Lec 2-3 EKG Images Flashcards Preview

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Flashcards in Lec 2-3 EKG Images Deck (75)
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31

What does this rhythm show? Which specific leads/signs?

anterolateral and inferior ischemia

 

T inversion and ST depression on II, III, aVF --> inferior ischemia

ST depression on V4, V5, V6 --> anterolateral ischemia

32

What stage of MI is this?

 

[hyperacute, fully resolved, resolution, or chronic stabilized]

resolution phase

 

because you see:

- Q wave

- inverted T wave

- no ST elevation

33

What stage of MI is this?

 

[hyperacute, fully resolved, resolution, or chronic stabilized]

chronic stabilized 

because you see

- Q wave

- upright T wave

- no ST elevation

34

What stage MI is this?

 

[hyperacute, fully resolved, resolution, or chronic stabilized]

hyperacute phase

this is because:

- huge ST elevation

- hyperacute tall T wave

- no Q wave yet

35

What stage MI is this?

 

[hyperacute, fully resolved, resolution, or chronic stabilized]

fully evolved phase

this is because:

- ST elevation

- start to see Q wave formation

- start to see T wave inversion

36

What pathology does this rhythm show? what phase?

anterior wall MI

hyperacute phase since T waves and STs still up

ST elevation in V3, V4, V5, V6

37

What does this EKG show?

 

If a patient presents with new onset of this type of EKG and chest pain what is the diagnosis?

this shows LBBB = wide QRS, QRS down in V1, rabbit ears notched/slurred in V5, V6

 

pt with new onset LBBB and acute chest pain = acute STEMI MI

this is an acute anterior wall MI

38

What does this EKG show?

 

 

Inferior wall MI

ST elevation in V2, V3, aVF

hyperacute phase

reciprocal ST depression/T wave inversion in 1 and aVL substantiate STEMI

39

What does this EKG show?

inferior and RV infarction --> RCA infarct

 

ST elevation in 2, 3, aVF [hyperacute] and in V4%, V5R, V6R

 

40

What does this EKG show?

inferior wall/posterior MI

II, III, aVF ST elevation = inferior wall MI

I and aVL ST depression = reciprocal changes

V1/V2 ST depression --> mirror image of posterior wall -> may signify posterior wall MI

41

What does this EKG show?

 

age-indeterminant inferior wall MI

- III, avF show Q wave = inferior infarction

42

What does this EKG show?

atrial fibrillation

 

-  irregularly irregular R-R interval b/c some P waves transmitted down and some aren't

- fibrillatory waves rather than discrete P waves

43

What does this EKG show?

multifocal atrial tachycardia

 

- atrial tachycardia with 3 or more different P wave morphologies

- irregularly irregular rhythm

44

What does this EKG show?

multifocal atrial tachycardia

 

- atrial tachycardia with > 3 different P wave morphologies

- irregularly irregular rhythm

- rate > 100 bpm

45

What does this EKG show? How should you treat?

supraventricular tachycardia

 

Give adenosine

46

What type of rhythm is this?

supraventricular tachycardia = SVT

47

What type of rhythm is this?

sinus tachycardia

 

P before every WRS and upright in 1 and 2 and inverted in aVR

48

What type of rhythm does this EKG show?

typical atrial flutter

- sometimes 1 or 2 or 3 p waves between each QRS

- irregularly irregular QRS 

- saw tooth pattern P-waves

- typical means upright in II, III, aVF

- distinguish from AFib: clear p wave activity

49

What type of rhythm does this EKG show?

typical atrial flutter

- fast sawtooth p waves

- a few P waves for each QRS

- typical b/c upright in II, III, aVF

50

What type of rhythm does this EKG show?

atypical atrial flutter

- sawtooth p waves

- very distinctive p waves

- atypical = down in II, III, aVF

51

Match each of the following rhythm strips with the following types of rhythms:

 

- multi-focal atrial tachycardia [MAT]

- atrial fibrillation

- atrial flutter

- atrial tachycardia

- AVNRT/AVRT [SVT]

- sinus tachycardia

1 = sinus tachycardia

2 = AVNRT/AVRT = SVT

3 = atrial fibrillation

4 = atrial flutter

5 = atrial tachycardia

6 = multi-focal atrial tacycardia [MAT]

52

What type of rhythm is this?

 

Treatment?

ventricular tachycardia

= fast wide QRS complexes

Treat: synchronized cardioversion

53

What is this rhythm?

ventricular tachycardia with fusion and capture beats mean VT

 

AV dissociation = no real association betwen P and QRS

capture beat = in middle of VT a p wave able to capture a narrow normal QRS

fusion beat = QRS in between supraventricular and ventricular beats

 

54

What rhythm is this? How do you treat?

Ventricular fibrillation

- chaotic irregular deflections

- no P waves or QRS or T

 

treat by defibrillations [not cardioversion]

55

What rhythm is this? How should you treat?

This is a fake fibrillation = an artifact on exam

Not fib because its regular [in fib = irregular] not flutter b/c don't have classic sawtooth pattern in II, III, aVF

 

don't do fibrillation!!

56

What rhythm is this? How should you treat?

This is torsade de pointes

 

treat with IV magnesium

57

What rhythm is this? How do you treat?

WPW with AFib

- broad complex tachycardia

-  irregularly irregular means not VT or VF --> must be AFib

- broad coming down accessory path

- WPW since broad QRS + delta complex pre-excitation = slurred QRS upstroke

Treat = procainamide or pronesta and synchronize cardiovert

58

What does this EKG show?

first degree AV block

- prolonged PR

- each P followed by QRS

- usually constant PR interval

59

What does this EKG show?

Mobitz type I 2nd degree EKG block [wenkebach]

- lots of p waves and irregularly irregular QRS = "group" beating

- progressive prolongation of PR until P fails to conduct

60

What does this EKG show?

second degree AV block mobitz type 2

more dangerous than type 1

lots of extra P waves

3 or more extra p waves for every QRS

no group beating like in wenkebach