Myocardial Infarction/ECG

Question 1

What are the limb leads?

Answer 1

I, II, III, AVR, AVL, AVF

Question 2

In what plane do the limb leads show depolarization?

Answer 2

Coronal plane

Question 3

What are the precordial leads?

Answer 3

V1 - V6

Question 4

In what plane do the precordial leads show deplorization?

Answer 4

Transverse (horizontal) plane

Question 5

What is meant by the cardiac axis?

Answer 5

Overall depolarization direction of the heart in the coronal plane

Question 6

What leads do you look at to determine the cardiac axis?

Answer 6

I and AVF

Question 7

If the QRS complex is deflected upward (+), where is the depolarization moving?

Answer 7

Towards lead

Question 8

If the QRS complex is deflected downward (-), where is the depolarization moving?

Answer 8

Away from the lead

Question 9

What is the normal axis?

Answer 9

0-90 degrees

Question 10

How do you plot the cardiac axis?

Answer 10

Take the number of boxes the leads I and AVF QRS complexes move (NET) and graph against each other.

Question 11

Normal axis

Answer 11

(+) Lead I and (+) Lead AVF

Question 12

Left axis

Answer 12

(+) Lead I and (-) Lead AVF

Question 13

(+) lead I and (-) lead AVF

Answer 13

Left axis

Question 14

Right axis

Answer 14

(-) Lead I and (+) Lead AVF

Question 15

(-) lead I and (+) lead AVF

Answer 15

Right axis

Question 16

What are the main symptoms of coronary artery disease/STEMI?

Answer 16

Chest discomfort that radiates to neck, jaw, shoulder, left arm
Sweating, nausea, vomiting, shortness of breath

Question 17

STEMI means the coronary A. is?

Answer 17

Occluded

Question 18

What are the 3 zones of infarction?

Answer 18

1. Ischemia (compromised)
2. Injury (dying tissue)
3. Infarction (dead tissue)

Question 19

With ischemia, what EKG change will be registered?

Answer 19

T wave changes

Question 20

With injury, what EKG change will be registered?

Answer 20

ST segment shifts up or down

Question 21

With infarction, what EKG change will be registered?

Answer 21

Q wave

Question 22

Main cardiac biomarker of necrosis?

Answer 22

Troponin I or T

Question 23

What can cause a false positive cTnT (troponin)?

Answer 23

Renal failure

Question 24

How soon after an acute MI is Troponin detectable?

Answer 24

1-4 hours

Question 25

NSTEMI has ____ ST elevation

Answer 25

NO

Question 26

NSTEMI, changes in troponin levels?

Answer 26

Increase!

Question 27

What changes are seen with a NSTEMI?

Answer 27

T wave inversion because NSTEMI does not cause complete occlusion of the artery

Question 28

STEMI has ST elevation of more than ___ in males

Answer 28

2 mm

Question 29

STEMI has a ST elevation of more than ____ in females

Answer 29

1.5 mm

Question 30

STEMI = complete occlusion of blood flow =

Answer 30

ACUTE MI

Question 31

What leads measure the anterior heart?

Answer 31

V1 - V4

Question 32

What artery supplies the anterior heart?

Answer 32

LAD - anterior interventricular

Question 33

What leads measure the posterior heart?

Answer 33

V1 - V3

Question 34

What artery supplies the posterior heart?

Answer 34

PDA - posterior interventricular

Question 35

What leads measure the inferior heart?

Answer 35

II, III, AVF

Question 36

What artery supplies the inferior heart?

Answer 36

Right coronary A.

Question 37

What leads measure the lateral heart?

Answer 37

I, AVL, V5, V6

Question 38

What artery supplies the lateral heart?

Answer 38

Circumflex

Question 39

What will you need to do in order to see ST segment elevation with a posterior infarction?

Answer 39

FLIP the EKG

Question 40

What classifies a sinus rhythm?

Answer 40

P wave before every QRS complex

Question 41

HR > 100 with p wave before every QRS

Answer 41

Sinus Tachycardia

Question 42

HR < 60 with p wave before every QRS

Answer 42

Sinus Bradycardia

Question 43

Ectopic beats

Answer 43

Cardiac depolarization originates from a place other than the normal pathway

Question 44

Premature Atrial Contraction looks like what on an EKG?

Answer 44

Normal, then a random weird looking P wave with a pause longer than normal after it

Question 45

Premature Ventricular Contraction looks like what on an EKG?

Answer 45

Weird, random QRS complex

Question 46

Where is the beat with a Premature Atrial Contraction (PAC)?

Answer 46

Ectopic foci in atria

Question 47

Where is the beat with a Premature Ventricular Contraction (PVC)?

Answer 47

Ectopic foci in the ventricles

Question 48

Can you have multiple ectopic foci?

Answer 48

YES, waves will look different

Question 49

Bigeminy

Answer 49

Every other beat is a PVC

Question 50

Trigeminy

Answer 50

Every third beat is a PVC

Question 51

Ventricular Tachycardia (VTACH)

Answer 51

Sudden, rapid ventricular foci paces rapidly | - sustained, nonsustained or pulseless

Question 52

How does Ventricular Tachycardia look on an EKG?

Answer 52

WIDE QRS complex!!

Question 53

Supraventricular Tachycardia (SVT)

Answer 53

Rapid atrial foci paces rapidly

Question 54

How does Supraventricular Tachycardia look on an EKG?

Answer 54

P wave likely hidden behind T wave | NARROW QRS complex!!

Question 55

Atrial Fibrilation, what is it and how is it described?

Answer 55

Chaotic quivering in atria - IRREGULARLY IRREGULAR

Question 56

How does Atrial Fibrilation look on an EKG?

Answer 56

Undulating baseline No discernible P waves IRREGULAR R-R interval!

Question 57

AV blocks

Answer 57

Any conduction block between SA node and Purkinje fibers

Question 58

1st degree AV block

Answer 58

PR Interval > 0.2 seconds

Question 59

With 1st degree AV block, what measurement on the EKG can you use to diagnose?

Answer 59

PR interval is longer than 1 big box

Question 60

What are the 2 types of 2nd degree AV block?

Answer 60

1. Mobitz type 1 (wenkebach) | 2. Mobitz type 2

Question 61

Mobitz Type 1 (wenkebach)

Answer 61

2nd Degree AV block | - Progressively lengthening PR intervals until 1 QRS complex fails

Question 62

Mobitz Type 2

Answer 62

2nd Degree AV block | - NO change in PR intervals but still a sudden QRS complex fail

Question 63

3rd degree AV block

Answer 63

NO atrial impulses conduct to the ventricles | = Atria and ventricles are depolarizing completely INDEPENDENT of each other!

Question 64

Do PR intervals lengthen with Mobitz Type 2, second degree AV block?

Answer 64

NO

Question 65

Do PR intervals lengthen with Mobitz Type 1, second degree AV block?

Answer 65

YES