EKG STEMI & BBB Flashcards
(34 cards)
<p>What are the 4 types of AV blocks?</p>
<p>1)1st degree</p>
<p>2)2nd degree Mobitz I(Wenckebach)</p>
<p>3) 2nd degree Mobitz II</p>
<p>4) 3rd degree</p>
<p>What interval is key in reading an EKG when differentiating between AV blocks?</p>
<p>PR interval (normal: 0.12-0.20 sec)</p>
<p>EKG is normal except the PR interval is prolonged, at a constant duration, in ALL beats. What type of block is this?</p>
<p>First-degree AV block, PRI > 0.20 sec (1 big box) in ALL beats</p>
<p>What type of EKG abnormality is this?</p>
<p>First-degree AV block</p>
<p>You're looking at an EKG and the PR interval gets longer and longer until a beat completely drops off (P wave, but no QRS). What type of block is this?</p>
<p>Second-degree AV block: Mobitz Type I(Wenckebach)</p>
<p>What type of block is this: the PR interval remains<strong>constant</strong>(can be normal or long) until a beat is dropped</p>
<p>Second-degree AV block: Mobitz II</p>
<p>What type of block is more dangerous, second-degree AVB Mobitz I or Mobitz II?</p>
<p>Second-degree AVB <strong>Mobitz II</strong>- this often progresses into a complete block</p>
<p>True/False: AV blocks will always have a P wave</p>
<p><strong>True,</strong>the SA node is firing, but the impulse gets blocked or delayed at the AV junction in an AV block</p>
<p>In this type of block, theatria and ventricles beat independently, with NO communication between the two. P-P is regular & R-R is regular</p>
<p>Third-degree AVB (AKA Complete heart block)</p>
<p>These types of blocks are caused by a delay or interruption in the transmission of impulses occurring<strong>below</strong>the bifurcation of the Bundle of His</p>
<p>Bundle branch blocks (RBBB or LBBB)</p>
<p>What leads are you looking at on an EKG when diagnosing BBBs?</p>
<p><strong>V1 </strong>and <strong>V6</strong> (looking at R-R')</p>
<p>QRS complex is usually wide (>0.12 sec)</p>
<p>Which BBB is more dangerous, left or right?</p>
<p>LBBB <strong>never </strong>occurs in a healthy heart. These are concerning, especially if it's new</p>
<p>What are some possible causes of a RBBB?</p>
<ul> <li>Coronary artery disease</li> <li>HTN</li> <li>Acute PE</li> <li>Chronic electrical degeneration</li> <li>Can occur in a healthy heart</li></ul>
<p>What are some common causes of a LBBB?</p>
<ul> <li>HTN</li> <li>Cardiomyopathy</li> <li>Acute MI</li> <li>Aortic stenosis</li> <li>Extensive CAD</li> <li>Diseased electrical system</li></ul>
<p>*Most often due to an organic heart disease, does NOT occur in a healthy heart</p>
<p>What characteristic feature will you see in the R waves in the V6 lead during a LBBB?</p>
<p>"Rabbit ears"</p>
<p>If you're using the turn signal method of determing R vs L BBB, what direction is this BBB?</p>
<p>RBBB, you are looking at<strong>V1 -</strong>you click your turn signal <strong>UP </strong>to turn <strong>Right</strong> (LBBB also has the "rabbit ears" in V6)</p>
<p>When looking at BBB, the deflection of the QRS is going the opposite direction of the T wave. What is this called? Is it good or bad?</p>
<p>This is called<strong>discordance,</strong>and it's<strong>good</strong></p>
<p>The QRS deflection is going the same direction as the T wave in a BBB. What is this called? What does it suggest?</p>
<p>This is<strong>concordance,</strong>it may suggest<strong>ischemia or myocardial infarction</strong></p>
<p>What is the Sgarbossa criteria tool used for?</p>
<p>It is used to identify an MI in the presence of a LBBB</p>
<p>\_\_\_\_\_\_\_ refers to reduced blood supply secondary to partial occlusion or spasm, heart muscle is savable.</p>
<p>\_\_\_\_\_\_\_\_ refers to no blood supply due to full vessel occlusion, the heart muscle is dead.</p>
<p><u><strong>Ischemia</strong></u><strong></strong>refers to reduced blood supply secondary to partial occlusion or spasm, heart muscle is savable.</p>
<p><u><strong>Infarction</strong></u><strong></strong>refers to no blood supply due to full vessel occlusion, the heart muscle is dead.</p>
<p>What leads on an EKG correspond to the septum of the heart (septal leads)?</p>
<p><strong>V1, V2</strong></p>
<p>What are the anterior leads?</p>
<p><strong>V2, V3, V4</strong></p>
<p></p>
<p>What are the lateral leads?</p>
<p>I, av<strong>L</strong>, V5, V6 (L=lateral)</p>
<p>II, III, av<strong>F</strong> are what leads?</p>
<p>Inferior leads (<strong>F</strong>=inFerior)</p>
A defect in the septal leads (V1, V2) indicates ischemia in what vessel?
Left anterior descending (LAD) artery
A defect seen in the anterior leads (V2, V3, V4) indicates ischemia in what vessel?
LAD
A defect seen in the lateral leads (I, avL, V5, V6) indicates ischemia in what vessel?
Circumflex branch of left coronary artery
A defect seen in the inferior leads (II, III, avF) indicates ischemia in what vessel?
Right coronary artery
ST depression and T-wave inversion seen in at least 2 anatomical leads indicates what?
Myocardial ischemia
There is a degree of ST depression that must be met to conclusively indicate myocardial ischemia:
> at least __mm in V5 or V6 (_____ leads) -or-
> at least __mm in III or avF (_____ leads)
> at least 1 mm in V5 or V6 (lateral leads) -or-
> at least 1.5 mm in III or avF (inferior leads)
T wave inversion is (normal/abnormal) in leads aVR and V1
T wave inversion is normal in leads aVR and V1
ST elevation in at least 2 anatomical leads indicates _______
Myocardial infarction
ST elevation: > 1mm in limb leads, >2mm in precordial leads (V1-V6)
______ is an MI without an elevated ST segment and is typically caused by an incomplete occlusion of an artery. The EKG may show ST depression, T wave inversion, or transient ST elevation. What will help you determine if this is an MI or not?
NSTEMI (non-ST segment elevation MI)
Labs will show elevated cardiac enzymes (i.e. troponin)
The arrows on this EKG are indicating ST elevation in leads II, III, and avF. This indicates a(n) _________ MI in the _______ ________ artery.
This indicates an inferior MI in the right coronary artery (RCA).
