Lecture 9: Clinical Cases-ECG Focus

Question 1

What are some things that can cause sinus tachycardia?

Answer 1

Emotion, anxiety, fear, drugs, hyperthryoid, fever, pregnancy, anemia, CHF, hypovolemia

Question 2

If you suspect sinus tachycardia, what should you do?

Answer 2

Look for the cause!

Question 3

Define orthopnea

Answer 3

Difficulty breathing in the supine position

• Want to know if this wakes the pt up at night and how many pillows they have to use to be able to breathe

Question 4

What classifies atrial tachycardia as multifocal?

Answer 4

Multifocal atrial tachycardia = 3 or more different atrial morphologies

Question 5

What are atrial arrhythmias associated with?

Answer 5

Stress, alcohol, tobacco, coffee, COPD and CAD

• Seen in absence of significant heart disease

Question 6

What can cause ventricular rhythm disturbances?

Answer 6

• stress
• hypoxia
• drugs
• Heart failure
• acute MI
• ischemic heart disease
• Cardiomyopathy
• Electrolyte disorder (hypo/hyperkalemia, hypomagnesemia)

Question 7

What is characteristic of the ST segment in a PVC?

Answer 7

Slopes downward opposite of the polarity of the R wave

Question 8

What are S3 gallops indicative of?

Answer 8

Heart failure -> especially in the elderly!

Question 9

What are characeristics of atrial fibrillation on an ECG?

Answer 9

• Atrial rate >350-600/min
• Undulating baseline
• No discernible P waves
• Irregular RR interval -> irregularly irregular ventricular rhythm

Question 10

How do you treat supraventricular tachycardia?

Answer 10

Give adenosine, if it doesnt work then wait a few minutes and give another dose but 2x the amount of the first one, if that still doesnt work then you need to add in a beta blocker or somehing

Question 11

What is claudication?

Answer 11

Walking and having pain iin the extremities -> caused by peripheral vascular disease (PVD)