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41 Cards in this Set
- Front
- Back
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How to determine rate from QRS complex?
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if you have a whole rhythm strip (50 large squares) x 6
if you have a half a rhythm strip (25 large squares) x 12 OR count amount of large 300/squares between each complex (only for regular rhythm) |
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PR interval length
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.12-.2
3-5 small squares |
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QRS width
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less than .12 or 3 small squares
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what should be included in rhythm analysis?
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rate, rhythm (sinus or not), relationship of P:QRS, PR length, QRS length
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What leads do you use for cardiac axis?
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AvF(y-axis) and I (x-axis)
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what values do you use to work out cardiac axis?
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R and S distance from isolelectric from AvF and I. plot them
RAD is lead I - and avF + (left bottom quad) normal is bottom half of top right quadrant and whole bottom right quadrant LAD is lead I + and avF - (but only the top half of this quadrant) |
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what are some causes of RAD?
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can be normal in tall, slim adults
RVH Antero-lateral MI Left posterior hemiblock |
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what are some causes of LAD?
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left anterior hemiblock
inferior MI hypercalcaemia |
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size of P in both limb and chest leads:
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less than 2.5 mm high
less than .12 (3 small squares) wide |
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where can you have a biphasic P that is normal? what makes it abnormal
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v1
however, if the negative component makes it wide, then that is left atrial abnormality. |
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how do you comment on normal p waves?
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upright and dome shaped
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where can a p-wave be inverted?
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avr
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when are Q waves non-pathological?
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if they are present in any lead except avR and III,
they must under .04 sec (1 small square) no more than 1/4 of R height. large and wide in AvR and III is okay. |
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Where can Q waves be large and wide?
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AvR and III
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How describe Q waves?
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pathological or non pathological
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Limb R and S waves:
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AvL: must be UNDER 13 mm high
avF: must be UNDER 20 mm high |
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Chest R and S wave
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none can be higher than 25 mm
highest R + deepest S can be no larger than 35 mm (from any combination of chest lead) wave progression from 1-6 at least one should be greater than 8 mm |
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how do you comment on normal RS?
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no tall R or RS
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when is ST segment normal?
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should be ±1 mm from isoelectric, otherwise it is depressed/elevated
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how should T's be in comparison to R?
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T should be between 1/8 and 2/3 of R height
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how do you comment on normal p waves?
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upright and dome shaped
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where can a p-wave be inverted?
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avr
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when are Q waves non-pathological?
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if present anywhere except avR and III,
they must be under .04 sec (1 small square) no more than 1/4 of R height. large and wide in AvR and III is okay. |
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Where can Q waves be large and wide?
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AvR and III
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How describe Q waves?
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pathological or non pathological. if there are pathological ones, record them as "abnormal Q waves in...."
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Limb R and S waves:
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AvL: must be UNDER 13 mm high
avF: must be UNDER 20 mm high |
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Chest R and S wave
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none can be higher than 25 mm
highest R + deepest S can be no larger than 35 mm (from any combination of chest lead) wave progression from 1-6 at least one should be greater than 8 mm |
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how do you comment on normal RS?
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no tall R or RS
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when is ST segment normal?
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should be ±1 mm from isoelectric, otherwise it is depressed/elevated
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what is a normal T?
how would you comment on it? |
T should be between 1/8 and 2/3 of R height
T may be inverted in V1 or avR comment: upright, flat or inverted. |
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Normal QT?
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QT should be between .36-.44
9-11 small squares |
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Finding corrected QT?
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QTc = QT/sqrtR-R
must put this. |
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what does a wide QRS indicate?
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a bundle branch block
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what do u see in 1st degree heart block
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increased PR
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what do you see in 2nd degree HB?
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type 1: increasing PR until QRS is dropped
type 2: no increase in PR before dropped QRS |
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criteria for LBBB?
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wide QRS >.1s
no secondary R in V1 no Q in v5, v6, 1 or aVL M in V5-V6 WiLLiaM |
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criteria for RBBB?
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wide QRS >.1 s
secondary R wave in V1 M pattern in right leads (v1-v2) MaRRoW |
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Criteria for left atrial hypertrophy
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V1 has BROAD biphasic p
lead II has notched P-wave (p-mitrale) |
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criteria for right atrial hypertrophy
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V1 iniial positive deflection INCREASED
lead II has tall peaked P wave (P-pulmonale) |
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Criteria for acute MI- times for changes?
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st elevation- 0-2 hours
T wave inversion 3-8 hours Q waves 3-8 |
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criteria for an OLD MI?
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abnormally deep Q's (>1/4 of R) or
abnormally wide Q's >.04 sec EXCEPT in aVR and III |
