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From Flashcardlet > EKG Part 6 (Ventricular) > Flashcards

EKG Part 6 (Ventricular) Flashcards

1
Q

What are Ventricular arrhythmias due to?

A

an ectopic focus somewhere in the ventricles

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2
Q

What part of the ventricles can act as an initiating focus for the contraction a ventricular arrhythmia?

A

any portion of the ventricles

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3
Q

When the ventricular focus initiates a beat, what is it called?

A

a premature ventricular contraction (PVC)

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4
Q

Do you see a P Wave prior to an abnormal QRS complex in a PVC?

A

no because depolarization is initiated in the ventricle

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5
Q

What does the QRS complex look like in a PCV?

A

premature, broad and distorted

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6
Q

Why does the QRS complex look wide and bizarre in a PVC?

A

because instead of following the normal conduction pathways, it has to depolarize the heart cell-to-cell

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7
Q

What does the T wave look like in a PVC?

A

usually opposite in direction to the R Wave

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8
Q

If the R Wave is primarily negative (downward) what will the T wave look like in a PVC?

A

positive (upward) and vice versa

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9
Q

Do PVCs interrupt the existing heart cycle?

A

No, the beat following the PCV is in proper sequence with the cycle set up before the PVC occurred

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10
Q

What is the shorter than normal R-R interval in a PVC compensated by?

A

an immediately following R-R interval which is longer than normal and results in a return to a previous cycle

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11
Q

What is the additional stretch of time (the longer than normal R-R interval) in a PVC called?

A

a compensatory pause

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12
Q

What is a compensatory pause in a PVC useful in distinguishing?

A

a PVC from a PAC since it rarely occurs in a PAC

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13
Q

If a sequence of PVCs occur every other beat, what is it called?

A

bigeminy

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14
Q

If a sequence of PVCs occur every third beat, what is it called?

A

Trigeminy

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15
Q

If a sequence of PVCs occur every fourth beat, what is it called?

A

Quadegeminy

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16
Q

What 3 important situations that can occur with PVCs predispose patient to more serious rhythms (ventricular tach)?

A
  1. Frequent PVCs (10 or more per minute)
  2. PVC falling on T wave of the previous beat
  3. Multifocal PVCs
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17
Q

What are multifocal PVCs?

A

those with different waveforms occurring in the same lead

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18
Q

What do Multifocal PVCs indicate?

A

that the PVCs arose from different foci in the vessels

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19
Q

What are two PVCs together called?

A

a couplet

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20
Q

When two PVCs are together but look different from each other, what is it called?

A

multifocal couplet

21
Q

What is a series of PVCs called?

A

Ventricular Tachycardia

22
Q

What does the term Ventricular Tachycardia called?

A

When there are 3 or more PVCs in a row with a rate greater than 100

23
Q

If there are 3 or more PVCs in a row with a rate of 99, what is it called?

A

a triplet

24
Q

How do you measure the rate between PVCs?

A

count the boxes between 2 waves and divide by 1500

25
Q

Is Ventricular Tachycardia usually sustained?

A

yes, rapid and sustained

26
Q

On an EKG, if you see a repetition of broad, abnormal QRS complexes and T Waves, which are opposite in direction from the QRS complexes, what is it?

A

Ventricular Tachycardia

27
Q

Does atrial activity continue in Ventricular Tachycardia?

A

yes but you will see NO evidence of P Waves

28
Q

Is the R-R interval regular?

A

not precisely regular, but it is small

29
Q

What two mechanisms operate in V-Tach that may help identifying the rhythm?

A

capture and fusion

30
Q

When causes capture to occasionally occur during the rapid function of V-Tach?

A

2 events coincide = capture

31
Q

What 2 events occasionally cause capture during the rapid function of V-Tach?

A

at the precise moment that the ventricles are receptive, an impulse arrives

32
Q

What happens after capture occurs in V-Tach?

A

V-Tach resumes

33
Q

On an EKG what will you see when capture occurs during V-Tach?

A

V-Tach and then the appearance of normal PQRST followed by V-Tach again

34
Q

What does the appearance of a normal PQRST in the middle of V-Tach, look like on an EKG?

A

it looks as though ventricular function was ‘captured’, for just one beat, by the SA node

35
Q

What causes fusion to occur during V-Tach?

A

When ventricles are simultaneously activated by both the normal conducting system and the ventricular ectopic focus?

36
Q

When fusion occurs during V-Tach, what appearance does the QRS complex have?

A

an intermediate or fused appearance

37
Q

What is the fusion beat during V-Tach a combination of?

A

a normal QRS complex and one ventricular tachycardia

38
Q

How does capture and fusion help distinguish V-Tach from other tachycardias (which have similar EKG characteristics)?

A

because they only occurs in V-Tach

39
Q

Can V-Tach be ruled out when no capture of fusion occur?

A

NO

40
Q

If you see either V-Tach or Supraventricular Tach (SVT) on an EKG with no history of either, what do you do?

A

assess vital signs:

if pulse and BP are present use medication, if not present, then defibrillate and use CPR

41
Q

What is V-Tach often a prelude to?

A

Ventricular Fibrillation

42
Q

What is depolarization like in V-Fib?

A

completely unorganized

43
Q

What happens to the muscles in V-Fib?

A

The muscles quiver and are unable to contract effectively

44
Q

For all practical purposes, what is the heart doing during V-Fib?

A

the heart is standing still

45
Q

What do the waves look like on an EKG during V-Fib?

A

they are fast and irregular in appearances, timing and size, there are no normal identifiable

46
Q

What happens if V-Fib continues?

A

dead ensues and the electrical activity ceases

47
Q

What is the last phase of V-Fib?

A

agonal rhythm

48
Q

What does agonal rhythm look like on an EKG?

A

cessation of waves and a wandering baseline

49
Q

What is agonal rhythm?

A

slow ventricular fibrillation = cardiac standstill

From Flashcardlet (107 decks)

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