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EKG
hard stuff for EKG that prob wont be on test
74
Medical
Professional
11/12/2012

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Cards

Term
P wave is over one small box (1mm) deep and one small box long

book: V1: diphasic P wave but terminal phase is larger and usually negative
Definition
Left Atrial Hypertrophy
Term
notched p wave (looks like two stuck together) that is more than 3 boxes in length (0.12 mm)
Definition
P. mitrale ( associated w/ L atrial Enlargement)
Term
tall upright narrow P wave

book: VI: diphasic P wave initial bigger than second part
Definition
Right atrial Hypertrophy
Term
tall narrow p wave over 2 1/2 boxes in amplitude in INFERIOR leads (II, III ,aVF) or 1.5 small boxes in V1/V2
Definition
P pulmonale (associated w/ R atrial enlargement)
Term
Normally in VI the QRS complex has a small r and large S.
Remember S is negative
this is because VI is anterior on right
and ventricle depolarizes left and posterior

so what if on VI you see a R that is larger than the S? Reversed of normal ... also becomes progressively smaller V1-> V4 etc.
Definition
RVH
Term
Normally in VI the QRS complex has a small r and large S.
Remember S is negative
this is because VI is anterior on right
and ventricle depolarizes left and posterior

what if V1: you have S that is super super deep?

while V5 has a huge R?
Definition
LVH
Term
R wave in AVL and S wave in V3
>28
Definition
LVH - Male
Term
R wave in aVL and S (negative) wave in V3 added up together > 20 mm
Definition
LVH - female
Term
often confused w/ ischemia, in ____the ST segment is displaced OPPOSITE ot QRS deflection
Definition
LVH
Term
left posterior fasicular block
Definition
mimics RVH
Term
WPW (Wolff parkinsons white syndrome)
Definition
mimics RVH
Term
has a delta wave (up slope QRS)
Definition
Wolff Parkinsons White
Term
Posterior wall MI
Definition
mimics RVH
Term
after bundle of his the impulse travels to the left bundle branch then
Definition
left posterior fasicle then left anterior fascile
Term
3 small boxes (.12) to 5 small boxes
Definition
normal PR interval
Term
Improves to *INCREASED *heart rate/av conduction (atropine/exercise)
Definition
type I Mobitz aka Wenckebach
Term
Improves to *REDUCING *HR / AV conduction
Definition
type II Mobitz
Term
Develops during an acute INFERIOR MI
Definition
type I Mobitz aka Wenckebach
Term
Develops during an acute ANTERIOR MI
Definition
type II Mobitz
Term
Usually has a history of syncope
Definition
type II Mobitz
Term
Usually NO history of syncope / asymptomatic
Definition
type I Mobitz
Term
Morphology does not meet criteria for LBBB/RBBB (less than 3 small boxes) but there is QRS notching
Definition
Interventricular Conduction Delay
Term
tall R in leads I/aVL
deep ass S in lead III
Definition
Left anterior hemiblock
Term
Left anterior hemiblock acts like
Definition
LVH
Term
Left posterior hemiblock acts like
Definition
RVH
Term
not considered left ANterior Hemiblock, probably makes a left axis devation
Definition
Ostium Primum ASD
Term
not considered left anterior hemiblock probably makes a left axis deviation
Definition
Hyperkalemia (severe)
Term
Right axis deviation w/ normal or barely prolonged QRS
Definition
Left posterior fasicular hemiblock
Term
fatigue, stress, normal variant, smoking, drugs (alcohol, caffeine), and COR PULMONALE, can all cause
Definition
Premature atrial complexes (PACs)
Term
Mitral valve disease, HTN, post CABG, MI, thyrotoxicosis, PE, chornic lung disease, ASD, WPW, alcohol, idopathic
Definition
causes of Atrial Fibrillation/Atrial Flutter
Term
generally easier to cardiovert compared to atrial fibrillation but harder to rate control
Definition
Atrial flutter
Term
Wolf-Parkinson-White is a classical example of
Definition
AVRT (atrioventricular reciprocating tachycardia)
Term
You don't want to give someone who has WPW this because it will further slow down AV node thus increasing chance for stuff to go through bundle of kent
Definition
B blockers
Term
retrograde P waves
narrow complex
needs dual AV nodal pathways
common/easy to control

