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MED239 EKG
MED239 EKG GLOSSARY
| Term | Definition |
|---|---|
| action potential | The change in the electrical potential of the heart muscle when it is stimulated. |
| acute coronary syndrome (ACS) | This is a broad term that refers to unstable angina, ST segment elevation MI (STEMI), and non-ST segment elevation MI (NSTEMI). ACS is usually associated with intracoronary plaque changes or thrombosis, where blood flow is suddenly stopped. |
| advanced cardiac life support (ACLS) | A set of clinical interventions for the urgent treatment of cardiac arrest and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions. |
| alternating current (AC) interference | Unwanted markings on the ECG caused by other electrical current sources. |
| ambulate | To walk; ambulating is walking. |
| ambulatory monitoring | The process of recording an ECG tracing for an extended period of time while a patient goes about their daily activities. |
| anatomically contiguous lead | Two or more leads looking at the same part of the heart, or numerically consecutive chest leads. |
| angina | An oppressive pain or pressure that occurs in the chest when the heart muscle does not receive enough oxygen due to partial or complete blockage of a coronary artery. |
| angioplasty | A minimally invasive procedure performed to open narrowed or blocked blood vessels. |
| angle of Louis | A ridge about an inch or so below the suprasternal notch where the main part of the sternum and the top of the sternum, known as the manubrium, are attached. |
| anomaly | Something that deviates from what is standard, normal, or expected. |
| anorexia | Decreased or loss of appetite. |
| anterior axillary line | An imaginary vertical line starting at the front axilla that extends down the left side of the chest. |
| antidysrhythmic | Type of medication given to prevent cardiac rhythm abnormalities. Also known as antiarrhythmic. |
| aorta | The largest artery of the body; transports blood from the left ventricle of the heart to the entire body. |
| aortic semilunar valve | A valve located in the aorta that prevents the backflow of blood into the left ventricle. |
| apnea | The absence of breathing. |
| artifact | Unwanted marks on the ECG tracing caused by activity other than the heart's electrical activity. |
| ascites | Abnormal collection of serous fluid within the abdomen (peritoneal cavity). This may occur secondary to congestive heart failure. |
| asystole | A condition in which no rhythm or electrical current is traveling through the cardiac conduction system. |
| atherosclerotic plaque | Fatty deposits accumulated due to elevated glucose levels. |
| atrial kick | Blood that is ejected into the ventricles by the atria before ventricular contraction. Atrial kick contributes a 10%-30% increase in cardiac output. |
| atrial pacing | Electrical stimulation is delivered to the atria to cause conduction from the AV node through the ventricles resulting in ventricular contraction. |
| atriobiventricular pacing | A sequential pacemaker stimulation of the atria and then both ventricles, rather than just the right ventricle. Also known as biventricular pacing. |
| atrioventricular (AV) node | Delays the electrical impulse to allow the atria to complete their contraction. |
| atrioventricular delay | The measurement from the atrial spike to the ventricular spike, or from the beginning of the P wave to the ventricular spike on a pacemaker tracing. |
| atrioventricular sequential pacing | A pacemaker stimulation of the atria and then the lower part of the right ventricle in a sequence that mimics the normal cardiac conduction system and allows for atrial kick. |
| atrium (pl. atria) | Top two chambers of the heart. |
| augmented leads | Normally small ECG lead tracings that are increased in size by the ECG machine in order to be interpreted. |
| auscultated blood pressure | Blood pressure determined while listening with a stethoscope. |
| automatic external defibrillator (AED) | A lightweight, portable device that recognizes abnormal rhythm and determines if the rhythm is considered a “shockable rhythm.” |
| automaticity | The ability of the heart to initiate an electrical impulse without being stimulated by an independent source. |
| AV junction | The AV node and surrounding tissue, including the bundle of His. |
| axis deviation | Changes that occur on a 12-lead ECG due to the orientation or position of the heart within the chest. |
