Term
Which ventricle dominates the visual view of the heart?
The electrical view? |
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Definition
visual: right
electrical: left |
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Term
| Trace the electrical conduction system of the heart |
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Definition
| SA --> AV --> His --> Bundle branches --> purkinje --> myocardial cells |
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Term
The little boxes are __ s x ___mm
The big boxes are __s |
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Definition
Little: 0.04s x 1mm
big: 0.2 s |
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Term
Which wave?
1. represents atrial depolarization
- normal is 0.08-0.11s
- Axis is 0-75 deg
2. Represents dead myocardium or is sometimes benign
- >0.03s is significant
- >1/3 hieght of R wave is significant
- Septal waves in I, aVL, and V6 are insignificant
3. represents ventricular depolarization
- normal 0.06-0.11s
Axis: -30-105
4. represents ventricular repolarization
- should be same direction as QRS
5. Unknown cause
- often seen in bradycardia and hypokalemia --> never hyperkalemia |
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Definition
P wave
2. Q wave
3. QRS complex
4. U wave |
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Term
Which segment/interval?
1. represents transmission from AV node to purkinjes
- bad if depressed below baseline = pericarditis or atrial infarct
2. represents the beginning of the beat to the purkinjes
- normal is 0.12-0.2s
- >0.2 = 1st degree AV block
3. represents an electrically neutral period btwn ventricular depolarizaiton and repolarization
- normal is at baseline
- 1 mm or greater variation in two contiguous leads is a problem
4. represents all events of ventricular systole
- should be <1/2 the RR, if it's greater, it indicates arrhythmia
5. beginning of QRS to downward slope of R
- represents time from purkinjes to epicardium
- should be 0.035 in right precordials and 0.045 in left
- Increased time = vent hypertrophy |
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Definition
1. PR segment
2. PR interval
3. ST segment
4. QT interval
5. intrinsicoid deflection |
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Term
How do you calculate rate for normal rates?
For irregular? |
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Definition
Regular: count big boxes between QRS's
300-150-100-75-60-50
Irregular/slow: count # of QRS's in 12 sec and multiply by 5 |
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Term
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Definition
90deg from another lead:
I and aVF
II and aVL
III and aVR |
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Term
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Definition
left anterior hemiblock
LVH
inferior MI
ectopic beats |
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Term
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Definition
kids
RVH
Left posterior HB
dextrocardia
ectopic beats |
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Term
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Definition
1. QRS > 0.12
2. Leads 1 & V6: slow, slurring S waves
3. Lead V1: RSR' (rabbit ears)
NEVER neg complexes in V1 |
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Term
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Definition
1. QRS >0.12s
2. I & V6: Broad, Monomorphic R waves (all pos or all neg)
3. V1: Broad, monomorphic S waves |
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Term
| Left anterior hemiblock criteria |
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Definition
1. Axis in pathologic left (I+, aVF -, II-)
2. I: qR or Large R
3. III: rS |
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Term
| left posterior hemiblock criteria |
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Definition
1. RAD - 1-, aVF+
2. I: s, III: q
3. Exclusion of RAE and RVH |
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Term
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Definition
Leads I & II:
- P wave >0.12 s and notched
V1:
- biphasic P wave
height of P (mm) x width of P (sec) > 0.3 --> probability of LAE is 95% |
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Term
| RAE (P pulmonale) criteria |
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Definition
Leads II & III:
peaked p waves (>2.5 mm high)
V1:
Biphasic P wave
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Term
| Intraatrial conduction delay (IACD) criteria |
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Definition
Def: non-specific conduction problem in atria
V1: biphasic
- if first half is taller --> RAE is likely
- if second half is taller --> LAE is likely |
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Term
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Definition
1. (S V1 or V2) + (R V5 or V6) > 35 mm
2. Any precordial QRS >45mm
3. R in aVL > 11mm
4. R in I > 12 mm
5. R in aVF > 20 mm
usually also signs of LAE
usually LAD |
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Term
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Definition
1. V1 and/or V2: R:S ratio >1
2. Sx of RAE |
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Term
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Definition
LVH:
1. V1-V3: ST elevation w/ upward concavity. T wave upright and asymmetric
2. V4-V6: ST depression w/ downward concavity. T wave inverted and asymmetric
RVH:
1. V1: Increased R:S
2. V1 or V2: ST segment depression w/ downward concavity and inverted asymmetric T wave |
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Term
ST elevation is __% accurate for AMI
Can't be used to R/O AMI |
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Definition
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Term
