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Flashcards in EKG Deck (25):
1

What 3 main ion currents dominate and at which parts of the cardiac cycle?

Phase 0 – Sodium Channel
Phase 1 – Sodium and Potassium Channel
Phase 2 – Potassium and Calcium Channels
Phase 3 – Potassium Channel
Phase 4 – Potassium Channel and Funny Current

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2

What are the 4 classes of antiarrhythmatic meds?

•Class I: Sodium channel blockers
–Inhibit depolarization/slow conduction velocity

•Class II: Beta-blockers
–Slow sinus node and AV node

•Class III: Potassium channel blockers
–Prolong repolarization

•Class IV: Calcium-channel blockers
–Slow SA node (some) and AV node (more)

•Others: Digoxin, Adenosine, Atropine

3

Where do you place EKG leads --where on chest/body?

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4

What are the 3 limb unipolar leads?

Use "ground" as composite as the major negative pole

aVR, aVF, aVL

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5

What are the 3 bipolar limb leads?

Where you subtract the difference between two leads:

I = R arm (-) --> L arm (+)

II = R arm (-) --> leg (+)

III = L arm (-) --> leg (+)

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6

What is the axial reference system?

Shows you the angle from which you are looking at each lead

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7

What is the count off system for calculating HR?

Count how many small boxes there are between peaks

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8

Which leads indicate problem with inferior potion of heart i.e. pathological Q wave? Which artery is this?

II, III, aVF

RCA

9

Which leads indicate problem with anteroseptal potion of heart? Which artery is this?

V1, V2

LAD, proximal

10

Which leads indicate problem with anteroapical potion of heart? Which artery is this?

V3, V4

LAD, distal

11

Which leads indicate problem with anterolateral potion of heart? Which artery is this?

V5, V6, I, AVL

Circumflex

12

Which leads indicate problem with posterior potion of heart? Which artery is this?

V1, V2 (tall R, not Q wave)

RCA

13

AVNRT: what is it and treatment

Atrioventricular nodal tachycardia

Blip in p wave at end of QRS due to self perpetuating loop in tissue secondary to atrial premature beat

Treat w vagal maneuvers

14

AVRT: what is it and treatmnet

Atrioventricular reentry tachycardia

Bypass tract --> signal can reach ventricles faster = wolff-parkinson white syndrome

short PR, delta wave in QRS, wide QRS

Treat with vagal maneuvers

15

Atrial tachycardia: what is it and treatmnet

Many p waves, with diff morphologies

Beta blockers, Ca channel blockers, IA, IC, and II antiarrhythmic drugs

16

AFib: what is it and treatment

 Chaotic depolarization of atria --> irregular Ventricular rate

Anticoags to prevent stroke (CHADS2 score)

No cardiac disease: meds or catheter ablation

Coronary disease: don't use Class IIC meds (propafenone, flecanide= worse outcome)

Htn, can't use sotalol, dofetilide (Class III)

CHF: ablation, amiodarone, dofetilide only (Class III)

17

Atrial flutter

Macro re-enterance loop --> sawtooth patterns, more organized rhtyhm than AFib

18

VT

3 or more ventricular premature beats

Wide QRS

Doesn't respond to vagal maneuvers

Treat with beta blockers, amiodarone & solatol (palliative), ICD, ablation

19

Torsades des Points

Associated with Long QT

20

Long QT- causes and treatment

Congenital, hypokalemia, hypomagnesia, drugs

Withdraw med that causes it, give Mg/K, pace the heart to make it faster, lidocaine, defibrillation

Long term: genetic testing, beta blockers, ICD, avoid meds that prolong QT

21

VFib-treatment

Defibrillation

22

What med do you give to treat sinus bradycardia?

Atropine: blocks action of Ach at parasympathetic sites

23

What are the 4 types of atrial bocks? Treatment?

1st degree: longer PR interval

2nd degree Mobitz type 1/Wenckebach: progressive PR elongation with eventual nonconduction of a p wave

2nd degree Mobitz type 2: normal PR intervals with a sudden failure of p wave to conduct

3rd degree: complete AV dissociation

Treat all with pacemaker

24

Junctional excape rhythm

QRS not preceeded by p wave

Rhythm arises from below atria = slow 40-60 bpm

25

Ventricular escape rhtyhm

widened QRS complexes

Slower rates 30-40 bpm