| Bachmann's bundle | The structure that relays the electrical impulse from the SA node to the left atrium in a normal heart. |
| beta blockers | Drugs used to treat hypertension. |
| bigeminy | Pattern in which every other complex is a premature beat (PVC). |
| biphasic | A waveform that has positive (upward) and negative (downward) deflections (phases) on the ECG tracing. When both deflections are approximately equal, a biphasic waveform is said to be equiphasic. |
| bipolar lead | A type of ECG lead that measures the flow of electrical current in both directions at the same time. |
| blocked or nonconducted impulse | Impulse occurs too soon after the preceding impulse, causing a period when no other impulses can occur in the ventricles. |
| body mechanics | Using movements that maintain proper posture and avoid muscle and bone injuries. |
| bolus | A concentrated amount of medication or fluid based upon body weight to be administered over a prescribed short period of time. |
| bundle branch block (BBB) | The electrical impulses that control the heartbeat cannot move properly throughout the heart (ventricles specifically). A block in the branches causes the impulses (within the ventricles) to travel slower than normal. |
| bundle branches | Left and right branches of the bundle of His that conduct impulses down either side of the interventricular septum to the left and right ventricles. |
| bundle of His (atrioventricular or AV bundle) | Located next to the AV node; provides the transfer of the electrical impulse from the atria to the ventricles. |
| cardiac cycle | The contraction and relaxation of the heart. |
| cardiac enzymes (cardiac markers or cardiac biomarkers) | Chemicals found in the bloodstream that are indicators of myocardial cell death (infarction). Common examples include troponin, CK-MB, and myoglobin. |
| cardiac output | The volume of blood the heart pumps each minute. |
| cardiac output parameters | Observation guidelines used to assess the blood supply to the vital organs of the body to maintain normal function includes measurements such as blood pressure, pulse, respirations, and blood oxygen saturation (SpO2). |
| cardiogenic shock | Inadequate flow of arterial blood, typically as a result of left heart failure. |
| cardiologist | A physician who specializes in the study of the heart. |
| cardiopulmonary resuscitation (CPR) | The provision of ventilations (breaths) and chest compressions (blood circulation) for a person who shows no signs of breathing or having a heartbeat. |
| cardiovascular disease (CVD) | Disease related to the heart and blood vessels (veins and arteries). |
| cardiovascular technologist | An individual who has advanced skills and can assist physicians with invasive cardiovascular diagnostic tests and procedures, such as angioplasty or cardiac device implants. |
| cerebrovascular accident (CVA; brain attack, stroke) | A stroke. Caused by a hemorrhage in the brain or more often by a clot lodged in a cerebral artery. |
| chemical stress echocardiogram | A stress echocardiogram in which the heart is stressed by chemicals, rather than physical exercise. |
| chemical stress test | Stress test performed after administering medications that cause the heart rate to increase or the coronary blood vessels to dilate; performed on patients who cannot perform the exercise required in a regular stress test. |
| chordae tendineae | Structures that connect the atrioventricular (tricuspid and mitral) valves to the papillary muscles and prevent them from opening in the wrong direction. |
| circumflex artery | One of the primary branches of the left coronary artery, which winds around, supplying blood to the lateral wall of the left ventricle. |
| Code Blue | A code blue indicates a medical emergency such as cardiac or respiratory arrest and notifies healthcare providers that assistance is needed immediately. |
| collateral blood vessels | Small blood vessels that develop forming a natural bypass to a region of tissue. |
| complex | Atrial or ventricular contractions as they appear on the ECG; complete ECG waveforms. |
| conductivity | The ability of the heart cells to receive and transmit an electrical impulse. |
| congestive heart failure (CHF) | Failure of the heart to pump an adequate amount of blood to the body tissues. Includes symptoms of shortness of breath (SOB), edema, pale skin, increased respiratory rate, and potential frothy sputum. |
| contractility | The ability of the heart muscle cells to shorten in response to an electrical stimulus. |
