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Cards ECG
Cardiology
| Question | Answer |
|---|---|
| Diffuse ST elevation in most leads, peaked T waves in V leads = | pericarditis |
| Irregular irregular | Atrial fibrillation; (if > 48 or chronic: anticoagulate) |
| ECG arrhythmia assoc w/COPD | multifocal atrial tachy |
| LVH on ECG | S in V1 + R in V5-V6 > 35; aVL (R) > 11; LAD; wide QRS; ST/TW changes |
| RVH on ECG | RAD. R>S in V1 (R gets smaller V1 -> V6). S wave persists V5-V6. Wide QRS |
| tachy on ECG (regular/narrow) = | sinus; atrial tachy or flutter; re-entrant (AVNRT/PSVT)(usu after p wave); give adenosine |
| tachy on ECG (irreg/narrow) = | sinus tach w/PAC; MAT; A fib; atrial flutter w/variable block |
| tachy on ECG (regular/wide) = | V-tach; SVT w/aberrancy (BBB); SVT w/WPW; pacemaker tachy |
| tachy on ECG (irreg/wide) = | V-fib; torsades; irreg SVT w/aberrancy; irreg SVT w/WPW |
| RBBB on ECG | RSR' in V1-V4. QRS wide (>.12). Slurred S wave at I, aVL, V5-V6. Biphasic QRS at I. STD & TWI |
| LBBB on ECG | QRS >120; notched/slurred R in I, aVL, V5-V6; teepee (big pos R) V5-V6, no Q waves in same; ST & T usually opp direction of QRS (=ischemia) (occ QRS-T concordance); V1-V2: broad negative rS or QS |
| Hypercalcemia on ECG | Shortened QT, Wide QRS, absent ST segment |
| Hypocalcemia on ECG | Prolonged QT in II, V1, and V5, predisposition to V-tach |
| Hyperkalemia on ECG | short QT, wide QRS, flat P wave, peaked T waves |
| Hypokalemia on ECG | U waves, ST flattening, TWI, ST depression; areflexia, paralysis, ortho hypotension, ileus |
| Hypomagnesemia on ECG | prolonged PR & QT, and wide QRS |
| Electrolyte imbalance: Shortened QT, Wide QRS, absent ST segment = | hypercalcemia |
| Lyte imbalance: Prolonged QT in V1, II, and V5, predisposition to V-tach = | hypocalcemia |
| Electrolyte imbalance: short QT, wide QRS, peaked T waves = | Hyperkalemia |
| Electrolyte imbalance: U waves, ST flattening, TWI, ST depression; areflexia, paralysis, ortho hypotension, ileus = | Hypokalemia |
| Antiarrhythmic: pos inotrope, neg chronotrope, decreases conduction velocity thru AV node = | digoxin |
| Effects of CCB: | Class IV, vasodilator; neg chronotrope, neg inotrope |
| Effects of beta blockers: | Class II; neg chronotrope, neg inotrope |
| COPD on ECG | Right axis deviation (RAD = RAD) |
| S1 Q3 TIII (Large S wave (I), ST depression (II), Q wave (III)) and TWI in V1-V4 = | PE |
| Hypermagnesemia on ECG: | wide QRS, long PR & QT |
| Short PR, wide QRS, Delta wave | Wolf-parkinson-white; avoid Digoxin |
| Most common cause of tachyarrhythmia | reentry; >1 pathway |
| Inferior STEMI reciprocates to which leads? | AVL and I |
| Anterior STEMI reciprocates to which leads? | Inferior leads (II, III, AVF) |
| Lateral STEMI reciprocates to which leads? | Inferior leads (II, III, AVF) |
| What type of STEMI reciprocates to the anterior leads? | None |
| Inferior MI: ECG correlation | MOST COMMON MI. (II, III, aVF); RCA; left circumflex if left-dominant |
| Anterior MI: ECG correlation | V1-V5; LAD |
| Lateral MI: ECG correlation | I, aVL, V5-V6; Circumflex |
| Inferolateral MI: ECG correlation | II, III, aVF, I, aVL; large RCA, or left-dominant Left circumflex |
| Septal / Posterior MI: ECG correlation | Large R in V1-V2. Possible Q wave in V6. Do mirror test. LCx (or septal branch of LAD) or RCA |
| EKG changes, N/V, yellow-green visual disturbances = | Digoxin toxicity (Hypokalemia will make worse) |
| Q waves in an MI usually develop within: | 12-36 hours |
| MVP on ECG: | often normal; ST depression or TWI in III & aVF |