PAC travels through slow AV pathway
Definition
AVNRT (AV nodal reenterant tachycardia)
Term
which is worst downsloping ST, upsloping ST or horizontal ST?
Definition
downsloping: further Myocardial injury
Term
TQ: notched/slurred J pt and upslope ST elevation (kinda looks like a large T wave)
Definition
early repolarization syndrome
Term
ST elevations everywhere... some look like they have a cup in them
Definition
pericarditis
Term
pseudoinfarction:
looks like ST elevation
(sine wave) caused by
Definition
hyperkalemia
Term
high chance of arrythmias w/
Definition
prolonged QT
Term
inferior MI
II, III, aVF ST elevation

reciprocal I aVL (high lateral)

what artery
Definition
prob RCA maybe LCx
Term
anterior MI what are reciprocal leads
Definition
inferior leads
Term
if left heart dominant an inferior infarction will mess up your
Definition
LCx
Term
If right heart dominant an inferior infarction will mess up your (most common)
Definition
RCA
Term
lateral myocardial involves the
Definition
LCx
Term
ST depression and R>s in V1-3
Definition
posterior (PDA) infarction
Term
block fast sodium channels (class Ia)
Definition
procainamide and quinidine
Term
prolong QT a little bit
*priminent u waves (early finding)
*torsades de points
*wide QRS
*various AV blocks
*sinus bradycardia (marked)
Definition
procainamide and quinidine
Term
sagging ST segment depression w/ upward concavity
saggin ST clsasic in leads V5/V6?

flattened t waves (inverted / biphasic)
wide u wave
lengthend PR
Definition
digitalis effect
Term
Digitalis toxicity can cause almost any cardiac dysarrythmia except for
Definition
BBB
Term
Digitalis toxicity can cause
AV 2nd or 3rd degree block

bidirectional ventricular tachycardia

paroxysmal atrial tachycardia w/ block

*reguarlization of A fib (b/c complete heart blocK)
Definition
Digitalis toxicity
Term
exacerbated by HYPOkalemia or HYPERcalcemia
Definition
Digitalis toxicity
Term
5.5 - 6.5: tall narrow based T waves greater than 10mm on precordial/ 6 mm seen best on V2-V4
Definition
Hyperkalemia
Term
6.5 -7 .5
first degree av block flattened and wise p waves, Qrs flatening
Definition
hyperkalemia
Term
causes sinus arrest (loss of P waves) at greater than 7.5

or LBBB/RBBB
idoventricular rhythm
VT/V fib
Definition
hyperkalemia
Term
prominent u wave is classic for

can also cause ST depressoin/flattened t waves

its basicallys stretching out t waves which creates u wafe
Definition
hypokalemia
Term
u waves can maybe be seein in
Definition
hypokalemia, hypercalcemia, digitalis
Term
Qt shortening
(from ST getting smaller)

(PR may be longer so look at ST)
Definition
hypercalcemia
Term
QT prolongation
Definition
hypocalcemia
Term
If QT bigger than a couple large boxes then start to think
Definition
hypocalcemia
Term
inverted P QRS T in leads I and aVL

also R waves get smaller in precordial from VI - V6
Definition
dextrocardia
Term
most common type of ASD
Definition
Ostium secundum ASD
Term
find a RSR' (kinda like two peaks )
but smaller than 3 boxes so not RBBB
right axis deviation
usually RVH
First degree av block
right atrial enlargement
Definition
Ostium Secundum ASD
Term
RSR' in V1
incomplete RBBB
(above are same as ostium secundum ASD)

but its Left axis deviation*******
Definition
Term
inverted t waves in V1-V3
dont think stemi
Definition
Juvenile pattern (young women)
Term
there is a prominent R waves at VI
Definition
at birth (until 3 years)
Term
associated w/ eCG CHANGES due to slowed conduction through K channels, resulting in prolongation of all eCG intervals
Definition
hypothermia
Term
arrhythmia at core temp of
Definition
30
Term
potential for vfib greatest at (temp)
Definition
22
Term
prolonged all intervals
st depression
inverted t waves
Definition
hypothermia
Term
osbourne J waves
Definition
hypothermia
Term
first letter is chamber
Definition
PACED
Term
second leter is chamber
Definition
SENSED
Term
response to what is sensed I inhibt T trigger D dual
Definition
third letter
Term
fouth letter
Definition
rate responsiveness
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