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30 Cards in this Set
- Front
- Back
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J point
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at the end of the QRS and the beginning of the ST segment
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Chest pain plus any ST elevation is what until proven otherwise
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Mi
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ST depression and T wave in opposite direction to the QRS
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ischemia
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ST elevation with or without T wave changes or Q waves
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infarction
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epsilon wave
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benign small waves at J point
WORRY: Arhythmogenic Right Ventricular Cardiomyopathy Right Ventricular inherited desmosome problem: Sudden Death Autosomal dominant, 30% penetrance Children, young adults: sudden death Frizzy hair, associated palmoplantar keryoderma 1/1000- 1/10,000 births in US/90% are male 1/250 births in Italy! |
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does the epicardium or the endocaridum depolarize first? what about repolarization
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epicardium depolarizes last and repolarizes first
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A negative wave traveling away from an electrode is perceived the same way as
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a positive wave moving toward it
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should T waves be symmetrical?
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no
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QTC
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QT interval corrected for heart rate
Increased HR, decreasing QT Normal up to 0.419 seconds, 419 msec. One of many formulas: QTC= QT + 1.75X (ventricular rate-60) |
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U waves are more pronounced and prolonged in
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hypokalemia; U waves should be the same direction as the T waves; if opposite it is a bad sign (ischemia until proven otherwise
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What to think with symmetrical T waves in more than 1 lead
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stroke, ASDH, electrolyte disorders
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T waves usually positive and negative in what leads?
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T vectors usually positive in leads I, II, V3-V6, negative in AVR
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how tall is too tall for T waves?
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T wave should never more than 6 mm. limb leads or 12 mm in the precordial leads
Rule of thumb: if T is 2/3 the height of the R, it screams abnormal: Acute MI, hyperkalemia early approximately 6meq/L |
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tombstone pattern
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acute MI
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ST elevation
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infarct
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ST depression
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ischemia or subendocardial MI
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which lead do you exclude for looking at ST depression
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AVR, lead is always opposite
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RV strain
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P pulmonale: RAE
Right axis, R>S V1 and V2 S1Q3T3 |
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LV strain
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ST depression with downward concavity
No presence of reciprocal change in appropriate leads with ST elevation |
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Ischemia criteria
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Sharp J point in ischemia
ST change of ischemia or infarct is flat T wave is symmetrical in ischemia!!!!!!! |
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Pericarditis
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PR depression
Diffuse ST elevation changes No reciprocal ST depression Scooping, upward slope of ST Notching end of QRS |
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ST in BBB
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T wave is always opposite the QRS (discordance)
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Transmural MI
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Increase in R wave: cause: increase in chamber size vs. electrolyte change
T wave symmetrical increase: ATP dependent K exchange channel: done in an angioplasty study: acute temporary coronary artery occlusion when the baloon is inflated |
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ischemia reversible up to how many minutes
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20
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is q wave in subendocardial MI common?
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no, rare
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Most common MI
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subendocardial
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leads inferior infarct
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II, III, and aVF
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leads lateral infarct
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I, V5, V6, AVL (high lateral)
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leads septal infarct
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V1, V2
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leads anterior infarct
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V3,V4
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