| coronary angiography | An X-ray visualization of the coronary vessels after a radiopaque dye is injected into the patient. |
| coronary artery bypass graft (CABG) surgery | Surgical intervention performed by taking a grafted or transplanted blood vessel and attaching it to the heart at a point beyond an occluded coronary artery to reestablish blood flow. |
| coronary artery disease (CAD) | Narrowing of the coronary blood vessels (arteries of the heart), causing a reduction in blood flow to the heart. |
| coronary circulation | The circulation of blood to and from the heart muscle. |
| coronary sinus | An area located on the back of the heart where the left atrium and left ventricle come together called the sulcus (groove). This structure is where the coronary veins return blood from the heart itself to the circulating blood in the right atrium. |
| coupling | Two PVCs that occur back to back. |
| crash cart | A cart or tray containing emergency medication and equipment that can be easily transported to the location of an emergency for life support. |
| defibrillator | A machine that produces and sends an electrical shock to the heart in an attempt to correct the electrical pattern of the heart. |
| delta wave | A widening at the beginning of the QRS complex due to ventricular pre-excitation. |
| deoxygenated blood | Blood that has little or minimal oxygen (oxygen-poor blood). |
| depolarization | The electrical activation of the cells of the heart that initiates contraction of the heart muscle. |
| dextrocardia | When the heart is on the opposite or right side of the chest. |
| diagonal artery | A branch of the left anterior descending artery that supplies blood to the anterior and lateral wall of the lower left ventricle. |
| diastole | The phase of the cardiac cycle when the heart is expanding and refilling; also known as the relaxation phase. |
| diastolic blood pressure | The blood pressure measured when the heart relaxes, representing the minimum amount of pressure exerted against the vessel walls at all times; the number corresponding to the last Korotkoff sound heard when performing an auscultated blood pressure. |
| dissociative | Not related at all; the atria and the ventricles beat entirely independently of each other. |
| dysrhythmia | Abnormal heartbeat. |
| ECG monitor (telemetry) technician | An individual who has the technical knowledge and skills to view and evaluate the electrical tracings of patients' hearts on an oscilloscope and, when necessary, alert the appropriate healthcare professional to treat abnormalities. |
| echocardiogram | Noninvasive diagnostic test that uses sound to study the heart, heart valves, and blood vessels. |
| ectopic foci | Abnormal cells that cause electrical impulses in the heart. |
| ectopic impulse | An electrical impulse that comes from outside of the normal pacemaker site or electrical conduction pathway. |
| Einthoven's triangle | A triangle formed by three of the limb electrodes—the left arm, the right arm, and the left leg; it is used as a reference for the first six leads of the 12-lead ECG. |
| electrical capture | Evidence of the heart's activity on an ECG tracing, including the spacing of spikes and waveforms. |
| electrocardiogram (ECG) | A tracing of the heart's electrical activity recorded by an electrocardiograph. |
| electrocardiograph | An instrument used to record the electrical activity of the heart. |
| electrocardiograph (ECG) technician | An individual who has the technical skills and knowledge to record an ECG and prepare it for the physician. |
| electrodes | Small sensors placed on the skin to detect the electrical activity from the heart. |
| electronic pacemaker | An artificial source of electrical current causing depolarization of the myocardium; artificial pacemakers are electronic. |
| embolism | A traveling blood clot. |
| enhanced external counter pulsation (EECP) | Treatment for chronic angina patients who do not have other options due to health status. This procedure is performed 6 days a week for several weeks, with the intent of developing collateral blood vessels—essentially creating a “natural” bypass around narrowed or blocked arteries. |
| ethics | Standards of behavior and concepts of right and wrong. |
| event monitor | An event monitor is a battery-powered portable device that the patient controls to record the heart's electrical activity (ECG) when symptoms occur. |
| excitability | The ability of the heart muscle cells to respond to an impulse or stimulus; also called irritability. |
