Term
| When we describe infarcts by location, we are speaking of an area within the __ ___. |
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Definition
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Term
| The MI triad is __, __, and __, but any one of these can occur alone. |
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Definition
- ischemia
- injury
- necrosis |
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Term
| ischemia means reduced ___ supply. |
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Definition
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Term
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Definition
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Term
| ___ ___ and possibly __ __ __ are indicators of ischemia. |
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Definition
- ST depressions
- possibly T wave inversions |
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Term
| Injury reveals itself on an EKG by __ __. This is significant when it is greater than __ mm above baseline in __ or more continuous leads. This represents prolonged ___. |
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Definition
- ST elevation
- 1
- two
- prolonged ischemia |
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Term
| The delivery of oxygen to the ventricular myocardium is determined by what 3 variables? |
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Definition
- oxygen content in arterial blood
- myocardial blood flow
- tissue oxygen extraction |
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Term
| The __ __ is the point at which the S wave ends and the ST segment begins. ST elevation is measured after this point. |
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Definition
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Term
Ischemia: temporary change in supply and demand, heart may go into oxygen debt
Injury: may have injury to few cells, but not full fledged necrosis
Infarction: large sections of dead cells= necrosis present |
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Definition
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Term
| 3 Types of ST depression: |
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Definition
- Upsloping
- Horizontal
- Downsloping |
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Term
| Injury usually indicates an __ process with __ __ and reciprocal ST depression in other areas. Consider injury if new onset bundle branch block (especially LBBB), conduction abnormalities, exaggerated peaked T-waves, or frequent dysrhythmias. |
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Definition
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Term
| ST segment elevation usually occurs within first few hours after onset of symptoms. Any elevation greater than __ mm in __ __ leads in significant. |
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Definition
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Term
| Name the Contiguous Leads: |
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Definition
- V2, V3, V4: anterior
- I and AVL: high lateral
- V5 and V6: lateral
- II and III: inferior leads |
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Term
| Leads __ and __ are contiguous high lateral leads over the __ __ __ artery. |
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Definition
- I and avL
- left circumflex artery |
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Term
| Leads __, __, and __ are anterior leads over the __ __ __ artery. |
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Definition
- V2,V3, and V4
- left anterior descending artery |
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Term
| Leads __ and __ are lateral leads over the __ __ artery. |
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Definition
- V5 and V6
- left circumflex |
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Term
| Leads __, __, and __ are inferior leads over the __ __ __. |
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Definition
- II, III, and AVF
- right coronary artery |
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Term
| Infarction may be indicated by a __ wave, but not all __ waves are pathological. A __ wave is the first negative deflection after the p wave. |
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Definition
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Term
| criteria for a pathological Q wave: |
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Definition
- any Q wave in leads V1-V3
- Q waves in 2 contiguous leads (not AVR) greater than or equal to 1mm in depth and 1 mm wide (.04 seconds) |
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Term
Q waves may occur early in an acute myocardial insult (may last months to years)
May have associated new or chronic onset bundle branch block (especially LBBB), conduction abnormalities, or frequent dysrhythmias. |
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Definition
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Term
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Definition
- ST segment elevation/depression
- Lower in hospital mortality
- Higher reinfarction rate after hospital discharge
- Early spontaneous reperfusion common
- Smaller infarct size |
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Term
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Definition
- ST-segment elevation
- Higher in hospital mortality
- Lower reinfarction rate after hospital discharge
- Sustained coronary artery occlusion common
- Larger infarct size |
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Term
| A pronounced ST segment elevation may appear as __. This is the result of fusing of the __ __ and __ __. |
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Definition
- tombstones
- ST segment and T wave |
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Term
| With an anterior wall myocardium, ischemia would result in ST __ in leads __, __, and __. Injury would result in ST __ in __, __, and __ with possibly some reciprocal ST ___ in the __ leads which are __, __, and __. Pathology with this area is associated with the __ __ __ artery. |
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Definition
- depression
- V2, V3, and V4
- elevation
- V2, V3, and V4
- depression
- inferior
- II, III, and AVF
- left anterior descending |
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Term
| put infarction, ischemia, and injury in order of progression from best to worst: |
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Definition
| - ischemia> injury> infarction |
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Term
| If there is ST elevation in V1 and V2 consider __ __ infarction. |
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Definition
| anterior septal infarction |
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Term
| V2, V3, and V4 lay over the __ wall of the __ ventricle. |
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Definition
| - anterior wall of the left ventricle |
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Term
| Inferior leads II, III, and AVF lie over __ ventricular wall. |
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Definition
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Term
| Inferior myocardial wall ischemic or infarctive changes: |
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Definition
Ischemia
ST depression in the inferior leads II, III and aVF
Injury/Infarction
ST elevation in the inferior leads II, III and aVF with or without associated Q waves
May see reciprocal ST depression in the anterior leads (I,L,V2-4)
Pathology
Usually associated with disease of the right coronary artery |
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Term
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Definition
ST segment depression seen in the opposite leads from ST segment elevation
Highly sensitive as an indicator of acute MI
Frequently seen in larger infarctions |
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Term
| To have a lateral wall myocardium issue, must see changes in __ __ leads. This means have to see changes in both __ and __ OR in both __ and __. |
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Definition
- 2 contiguous
- I and AVL
- V5 and V6 |
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Term
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Definition
Lateral Myocardial Wall
Ischemia
ST Depression in Leads I, AVL, V5-6
Injury/Infarction
ST Elevation in Leads I, AVL, V5-6 with or without Q waves
Pathology
Usually disease process in the left circumflex artery |
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Term
| With right ventricular infarct suspect __ __ MI, which means it will be in leads __, __, and __. This has __ clinical prognosis, especially in elderly. |
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Definition
- inferior wall MI
- II, III, AVF
- poor |
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Term
| Right ventricular infarct EKG criteria: |
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Definition
Includes Inferior Wall changes especially Q wave MI
ST depression in V1-3
ST elevation of V3R-V6R |
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Term
| Conditions that mimic ischemia, injury, and infarct on the EKG: |
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Definition
Pericarditis
Left Ventricular Strain
Hyperkalemia/Hypokalemia
Digitalis Effect
Pulmonary Embolus
Early Repolarization |
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Term
| What EKG finding is seen in some patients with PE? |
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Definition
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Term
| Patient comes in with continuous constant chest pain. Their EKG reveals diffuse ST elevation on all leads. What is their diagnosis? |
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Definition
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Term
| Initially during an MI, __ or __ __ waves may develop signifying cardiac __. These are only present for a short period of time, so may miss seeing them. __ or ___ causes them. |
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Definition
- tall or hyperacute T waves
- ischemia
- injury or hyperkalemia |
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Term
| No previous history of heart failure or systemic disease, but see II, III and AVF, v2, v3, v4, maybe v5. |
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Definition
| THIS IS EARLY DEPOLARIZATION |
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