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25 Cards in this Set
- Front
- Back
- 3rd side (hint)
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myocardial Infarction
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Complete occlusion of a coronary artery
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Coronary artery: sole blood supply to the heart
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MI Triad
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Ischemia, injury, necrosis
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Ischemia
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Occurs when: decreased blood flow to a portion of the heart
looks like: symmetrical inverted T wave |
can indicate ischemia w/o infarct or w/ infrarct
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Injury
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acute/recent infarct
-looks like: ST elevation (above baseline, can vary from slight to large amplitude elevation) |
In time, ST returns to baseline...this is one way acute injury is separated from other causes of ST elevation.
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Brugada Syndrome
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occurs when: hereditary condition causing sudden death.
Looks like: RBBB with ST elevation in leads V1-V3. |
*elevated ST segments can have a distinctive downward slope
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Pericarditis
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occurs when: inflammation of the pericardium caused by virus, bacteria, cancer, infarction etc.
-looks like: elevated ST segment that is flat/slightly concave. |
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Subendocardial Infarction
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occurs when: small area of myocardium beneath the endocardial lining suffers undergoes ischemia.
looks like: flat ST depression which can be either flat or down-sloping |
ANY ST segment depression indicates compromised coronary blood flow...
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Necrosis
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occurs when: there is an infarct which has lead to dead heart tissue
looks like: Q wave (.04 sec/one small square or more). Also, Q is 1/3 the amplitude of entire QRS complex. |
OMIT AVR when looking for significant Q waves. Remember, lateral (AVL and I, Inferior: AVF, II, and III, and CHEST).
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Anterior Infarct
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looks like: Q Wave is inscribed in V1-V4 (V5 and V6 not detected because it is necrotic)
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Lateral Infarct
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looks like: Q Wave in lead I and AVL
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Acute Posterior infarction
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looks like: Large R wave and ST depression in V1 or V2 and sometimes V3.
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THINK: in right chest leads, R wave is usually very tiny, so this is an unusual appearance.
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Check V1 and V2 for...
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ST elevation and Q waves (indicates anterior infarct)
ST depression and Large R waves (Posterior infarct!) |
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Right Coronary Artery block leads to...
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Posterior infarct
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Left coronary artery block (circumflex) leads to...
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Lateral infarct
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Left CA block (anterior descending) leads to...
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anterior infarct
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Right Coronary Artery supplies blood to the...
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AV node, B of HIS, twig to the posterior portion of the LBB
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Anterior Desc. Branch of the Left Coronary artery supplies blood to the...
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RBB, anterior division of the of the LBB, and twig to the posterior portion of the LBB
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Hemiblock...
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occurs when: there is a block in either the posterior of anterior division of the LBB in the Ventricular conduction system.
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Anterior Hemiblock...
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occurs when: there is a block in the Anterior Descending branch of the left coronary artery.
looks like: Acute Left Axis Deviation, widened QRS, and Q1S3 |
Think-longer conduction time, therefore upward left deflection-causing acute LAD and also widened QRS.
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Anterior Hemiblock + RBBB
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occurs when: Left CA anterior desc. is blocked and blocks flow to both the Anterior Div. of LBB AND the RBBB
Looks like: |
RBBB usually doesn't result in Axis deviation, o if so very minimal RAD. However, if RBBB is coupled with block of the Anterior DIV of LBB there will be an acute LAD.
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Posterior Hemiblock
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Occurs when: inferior infarct (which is caused by either L or R coronary ischemia).
Looks like: RAD and a S1Q3. |
Think RAD: due to unopposed deflection to the superior and right from the Left.
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fascicular block means
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Hemiblock plus BBB
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Inferior Infarct
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looks like: Q Wave in II, III and AVF
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THINK-Q wave occurs because electrode is recording vector activity "away" from and the through necrotized tissue.
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Acute Anterior Infarct
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Looks like: Q Wave in V1 and V2 followed by ST Elevation
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Acute Posterior Infarct
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Looks like: OPPOSITE of Anterior Infarct. Large R Wave
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