| false positive | When a diagnostic test indicates that disease is present but, in reality, no disease is present. A false positive is never considered a negative result. It is a positive result, albeit a falsely positive one. |
| fibrinolytic agent | Medications administered to break down the fibrin in a blood clot, essentially dissolving it. |
| filtering facepiece respiratory (FFR) | Specialized PPE mask to be worn when caring for patients with or with the potential for respiratory illnesses or contagious diseases. |
| focus (pl. foci) | A cardiac cell or group of cells that produces an ectopic beat; cells that are notably different or abnormal in some manner. |
| frequent PVC | Six or more PVCs per minute. |
| gain | A control on the ECG machine that increases or decreases the size of the deflections on the ECG tracing. |
| gamma camera | A camera that records the gamma radiation emitted by the radioactive tracers in a patient's blood. |
| gate | A selective technique in which a gamma camera is triggered by specific events captured by a three-lead ECG monitor. |
| healthcare provider | The scope of practice of each healthcare provider will determine the extent of the interpretation and treatment of each of the cardiac dysrhythmias or conditions. Each specific scope is determined by the licensure of each state. For example: Prescribing a medication is the responsibility of the physician. But some state practices allow nurse practitioners and physician assistants to prescribe medication under the guidance of the physician. |
| hertz (Hz) | A unit of frequency measured in cycles (or events) per second. |
| Holter monitor | An instrument that records the electrical activity of the heart during a patient's normal daily activities; also known as an ambulatory monitor. |
| hypercoagulopathy | An increased ability of the blood to form clots. |
| hypertension | High blood pressure. |
| hypertrophy | Abnormal thickening of the ventricular wall due to chronic pressure overload; often caused by hypertension. |
| hyperventilation | To breathe at an increased rate and depth of inspiration and expiration. |
| hypotension | A lower than normal blood pressure that can cause reduction of blood flow to vital organs. |
| inherent rhythm | The patient's own heart rhythm. |
| input | Data entered into an ECG machine, usually through electrodes on the skin surface. |
| interatrial septum | A wall of tissue that separates the left and right atria of the heart. |
| intercostal space (ICS) | The space between two ribs. |
| interpolated PVC | A PVC that occurs during the normal R-R interval without interrupting the underlying rhythm. |
| interrupted baseline | When one or more leads appear as a flat line on the ECG tracing. Usually caused by loose or unplugged leads. |
| interval | The period of time between two activities within the heart. |
| interventricular septum | A partition or wall (septum) that divides the right and left ventricles. |
| ischemia | A sudden loss or reduction in blood supply (oxygen) to a region of the heart tissue. This occurs due to the presence of atherosclerotic plaque, blood clot, emboli, or even vascular spasm (Prinzmetal's angina). |
| isoelectric line | The period when the electrical tracing of the ECG is at zero or a straight line, and no positive or negative deflections are seen. |
| isolation precautions | The second level of steps taken to prevent the spread of infection; some examples include separating the infected patient from others and using personal protective equipment. |
| IV fluid challenge | Administration of IV fluid (i.e., 0.9% NaCl) to offset the effect of administered medication or to treat for hypovolemia. Often referred to as a fluid resuscitation. |
| J point | A point on the QRS complex where the depolarization is completed and repolarization starts. |
| junctional escape rhythm | A rhythm that occurs when the SA node fails to initiate the electrical activity and one of the backup pacemaker sites takes over. |
| law | Rules of conduct enforced by a controlling authority such as the government. |
| leads | Covered wires that conduct the electrical impulse from the electrodes to the ECG machine. |
| left anterior descending artery | One of the primary branches of the left main coronary artery supplying blood to the anterior wall of the left ventricle. |
| left atrium | The left upper chamber of the heart, which receives blood from the lungs. |
