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5EKG
tiny details
| Question | Answer |
|---|---|
| 1 big box is how many seconds? | .2s |
| 1 small box is how many seconds? | .04s |
| 1 big box has how many little boxes ? | 5 |
| PR interval is how long and how many boxes? | .12-.2 s and 3-5 little boxes |
| Name two short PR interval diseases | Wolf Parkinson White (WPW) and Lang-Ganong-Levine (LGL) |
| What’s WPW | short PR; young adult’s bundle of kent when high catecholamines; delta wave encroaches |
| What’s LGL? | short PR; in James bundle |
| What is a long PR interval? | AV nodal blocks |
| How long is the QRS interval? | .4-.12 seconds |
| What are wide QRS pathologies? | vent. Tachycardia, L/R BBB |
| QT interval is how long? | .3-.4 s |
| Describe the limb leads (Einth. frontal p): angle, and degree and + vs - | 1RA-LA+ 0; 2RA-RF+ 60; 3LA-LF+120 |
| Describe Augmented leads: | Unipolar leads; AVR-150,AVL -30, AVF +90 Frontal plane too |
| Describe V leads | aka Precordial leads v1-6; horizontal plane; R wave progression |
| What are the anterior leads and what pathologies do they look at? | V3 and V4; LAD |
| What are the lateral leads and what do they look at? | I, V5, V6; Lcx |
| What are the septal leads and what do they look at? | v1&V2; septal branch of LAD |
| What are the inferior leads and what do they do? | II, III, avF; RCA |
| What is the normal sinus rhythm between? | 60-100 bpm |
| Asdf | asdf |
| Atrial Flutter has what rate and what pattern? | 250-350; sawtooth |
| List some common atrial cell problems | PAC, atrial flutter, atrial fibrillation |
| What are AV junctional problems? | Paroxysmal supraventricular tachycardia, AV junctional (nodal blcks |
| What is lost in paroxysmal supraventricular tachycardia? | P waves (there’s continuous firing here) |
| What are ventricular cell problems? | PVCs, ventricular fib, ventricular tachycardia, v fib, torsades de pt. |
| Which ventricular cell problems fire from multiple foci? | Ventricular fib, sometimes PVCS, |
| QT interval should be what in relation to RR interval | Half of RR interval |
| PR interval should be what if normal? | less than .2 |
| If PR interval is greater than .2 what might this indicate? | 1st degree AV block via prlonged conduction delay@ B of His |
| What’s 2nd AV blockI | winkiblock-PR interval progressively increases and then stops: P & no QRS: AV n. delays then fails |
| What’s 2nd AV block II? | P wave & no QRS; PR interval the same the whole time; Block in bundle of His |
| What’s 3rd AV block? | atria and ventricles don’t communicate-need pacemaker, P wave blocked, 30-45 bpm |
| ST segement elevation indicates what pathology? | Acute MI Q wave; transmural infarction |
| J point is what? | junction btw S and T waves: isoelectric |
| Which leads are inferior? | II, III, AVF |
| Which leads are lateral? | I, avL, V4-V6 |
| Anterior leads are? | V2-V4 |
| How do you determine posterior infarction? | R >S V1, V2, V3 and ST segment depression in those leads |
| How low is the heart rate in RCA occlusion? | less than 60bpm |
| What is an ST segment depression? | myocardial ischemia |
| What’s nonST elevation MI? | Non-q wave MI-subendocardial infarc. w/EKG changes w/time-ST depression=nonspecific |
| What is fibrosis distinguished by? | ST segments and T waves go back to normal but there are still Q waves |
| What is a T wave inversion indicative of? | And what is this called? |
| Time and amplitude of a normal Q wave are what? | < . 04 seconds & <25% amplitude of R wave |
| L ventricular hypertrophy identified by? | R wave in I + S in lead III> 25mm or tallest R in V5/6+deepest S in V1/2=35mm> |
| How is R Ven Hypertrophy ided? | V1 has r-s ratio >1 or R>5mm and S<2mm |
| R Atrial Enlarg. is dxed how? | II has P>2.5mm or V1 or V2 has a P wave of >1.5mm |
| PR interval should be what if normal? | less than .2 |
| If PR interval is greater than .2 what might this indicate? | 1st degree AV block via prlonged conduction delay@ B of His |
| What’s 2nd AV blockI | winkiblock-PR interval progressively increases and then stops: P & no QRS: AV n. delays then fails |
| What’s 2nd AV block II? | P wave & no QRS; PR interval the same the whole time; Block in bundle of His |
| What’s 3rd AV block? | atria and ventricles don’t communicate-need pacemaker, P wave blocked, 30-45 bpm |