| ST segment elevation greater than 1 mm in 2 or more contiguous leads OR presumed new LBBB |
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Definition
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Term
| ischemic ST depression of 0.5 mm or more OR dynamic T wave inversion with pain and disocomfort OR transient ST elevation of 0.5mm or greater for less than 20 min |
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Definition
| NSTEMI or unstable angina |
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Term
Door to balloon time (PCI) should be < __ min
Door to needle time (fibrinolytics) should be < ___ min |
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Definition
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Term
| Transmural MI diagnostic criteria |
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Definition
Q waves
ST elevation
T wave inversion
AKA (but not really) Q wave MI |
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Term
| what does "acute phase", "injury pattern" and "current of injury" mean? |
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Definition
| progression of EKG changes as ischemia/MI gets worse |
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Term
Anterior MI key points:
- what leads?
- what reciprocal leads?
- tx?
- which BB are affected?
- What artery/ |
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Definition
- leads: I, aVL, V1-V6
- reciprocal: II, III, aVF
- nitrates -- NOT fluids
- All bb are affected
- LAD
are most deadly - "widow makers"
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Term
Inferior MI key points:
- what artery?
- what leads/reciprocal leads?
- what is a major sx?
- tx? |
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Definition
- RCA
- II, III, aVF
- reciprocal: I, aVL, V1-V6
-sx:: hypotensino
- Tx: fluids, NOT nitrates |
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Term
| Post MI ST segment elevation persisting more than 2 weeks after an acute event indicates? |
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Definition
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Term
what kind of MI?
- some tissue dies but necrosis doesn't extend through the wall. No Q waves.
- usually has ST depression
ACC defines diagnosis as CP + elevated enzymes |
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Definition
| NSTEMI/subendocardial MI/non-Q wave MI |
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Term
Minor deviation sof the ST segment + flattening of T waves + slight T wave inversion
often seen in what dz? |
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Definition
Nonspecific ST-T changes
often seen in prinzmetal's |
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Term
| early repolarization is benign and is indicated by non-ischemic ST segment elevation |
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Definition
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Term
| 3 most common causes of pseduoinfarcts |
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Definition
WPW
Acute pericarditis
CNS disease |
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Term
Non-ischemic ST segment elevation with scooped ST segment + elevated T wave. creates "smiley" pattern
In all leads except aVR and VI\1 |
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Definition
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Term
| Scooped ST depression in inferior and lateral leads |
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Definition
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Term
Pre-excitation syndrome caused by accessory electrical pathway (bundle of kent) between the atrium and ventricle that causes pre-excitation of ipsilateral ventricle
EKG: delta R wave -- upsloping R wave + short PR interval |
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Definition
| Wolff-Parkinson-White syndrome |
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Term
AV node is bypassed by an extension of the anterior internodal tract called the James bundle, which conducts depolarizations directly to bundle of His.
Causes significant atrial arrhythmias like atrial flutter
Causes flutter QRS complexes on EKG |
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Definition
| lown-ganong-levine syndrome |
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Term
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Definition
(amplitude of) I + (amplitude of) III = (amplitude of) II
if this is not true, check lead placement |
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Term
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Definition
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Term
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Definition
For BBB:
At V1, if you turn right, it's a RBBB, if you turn left, its a LBBB |
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Term
| ST elevation on every lead + smiley face pattern (scooped ST segment) |
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Definition
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Term
| AV node circulation is always supplied by the ___? |
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Definition
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Term
| What is the one thing you should look for when you see a U wave? |
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Definition
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Term
| slowing of the AV node may prolong what interval? |
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Definition
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Term
| What 3 factors can prolong the QT interval? |
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Definition
| hypokalemia, hypothermia, SAH |
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