| left bundle branch block (LBBB) | Blockage of the left bundle branch, so that the current has to travel down the right bundle branch to stimulate first the right ventricle, then the septum, and then the left ventricle. |
| left ventricle | The left lower chamber of the heart, which pumps oxygenated blood through the body. It is the biggest and strongest chamber, known as the workhorse of the heart. |
| left ventricular assist device (LVAD) | A mechanical, battery-powered device that is surgically implanted in a patient's chest to help the left ventricle pump blood throughout the body. |
| Levine sign | Named after a cardiologist this sign is seen with ischemic heart pain. It is demonstrated in patients through holding a clenched fist over the chest. |
| libel | Writing defamatory words about someone; this is both illegal and unethical. |
| limb lead | An ECG lead placed on an arm or a leg. |
| loop-memory monitor | A cardiac monitor that can hold up to 5 minutes of an ECG tracing and can provide the physician with an ECG tracing of the heart before, during, and after an episode or cardiac event. |
| loss of capture | The pacing activity continues to occur without evidence that the electrical activity has depolarized or captured the myocardium. Also called failure to depolarize. |
| malfunctioning | Failure of a pacemaker to send electrical impulses to the myocardium; also called failure to pace. |
| malsensing | The pacemaker does not recognize or sense the patient's own inherent cardiac electrical activity; also called failure to sense. |
| marginal artery | The branch of the right coronary artery that supplies the walls of the right atrium and the right ventricle. |
| maximal exercise | Target heart rate of 220 minus the age of the patient. |
| mechanical capture | The heart's ability to respond to electrical impulses delivered by a natural or electronic pacemaker. |
| medical professional liability | Legal responsibility of healthcare professionals for their performance. |
| midaxillary line | An imaginary vertical line that starts at the middle of the axilla (armpit) and extends down the side of the chest. |
| midclavicular line | An imaginary line on the chest that runs vertically through the center of the clavicle. |
| midscapular line | Imaginary line on the back that runs vertically through the center of the scapula. |
| millimeter (mm) | A unit of measurement to indicate time on the ECG tracing. Time is measured on the horizontal axis. |
| millivolt (mV) | A unit of measurement to indicate voltage on the ECG tracing. Voltage is measured on the vertical axis. |
| mitral (bicuspid) valve | Valve with two cusps or leaflets located between the left atrium and left ventricle; it prevents backflow of blood into the left atrium. |
| mobile cardiac outpatient telemetry (MCOT) | Telemetry that uses a small, portable monitor that automatically sends data when a cardiac anomaly is detected. They can hold up to 96 hours of data as well, allowing licensed practitioners to capture significant events even when no symptoms are experienced. |
| morphology | Overall form and structure (shape). |
| multichannel recorder | An ECG machine that monitors all 12 leads but records three leads at a time and switches leads automatically, recording each of the four sets of three leads. |
| multifocal PVC | Varied shapes and forms of the PVCs, suggesting more than one irritable focus. |
| myocardial | Pertaining to the heart (cardia) muscle (myo). |
| myocardial infarction (MI) (heart attack) | Occlusion (blockage) of one or more of the coronary arteries causing lack of oxygen to the heart and death of the muscle tissue. |
| myocardial injury | Injury to the cardiac muscle caused by prolonged reduction or interruption of blood flow. |
| myocardial ischemia | A reduction or interruption in blood flow and oxygen to the myocardium for a short period of time. |
| neurological | Pertaining to the nervous system, its diseases, and its functions. |
| neuropathy | Nerve damage that causes vascular and autonomic nervous system problems, with loss of ability to maintain blood pressure and loss or impaired sensation. Common cause is chronic diabetes mellitus. |
| non-ST segment elevation MI (NSTEMI) | A type of heart attack in which the classic signs are not present. Caused by incomplete occlusion of a coronary artery. |
| noninvasive | Procedure that does not require entrance into a body cavity, tissue, or blood vessel. |
| nuclear stress test | A stress test in which radionuclides (radioactive tracers) are administered to trace the path of blood through the heart. |