| ST segement elevation indicates what pathology? | Acute MI Q wave; transmural infarction |
| J point is what? | junction btw S and T waves: isoelectric |
| Which leads are inferior? | II, III, AVF |
| Which leads are lateral? | I, avL, V4-V6 |
| Anterior leads are? | V2-V4 |
| How do you determine posterior infarction? | R >S V1, V2, V3 and ST segment depression in those leads |
| How low is the heart rate in RCA occlusion? | less than 60bpm |
| What is an ST segment depression? | myocardial ischemia |
| What’s nonST elevation MI? | Non-q wave MI-subendocardial infarc. w/EKG changes w/time-ST depression=nonspecific |
| What is fibrosis distinguished by? | ST segments and T waves go back to normal but there are still Q waves |
| What is a T wave inversion indicative of? | And what is this called? |
| Time and amplitude of a normal Q wave are what? | < . 04 seconds & <25% amplitude of R wave |
| L ventricular hypertrophy identified by? | R wave in I + S in lead III> 25mm or tallest R in V5/6+deepest S in V1/2=35mm> |
| How is R Ven Hypertrophy ided? | V1 has r-s ratio >1 or R>5mm and S<2mm |
| R Atrial Enlarg. is dxed how? | II has P>2.5mm or V1 or V2 has a P wave of >1.5mm |
| Wandering pacemaker | # SA node to atrial foci; normal rate, but irregular P waves |
| Multifocal atrial tachycardia | #COPD patients rate >100 with irregular P waves (similar to wandering pacemaker) |
| Junctional Escape rhythm | #series of lone QRS complexes 60-80bpm; inverted P waves |
| Atrial escape rhythyms | P waves aren’t identical to the P wave before anymore: Paces 40-60 bpm |
| Ventricular escape rhythm | enormous QRS complexes 20-40 bpm; pt is unconscious: stokes-adams syndrome |
| Escape beat | transient focus escape; similar pattern |
| Premature beats | earlier than expected; |
| Atrial bigeminy | irregular P wave every other cycle |
| Atrial trigeminy | irregular P wave every third cycle |
| Premature ventricular Contraction (PVC) | have huge ventricular complex: opposite of QRS think coronary block; cocaine |
| V-tach | three or more PVCs in rapid succession |
| PR interval should be what if normal? | less than .2 |
| If PR interval is greater than .2 what might this indicate? | 1st degree AV block via prlonged conduction delay@ B of His |
| What’s 2nd AV blockI | winkiblock-PR interval progressively increases and then stops: P & no QRS: AV n. delays then fails |
| What’s 2nd AV block II? | P wave & no QRS; PR interval the same the whole time; Block in bundle of His |
| What’s 3rd AV block? | atria and ventricles don’t communicate-need pacemaker, P wave blocked, 30-45 bpm |
| ST segement elevation indicates what pathology? | Acute MI Q wave; transmural infarction |
| J point is what? | junction btw S and T waves: isoelectric |
| Which leads are inferior? | II, III, AVF |
| Which leads are lateral? | I, avL, V4-V6 |
| Anterior leads are? | V2-V4 |
| How do you determine posterior infarction? | R >S V1, V2, V3 and ST segment depression in those leads |
| How low is the heart rate in RCA occlusion? | less than 60bpm |
| What is an ST segment depression? | myocardial ischemia |
| What’s nonST elevation MI? | Non-q wave MI-subendocardial infarc. w/EKG changes w/time-ST depression=nonspecific |
| What is fibrosis distinguished by? | ST segments and T waves go back to normal but there are still Q waves |
| What is a T wave inversion indicative of? | And what is this called? |
| Time and amplitude of a normal Q wave are what? | < . 04 seconds & <25% amplitude of R wave |
| L ventricular hypertrophy identified by? | R wave in I + S in lead III> 25mm or tallest R in V5/6+deepest S in V1/2=35mm> |
| How is R Ven Hypertrophy ided? | V1 has r-s ratio >1 or R>5mm and S<2mm |
| R Atrial Enlarg. is dxed how? | Tall P waves in II, III, and avF; II has P>2.5mm or V1 or V2 has a P wave of >1.5mm |
| Causes of Right atrial enlarge | Pulmonary htn; copd, RVH |
| L atrial enlargement | Notching in II >1 box; (-) deflection of P in V1-> 1 box wide and 1 box deep |
| Causes of LAE? | from LVH via HTN |
| BBB are what ? | Intraventricular conduction delays which manifest as long QRS |
| What do BBB look like? | 2 R waves R and R’bunny ears |
| Where are the R waves in R and L BBB? | V1 R and V6 L |
| What form can RBBB have? | RSR’ and R-R’ |
| What is the length of complete BBB? | >.12 |
Created by:
VCOM2013
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