes
True or false: Atrial & junctional Premature beats may initiate more sustained arrhythmias, and neither indicate a pathology
True
List the 4 different ways to determine HR on an EKG
1) Estimate by 300-150-100-75-60-50-42
2) 300/# of large boxes between R-R interval
3) 1500/# of small boxes between R-R interval
4) For slow/irregular rates, count the # QRS complexes noted on the rhythm strip & multiply by 6 (typical EKG runs for 10 seconds)
Name some medications that can cause sinus bradycardia
Opioids, Beta blockers, CCBs (mainly diltiazem and verapamil)
List some meds/ drugs that can cause ectopic rhythms
SABA/LABA, digoxin (digitalis toxicity), ADHD Rx, cocaine, methamphetamine
True or false: a jct. premature beat or jct escape beats do not have p waves
True
What is the heart rate with AFIB?
120-180 bpm
What is the heart rate with AVNRT?
150-250/ min
Reentrant rhythm around annulus of tricuspid valve (above AV node) may be indicated by what?
Atrial flutter