| occasional PVC | Less than six PVCs per minute. |
| output display | The part of the ECG machine that displays the tracing for the electrical activity of the heart, usually in an electronic or printed form on a 12-lead ECG machine. |
| oversensing | The pacemaker senses electrical current from other muscle movements or electrical activity outside of the body as the electrical current in the patient's heart. |
| oxygenated blood | Blood having oxygen (oxygen-rich blood). |
| pacemaker competition | Competition between the pacemaker generator and the heart's inherent rate over control of the myocardium. |
| pacing spike | A thin spike on the ECG tracing that results from the pacemaker stimulation impulse. |
| pallor | Pale skin. |
| palpitations | Rapid irregular beating of the heart which may or may not be associated with complaints of chest pain. |
| papillary muscles | Muscles in the ventricles that anchor the chordae tendineae and atrioventricular valves. |
| paraspinous line | Imaginary line on the spine that runs vertically through the side of the spine. |
| parasympathetic | The branch of the autonomic nervous system (ANS) that helps to slow the heart rate. |
| paroxysmal event | Witnessed change in any cardiac rhythm, including starting, stopping, or both. |
| pathologic Q wave | A Q wave that measures 0.04 second or wider in duration and/or is one-third or more the height of the R wave in that lead. |
| pericardium | A two-layered sac of tissue enclosing the heart. |
| personal protective equipment (PPE) | Devices such as gloves, gowns, face masks or shields, and eye protection designed to protect a healthcare worker from sources of infection. |
| physiologic Q wave | A normal Q wave, measuring less than 0.04 second in duration and less than one-third the height of the R wave in that lead. |
| polarization | The state of cellular rest in which the inside is negatively charged and the outside is positively charged. |
| posterior axillary line | Imaginary line on the back that runs vertically from the shoulder down on the outer edge of the rib cage. |
| posterior descending artery | One of the primary branches of the right coronary artery providing blood to the interventricular septum and the posterior wall of the heart. |
| precordial lead | A type of lead placed on the chest in front of the heart; known as a V lead. |
| premature ventricular complex (PVC) | An ectopic impulse originating in either ventricle that occurs too early in the cycle. |
| pulmonary artery | Large artery that transports deoxygenated blood from the right ventricle to the lungs. This is the only artery in the body that carries deoxygenated blood. |
| pulmonary circulation | The transportation of blood to and from the lungs; blood is oxygenated in the lungs during pulmonary circulation. |
| pulmonary edema | Abnormal collection of fluid within the pleural space (lungs) due to congestive heart failure (left ventricle). |
| pulmonary embolism | A blocked artery in the lungs, usually caused by a blood clot. |
| pulmonary semilunar valve | A valve found in the pulmonary artery that prevents backflow of blood into the right ventricle during pulmonary circulation. |
| pulmonary veins | Transport oxygenated blood back into the left atrium of the heart. These are the only veins in the body that carry oxygenated blood. |
| Purkinje fibers | The fibers within the heart that distribute electrical impulses from cell to cell throughout the ventricles. |
| Purkinje network | Spreads the electrical impulse throughout the ventricles by means of the Purkinje fibers. |
| QS complex | A deep Q/S wave with no preceding R wave. Can indicate a left bundle branch block. Depolarization of the ventricles without the presence of the positive R wave typically seen. This results in the joining of the two negative wave forms (Q & S) of the QRS complex. |
| quadgeminy | Pattern in which every fourth complex is a premature complex (e.g., PVC). |
| R-on-T PVC | PVC occurs on the downslope of the T wave or the vulnerable period of the ventricular refractory period. |
| radiologist | A physician who specializes in the use of radioactive substances to diagnose and treat disease. |
| rales (crackles) | Noisy breath sounds during inhalation caused by retained airway secretions. When caused by pulmonary edema, rales are heard as very short, soft, bubbling lung sounds. |
| rate pressure product (RPP) | Systolic blood pressure multiplied by the heart rate; also known as double product. |
