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30 Cards in this Set
- Front
- Back
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True or false?
Occlusion to any coronary artery results in ST changes? |
False
In 30% of the population, no ST changes are visible on the the standard 12 lead EKG |
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Best leads to detect left circ occlusion affecting lateral wall?
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V5 & V6
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Best lead for detecting "demand related" ischemia
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The lead right over the LV apex - V5
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Best lead for monitoring "ST-finger print"
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All 12 leads
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Most valuable two leads when 12 lead is unavailabe?
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Lead 111 & V3
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best 3 lead combo?
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Lead 111, V3 & V5
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What is a good ST-alarm?
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An alarm indicating that the ST segment has returned to baseline after thrombolytic therapy
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Bad ST -alarm?
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Alarm indicating return of ST pattern
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What are the 3 principles governing the direction of the wave of excitation in a normal heart?
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1 - it travels towards the positive electrode -> upright QRS
2- when it travels away from the positive pole, the EKG complex is inverted 3- when the it travels in a direction perpendicular to the positive pole, the QRS is diphasic |
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Areas perfused by the LAD
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Anterior LV, anterior RV, anterior IV septum, posterior apex, RBBB (along with the RCA), anterior fascicle of LBBB & posterior fascicle of LBBB (along with RCA)
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Areas perfused by the left circ
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LA, l/lateral wall, l/posterior wall, SA node in 45% of population, AV & proximal bundle of His in 10% of the population
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Areas perfused by the PDB of the RCA
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Posterior IV septum, RA, , r/posterior wall
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Areas perfused by the MB of the RCA
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R/anterior wall, inferior wall, IV septum
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If there are injuries (ischemia, infarct) in the anterior wall, where are you likely to see recipricol changes?
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Leads 11, 111 & AVF
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If there are injuries in the anteroseptal wall, where are you likely to see recipricol changes?
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Leads 11, 111, AVF or V4, V5, V6
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Ischemia/infarct in lateral wall, reciprocal changes in ___ ?
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Leads 11, 111, AVF or V1, V2 V3
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Ischemia/infarct in posterior wall, reciprocal changes in ___ ?
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V1, V2
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Artery perfusing anteriro wall?
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LAD
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Artery perfusing anteroseptal wall?
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LAD
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Artery perfusing inferior wall?
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RCA
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Artery perfusing RV wall
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RCA
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Indentify ischemia/infarct.
T-wave changes in leads 11, 111, AVF, ST elevation in V2 thru V5 & Q-waves in 11, 111, AVF, V1 theu V5 |
Inferior wall ischemia, acute anteroseptal infarct & old inferior wall infarct
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Indentify ischemia/infarct.
T-wave changes in leads 11, 111, AVF, V1 thru V6, & Q-waves in 11, 111, AVF, V1 theu V5 |
Inferior wall ischemia, anteroseptal ischemia, old inferior wall infarct
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What causes BBBs?
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MI, ischemia, valve disease & myocarditis
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Criteria for LBBB
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QRS =/> 0.12
RSR' in V5 & V6 ST-T changes in 1, V5 & V6 QRS complex remains in predominantly negative in V1 Left axis deviation |
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Criteria for RBBB
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QRS =/> 0.12
RSR' in V1 & V2 Wide S in 1, V5 & V6 QRS complex in V1 tall, upright & notched Right axis deviation |
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Criteria for VT vs SVT
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R-R usually regular but may vary in VT, regular or irregular in SVT
Presence of AV dissociation supports VT but absence does not aid dx QRS > 0.16 If axis is between -90 to +/- 180 - VT |
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Quick hexaxical determination - extreme right axis deviation
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Lead 1 (-)/AVF (-)
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Quick hexaxical determination - left axis deviation
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Lead1 (+)/AVF (-)
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Quick hexaxical determination - right axis deviation
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Lead 1 (-)/AVF (+)
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