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37 Cards in this Set
- Front
- Back
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How do you know a normal axis?
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I and II are both +
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How do you recognize a left axis deviation?
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I is +, II is -
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How do you recognize a right axis deviation?
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I is -, II is +
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How do you recognize an indeterminate axis?
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I and II are both -
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What does lead I show?
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Right shoulder to left shoulder
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What does lead II show?
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Right shoulder to left leg
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What does lead III show?
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Left shoulder to left leg
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What's the quick and easy way to distinguish L from R BBB?
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R is + in V1, L is -. RBBBs often have "rabbit ears" in V1-2.
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What is the most common cause of LBBB?
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Chronic HTN (other common: AMI, CHF, trauma,myocarditis)
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What is the most common cause(s) of RBBB?
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Anteroseptal MI, PE, CHF, myocarditis
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How do you identify a left posterior fascicular block?
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Right axis deviation, normal QRS width. Only significant if no other causes of RAD.
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How do you identify a left anterior fascicular block?
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Left axis deviation, normal QRS width. Only significant if no other causes of LAD.
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How is right atrial enlargement identified?
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tall, peaked p-waves in II,III, AVF; Biphasic P-waves in V1-2
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How is left atrial enlargement identified?
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P wave > 0.12 sec in duration (may be notched, biphasic)
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What are possible caused of Right Atrial (or ventricular) Hypertrophy?
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Pulmonary valve stenosis, Tricuspid Regurg/stenosis, Pulm hypertension (COPD, PE, Pulmonary Edema)
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What causes Left atrial (or ventricular) hypertrophy?
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MI, Mitral valve stenosis/insufficiency, Left-sided heart failure, Left-sided ventricular hypertrophy (d/t aortic stenosis, insufficiency, HTN, hypertrophic cardiomyopathy.)
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How is Right Ventricular Hypertrophy identified?
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Right axis deviation, tall positive R-waves in V1 (> 7mm) (decreasing in 2, 3, etc.), and II, and III
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How if left ventricular hypertrophy identified?
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If the sum of R in I and S in III > 25mm (often with large complexes in V5-6)
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What rhythm is seen in pericarditis?
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Diffuse ST elevation, which may vary w/ the respiratory cycle
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What are EKG signs of hyperkalemia?
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Peaked T-waves (w/ widened QRS w/ K>6)
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What are EKG signs of hypokalemia?
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U waves, tall, peaked P waves (pseudo P pulmonale), w/ QRS widening K<3
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What are symptoms of hypokalemia?
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polyuria, muscle weakness, arythmias (incl. torsades)
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What are the EKG signs of hypercalcemia?
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QT < 0.32 seconds
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What are the EKG signs of hypercalcemia?
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QT > 0.39 seconds
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What are common causes of hypercalcemia?
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Adernal insufficiency, hyperparathyroid, immobilization, kidney failure, malignancy, sarcoidosis, thyrotoxicosis
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What drug is particularly dangerous in hypercalcemia?
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Digoxin
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What are common causes of hypocalcemia?
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Chronic steatorrhea, diuretics (incl. lasix), hypomagnesemia (r/t hypoparathyroid), osteomalcia, hypoparathyroidism, pregnancy, resp. alkalosis/hyperventilation
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What does the digitalis effect look like on EKG?
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QT prolongation, scooped ST. May also see PACS/exitatory phenomena, blocks
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What does procainamide toxicity look like on the EKG?
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1 deg block, QRS widening, QT prolongation.
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What does quinidine toxicity look like on the EKG?
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Like procainamide
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What EKG changes are present in COPDers?
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RAH/RVH, afib/WAP, PACs. May be low voltage (chest is hyperinflated)
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What are the sxs of PE? (4)
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1) SOB (sx) 2) tachypnea, tachycardia, apprehension (compensation) 3) distended jugular/neck pain (R-side backup) 4) AMS (decompensation)
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What does early depolarization look like? Who has it? How is it differentiated form MI?
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1) ST elevation 1-3mm (I,II, V2-6). 2) Healthy young folk 3) No reciprocal depression, no Q waves.
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What do pre-excitation syndromes look like on the EKG?
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1) possible short PR interval 2) Delta wave (makes QRS more triangular, in a tachy situation may look like vtach).
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What is the criteria for an abnormal Q-wave
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>25% of R-wave height, > 0.04 seconds
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What leads do we ignore Q-waves in?
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Augmented leads (aVR,aVL,aVF), III, V1.
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How do the augmented leads work?
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They point out from the center of the heart toward the left, right or feet. Where they go is positive, and negative is the combination of the arms/legs opposite to the direction.
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