| renal infarction | A lack of oxygen to kidney tissue due to a blocked blood vessel. |
| repolarization | The return of heart muscle cells to their resting electrical state, causing the heart muscle to relax. |
| restenosis | The return of a blood vessel to a blocked state. |
| retrograde | Moving backward. |
| right atrium | The right upper chamber of the heart, which receives blood from the body. |
| right bundle branch block (RBBB) | Block that occurs in the right bundle branch, so that the current has to travel down the left bundle branch to activate the ventricles. |
| right ventricle | The right lower chamber of the heart, which pumps blood to the lungs. |
| run of ventricular tachycardia | Three or more PVCs in a row at a rate of greater than 100 bpm. Also known as triplet PVCs or salvo. |
| salvo | Three or more PVCs in a row at a rate exceeding 100 bpm; also called triplet PVCs or run of ventricular tachycardia. |
| segment | A portion or part of the electrical tracing produced by the heart. |
| seizure | An interruption of the electrical activity in the brain that causes involuntary muscle movement and sometimes unconsciousness. |
| semilunar valve | A valve with half-moon-shaped cusps that open and close, allowing blood to travel only one way; located in the pulmonary artery and the aorta. |
| serial ECG comparison | Multiple and frequent ECG tracings recorded at intervals based upon the patient's condition and compared to identify changes. |
| sick sinus syndrome | A disease that affects the function of the SA node. It can result in bradycardia, tachycardia, or even cause pauses in the conduction such as sinus arrest. |
| signal processing | The process within the ECG machine that amplifies the electrical impulse and converts it to a mechanical action on the output display. |
| sinoatrial (SA) node | An area of specialized cells in the upper right atrium that initiates the heartbeat. |
| sinus bradycardia | A slow heart rate, usually less than 60 beats per minute. |
| sinus exit block | Condition in which the SA node initiates an electrical impulse but the impulse is blocked and not conducted to the atria. Also known as sinus block or SA block. |
| sinus tachycardia | A fast heart rate, usually greater than 100 beats per minute. |
| slander | Making derogatory remarks about someone that jeopardizes his or her reputation or means of livelihood; slander is both illegal and unethical. |
| somatic tremor | Voluntary or involuntary muscle movement; also known as body tremor. |
| speed control | A control on the ECG machine that regulates how fast or slow the paper runs during the tracing. |
| sphygmomanometer | Blood pressure cuff. |
| ST segment elevation MI (STEMI) | Classic MI with expected ST segment deviation and development of pathologic Q wave. |
| standard precautions | Procedures, used with all patients, that are designed to prevent the spread of infection, such as performing hand hygiene and wearing gloves. |
| stat | Immediately. |
| stent | A matrix of crisscrossed metal that forms a small tube to help keep an artery open after angioplasty. |
| stress ECG | Another name for exercise electrocardiography. |
| stress echocardiogram | A test that combines an exercise stress test with an echocardiogram to assess left ventricular wall motion both before and immediately after exercise. |
| stroke volume | The volume of blood ejected by the left ventricle with each contraction. |
| submaximal exercise | Target heart rate of 220 minus the age multiplied by a percentage between 60 and 85. THR = [(220 - age) x 0.60] to THR = [(220 - age) x 0.85]. |
| sudden cardiac arrest | A condition in which the heart stops beating suddenly, often without warning, due to a failure of its electrical system. |
| suprasternal notch | The dip you feel at the anterior base of the neck just above the manubrium, where the clavicle attaches to the sternum. |
| supraventricular | An ectopic focus originating above the ventricles in the atria or junctional region of the heart. |
| sympathetic | The branch of the autonomic nervous system (ANS) that causes an increase in the heart rate. |
| symptom event monitor | A type of cardiac event monitor that activates when the electrode feet (small metal discs) are pressed onto the patient's chest and records a lead II tracing. |
| syncope | Loss of consciousness (fainting). |
| systemic circulation | The pathways for pumping blood throughout the body and back to the heart. |
