W2: ECG Interpretation

Question 1

Acute Coronary Syndrome Conditions

Answer 1

Unstable Angina
NSTEMI
STEMI

Question 2

ACS MOA

Answer 2

coronary obstruction caused by rupture atehrosclerosis plaques. = clots

Question 3

mild/brief ischemia leads to __

Answer 3

angina

Question 4

prolonged ischemia leads to ___

Answer 4

MI

changes in ECG
release of cardiac enzymes

Question 5

degree of ischemia is determined by

Answer 5

degree of occlusion
oxygen demand of myocardium

Question 6

arterial occulusion signifance at ___ %

Answer 6

70

Question 7

rupture of plaques –> thrombus =

Answer 7

dec lumen and dec BF

Question 8

Unstable Angina

Answer 8

form of ACS (NSTEMI)

transient episodes of thrombotic vessel occlusion and vasoconstriction at site of plaque damage

sign of impending MI

Question 9

UA: diagnostic results

Answer 9

ST depresison
T wave inversion

Question 10

Types of MI’s

Answer 10

subdenocardial infarction (NSTEMI)
transmural infarction (STEMI)

Question 11

Subdenocardial Infarction

Answer 11

thrombus disintegrates before full distal tissue necrosis

involves only the myocardium directly below the endocardiu
- partial wall thickness damage

ST depression
T wave inversion (w/o st elevation)

Question 12

Transmural Infarction

Answer 12

thrombus lodges permanently in vessel

infarction extends from myocardium to endocardium to epicardium (full wall thickness damage)

need intervention!!!!

Question 13

A Fib: Patho

Answer 13

rapidly firing action potentials in the atrial myocardium d/t myocardial remodelling (HTN, valvular/ischemic disease, genetics)

irregular rapid HR - poor blood flow

Question 14

AFib: ECG

Answer 14

absent p waves
irregular R-R intervals
fibrillatory waves
high ventricle rate (400-600bpm)

Question 15

AFib: Hemodynamics

Answer 15

inc risk for stroke
HF

Question 16

Atrial Flutter: Patho

Answer 16

atrias contract rapidly (not all conduct to ventricles)

ventricle response varies

rapid regular rhythm

should suspect Atrial flutter in anyone with a resting HR >150

Question 17

Atrial Flutter: ECG

Answer 17

sawtooth flutter at regular rate

Question 18

Atrial Flutter: Hemodynamics

Answer 18

inc HR = cardiac insuffiency

Question 19

Premature Arterial Cx (PACs): Patho

Answer 19

depolarization insitgated outside the SA node (early heartbeat initiated by atria)

Question 20

PACs: ECG

Answer 20

premature + abnormal p wave

normal QRS complex

compensatory pause (artirial bigeminy)

Question 21

PACs: Hemodynamics

Answer 21

benign but disrupted cardiac rhythm

Question 22

PVCs: patho

Answer 22

venticles generate action potential before SA node ( early heartbeat initated by the ventricles)

Question 23

PVCs: ECG

Answer 23

no p wave
wide/abnormal QRS
irregular R-R Interval
compensatory pause (skipping a beat)

Question 24

PVC: Hemodynamics

Answer 24

benign, palpitations

Question 25

VTach: Patho

Answer 25

rapid heartbeats from ventricles ventricle rate >100bpm common in people with structural heart disease

Question 26

VTach: ECG

Answer 26

regular rhythm no p wave wide and abnormal QRS

Question 27

VTach: Hmeodynamics

Answer 27

hemodynamic instability - hypotension- life threatning (emergency!!!!!!)

Question 28

VTach: monomorphic

Answer 28

same shape/symmetry of QRS b/c start in same place in myocardium

Question 29

VTach: polymorphic

Answer 29

variable QRS b/c depolarization at multiple points

Question 30

Vfib: Patho

Answer 30

disorganzied contraction of ventricle muscle fibres d/t CAD, MI (ischemia, scarring). tissue damage creates reentry patterns --> chaotic depolarizations

Question 31

VFib: ECG

Answer 31

no identifiable waves or complexes

Question 32

VFib: hemodynamics

Answer 32

extremely compromised CO, low chance of survival outside of hospital

Question 33

First Degree Block: overview

Answer 33

results from slow action potential conduction through AV node d/t damage diease causing changes in structure/vagal tone. takes a min, but all impulses get through asymptomatic, no tx

Question 34

First Degree Block: ECG

Answer 34

prolonged PR interval (>0.2s)

Question 35

Second Degree Block: Overview

Answer 35

changes in PR interval, >0.2s some impulses don't reach ventriclesS

Question 36

Second Degree Block: ECG

Answer 36

some p waves not followed by QRS complex

Question 37

SDB: Mobits I

Answer 37

PR interval increases until no QRS complex pause cycle repeats benign, low vagal tone

Question 38

SBD: Mobitz II

Answer 38

blocked P wave PR Interval constant issues with bundle brances tx: pacemaker

Question 39

Third Degree (Complete Block)

Answer 39

complete block, no atrial impulses to ventricle. must generate on impulses to survive. AV disassociation. No P wave have QRS complexes atrial rate > ventricular rate d/t ischemia, disease CM: LOC, dizziness tx: pacemaker

Question 40

Amiodarone: MOA

Answer 40

blocks potassium + sodium channels and beta-adrenergic + calcium channels --> dec HR and resistance

Question 41

Amiodarone: Indication

Answer 41

VTach Atrial dysrythmmias PVCs AFib/Flutter

Question 42

Amiodarone: DE

Answer 42

cardiac stabiliy normal heart rhyth, increased VF threshold

Question 43

Amiodarone: AE

Answer 43

thyroid d/o liver toxicity drug interaction bradycardia pulmonary fibrosis hypotension QT prolongation cyanosis photosensitivity rashes fatigue