| HCM on ECG = | LVH, nonspecific ST-T abnormalities, deep septal Q waves in inferior leads, or tall narrow R waves in V1-V2 |
| VSD on ECG | LVH, RVH, atrial enlargement |
| ASD on ECG: | RAD, rsR' pattern; RVH -> RBBB |
| PDA on ECG: | LVH, LAH |
| Alcoholic with palpitations, arrhythmia = | Atrial fibrillation (Holiday heart) |
| Kawasaki on ECG | Peaked T waves, 1st degree block, STE or STD, QT prolongation |
| Mitral stenosis ECG | P-mitrale: broad notched P wave |
| Acute infarct on ECG | Q waves, ST elevation |
| Age-indeterminate infarct on ECG | Q waves, ST at baseline, T wave inversion |
| Old infarct on ECG | Q waves, ST at baseline, T wave upright |
| Anterolateral MI: ECG correlation | Q waves in V5-V6 (and I, aVL). LCx > LAD |
| Idioventricular rhythm on ECG | Usually 30-40 bpm. Slow V-tach. Atria failed or blocked |
| Anterior hemiblock is associated with: | LAD. Normal-to-slightly wide QRS. Q1-S3 (assoc with MI, etc) |
| Posterior hemiblock is associated with: | RAD. Normal-to-slightly wide QRS. S1-Q3. |
| Atrial enlargement is best seen in which lead | VI. Right atrial enlargement: initial component larger. Left: terminal component larger. |
| Right atrial enlargement | Initial part of P wave taller (with notching downslope). P>2.5mm in any limb lead. "P pulmonale" |
| Left atrial enlargement | See VI (and II). Wide notched P wave >.12. Taller terminal point; notching upstroke. Large biphasic P wave with wide, negative terminal part. "P mitrale" |
| RVH may cause: | extreme RAD (if V1 and aVF both very deflected) |
| LVH with strain on ECG | Asymmetric ST depression / T wave inversion |
| Inherent rate of SA node | 60-100 |
| Inherent rate of atrial focus | 60-80 |
| Inherent rate of AVN / junction | 40-60 |
| Inherent rate of ventricles | 20-40 |
| Atrial escape beat | 60-100. PR <.20. QRS <.12. QT <.44 (1/2 of RR). P waves present, pause, then different shape |
| Junctional escape beat | 40-60. PR variable. QRS normal, QT normal. P waves inverted before, during, and after QRS |
| Ventricular escape beat | 20-40. P waves absent. QRS wide, bizarre >.10. Potentially life threatening. |
| Wandering atrial pacemaker | 60-100. P waves present, difference appearance. P to P differences. R to R differences. |
| Multifocal atrial tachycardia | 100-200. Irregular. WAP, but faster |
| Paroxysmal atrial tachycardia | 160-240. Regular. P waves regular (often inverted?). May be hidden in previous T wave |
| Paroxysmal SVT | 150-250. Regular. P wave slurred in QRS |
| Atrial flutter | 240-360 (atrial). Regular, sawtooth. Ventricular rate depends on block (2:1, 3:1). Danger: allow clots to form |
| A-fib | 400-800 (atrial). P waves indistinguishable; irregular, charotic. Ventricular rate varies |
| Ischemia on ECG | ST depression. TWI. Symmetric T waves (inverted) esp in V leads; often corresponds to angina |
| Injury on ECG | ST elevation. Hyperacute T waves |
| Injury (STEMI) on ECG: ___ mm above baseline (limb) and ___ mm above baseline (chest leads) | = acute damage. 1 mm limb leads; 2 mm in chest leads |
| Injury (STEMI) on ECG: J point | .08 seconds to right of J point. Find in 2 leads facing same area |
| Infarct on ECG | =necrosis. Significant Q wave (>1 mm wide and 1/3 of QRS height). Often see ST depression |
| Pericarditis on ECG | Diffuse ST elevation in most leads (does not resolve, as MI does). PR depression. Peaked T waves (often above baseline) in V leads |
| Down-sloping (depressed) ST segment = | specific for ischemia |
| Significant Q waves = | >0.04 seconds (1 little box or 1/3 QRS height) |
Created by:
Abarnard
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