| systole | The contraction phase of the cardiac cycle, during which the heart is pumping blood out to the pulmonary (lungs) and systemic (body) circulation. |
| systolic blood pressure | The blood pressure measured when the left ventricle of the heart contracts; the number corresponding with the first Korotkoff sound heard when performing an auscultated blood pressure. |
| target heart rate (THR) | Heart rate measurement needed to truly exercise the heart. |
| telemedicine | A monitoring system in which ECG tracings are communicated from a patient outside a medical facility to the physician via a telephone or digital system. |
| telemetry monitoring | Real-time monitoring in which a small transmitting device attached to the chest with three or five electrodes sends a continuous ECG tracing of the heart directly to a monitoring station. |
| thrombolytic agent | Medications administered intravenously that possess the ability to lyse or dissolve a clot. |
| thrombus | A blood clot that forms on the wall in a diseased area of the endocardium or on the wall of an injured blood vessel. |
| tilt table test | A test to determine whether a change in a patient's blood pressure or heart rate due to a change of position is causing symptoms of lightheadedness or fainting. |
| torsades de pointes | Type of ventricular tachycardia in which depolarization impulses move from one ventricle to the other, resulting in a “twisted ribbon” appearance on the ECG tracing. |
| TP segment | The segment of a waveform that extends from the end of the T wave to the point of initiation of the following cardiac complex, typically the P wave. |
| transcutaneous pacemaker | A type of pacemaker applied to the external skin for a temporary condition for only 24 hours at a time. |
| tricuspid valve | Valve located between the right atrium and right ventricle; it prevents backflow of blood into the right atrium. |
| trigeminy | Pattern in which every third complex is a premature (PVC). |
| triggered | Caused to occur; for example, electrical impulses are caused to occur if a pacemaker fails to detect the heart's normal contractions. |
| triplet PVCs | Three or more PVCs in a row at a rate exceeding 100 bpm; also called salvo or run of ventricular tachycardia. |
| underlying rhythm | The heart rhythm that would be present if the abnormal impulses were ignored or removed from the tracing. |
| undersensing | The pacemaker is unable to detect any electrical activity and never turns off. |
| unifocal PVC | Early complex that has shape suggesting only one irritable focus present. |
| unipolar lead | A type of ECG lead that measures the flow of electrical current in one direction only. |
| unstable angina (pre-infarction angina) | A warning sign that the disease that has been causing angina has worsened. Signs and symptoms are less predictable, last longer, and are more painful than previously experienced. |
| vagal tone | A constant tension on the vagus nerve that causes the heart to beat more slowly. |
| vena cava (pl. venae cavae) | Largest vein in the body, which provides a pathway for deoxygenated blood to return to the heart; its upper portion, the superior vena cava, transports blood from the head, arms, and upper body; and its lower portion, the inferior vena cava, transports blood from the lower body and legs. |
| ventricular pacing | Electrical stimulation is delivered to the ventricle(s) to stimulate ventricular depolarization and result in ventricular contraction. |
| vital signs | Temperature, pulse, respirations, blood pressure, and pain assessment. |
| volume expander | IV solution administered to fill fluid volume or replace the space that blood normally takes up. The context referred to in this book is referring to inert fluids, specifically 0.9% NaCl. It is given to increase blood volume in the hypotensive or potentially hypotensive patient in an effort to maintain homeostasis. |
| wandering baseline | Artifact in which the tracing drifts away from the center of the graph paper. Also known as baseline shift. |
| Wolff-Parkinson-White syndrome | A type of supraventricular tachycardia in which an extra electrical pathway allows the electrical signal to arrive at the ventricles too soon. This pre-excitation syndrome causes tachycardia and affects the morphology of the QRS complex. As a result of the abnormal conduction pathway, the QRS complex begins early and measures abnormally wide (0.12 second or greater) with a classic “delta” wave. |
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