EKG rhythms BASIC DYSRHYTHMIA-RELIAS 2024 EXAM DETAILED ANSWERS WITH RATIONALES VERIFIED ANSWERS ALREADY GRADED A+
Accelerated idioventricular rhythm (AIVR) - ANS40-120
- occur in short burst, usually following MI
- mostly asx with no progression to vtach / vfib
Angina pectoris - ANS...
anterior wall - ANSV1, V2, V3, V4
- occlusion of anterior descending coronary artery
Anteroseptal region - ANSV1, V2
Asystole - ANS- dead
- no electrical activity, only straight line (no rate/pulse) A dire form of cardiac arrest in which the heart stops beating -- there is no systole -- and there is no electrical activity in the heart. The heart is at a total standstill.
Atrial Fibrillation - ANSA: 350-450 (atria quivering)
- irreg-irreg rhythm (R-RI=irreg)
**unsure/no P-wave (non-distinguishable)**
- irreg rhythm BUT reg QRS!
Danger: increase the risk of thromboemoblic events don't convert unless occurring less than 48 hrs, if don't know pt need to be put on thrombolytics)
Atrial Flutter - ANSA: 250-350 - "saw tooth" p-waves
- a continuous rapid sequence of atrial complexes from a single rapid-firing atrial focus
(hint: if see 2 P waves and QRS think A Flutter)
Axis - ANSRefers to the direction of movement of depolarization - Look in leads I and AVF
- I-left, AVF-right
Thumbs:
- both up = Normal axis - both down = Extreme right axis deviation
- Lup/Rdown = Left axis deviation - Rup/Ldown = Right axis deviation
- Specific axis degrees: determine type of deviation, choose most iso-electric line and go to that line on the circle chart. Go 90 degrees into the good quadrant (the one you know you're in) and that will tell you the exact degrees.
Axis pic - ANS
BBB - ANS- Wide QRS >3 box
- 2-R waves "bunny ears"
A block in the Bundle Branch produces a delay in depol of the ventricle that it supplies
(note: can't read ischemia b/c BBB distort this)
if have L & R BBB = complete block
Digitalis Effect - ANS- shortened QT interval
- characteristic down-sloping ST depression (SCOOPING ST seg) EKG rhythms BASIC DYSRHYTHMIA-RELIAS 2024 EXAM DETAILED ANSWERS WITH RATIONALES VERIFIED ANSWERS ALREADY GRADED A+
First-degree AV block - ANS- PRI >5 boxes/.20 sec
- Fixed but prolonged PRI (consistent but long)
- normally get bradycardia here
Hypercalcemia - ANSShort/absent QT segment
(tooo healthy --> short QT (skinny))
Hyperkalemia - ANStall, peaked and narrow T
severe --> flattening of P wave, wide QRS, and tall T='sine wave'
Hypocalcemia - ANS(not healthy (not taking vit like Ca++) so look like a hipo which is large -> long QT)
Hypokalemia - ANS- flat T present - depressed ST seg
- U wave to prominent U wave
Idioventricular rhythm - ANS<40
*looks like vtach but slow*
- no P waves (from vent foci)
- Wide QRS
(serious, death like rhythm)
- called "dying heart" rhythm...occasional ventric beat b4 death (asystole)
Inferior wall - ANSII, III, aVF
- occlusion of right or left coronary artery
Injury - ANSST segment elevation (a sign of acute injury going on presently) (look for sad face)
- Injury indicates the acuteness of an infarct (acute or recent)
- can still save heart cells/reverse
Ischemia - ANS- T wave inversion - Ischemia is caused by a decrease in oxygen to the myocardial tissue (hypoxia/diminished blood supply)
- can still save heart cells/reverse
Junctional Escape beats - ANSretrograde atrial depolarization P' is inverted
Junctional rhythm - ANS40-60 Regular!
-impulse from AV node w/ retro/antegrade transmission
- P wave often inverted/buried/follow QRS
- slow rate
- narrow QRS (not wide like ventricular)
Junctional Tachycardia - ANS>60 bpm (ms. K; 150-250)
- KEY: will be regular (consistent)
- AV junction produces a rapid sequence of QRS-T cycles
- p-wave often inverted/buried/follow QRS
L atrial hypertrophy - ANSI --> wide P wave (biphasic)
Accelerated idioventricular rhythm (AIVR) - ANS40-120
- occur in short burst, usually following MI
- mostly asx with no progression to vtach / vfib
Angina pectoris - ANS...
anterior wall - ANSV1, V2, V3, V4
- occlusion of anterior descending coronary artery
Anteroseptal region - ANSV1, V2
Asystole - ANS- dead
- no electrical activity, only straight line (no rate/pulse) A dire form of cardiac arrest in which the heart stops beating -- there is no systole -- and there is no electrical activity in the heart. The heart is at a total standstill.
Atrial Fibrillation - ANSA: 350-450 (atria quivering)
- irreg-irreg rhythm (R-RI=irreg)
**unsure/no P-wave (non-distinguishable)**
- irreg rhythm BUT reg QRS!
Danger: increase the risk of thromboemoblic events don't convert unless occurring less than 48 hrs, if don't know pt need to be put on thrombolytics)
Atrial Flutter - ANSA: 250-350 - "saw tooth" p-waves
- a continuous rapid sequence of atrial complexes from a single rapid-firing atrial focus
(hint: if see 2 P waves and QRS think A Flutter)
Axis - ANSRefers to the direction of movement of depolarization - Look in leads I and AVF
- I-left, AVF-right
Thumbs:
- both up = Normal axis - both down = Extreme right axis deviation
- Lup/Rdown = Left axis deviation - Rup/Ldown = Right axis deviation
- Specific axis degrees: determine type of deviation, choose most iso-electric line and go to that line on the circle chart. Go 90 degrees into the good quadrant (the one you know you're in) and that will tell you the exact degrees.
Axis pic - ANS
BBB - ANS- Wide QRS >3 box
- 2-R waves "bunny ears"
A block in the Bundle Branch produces a delay in depol of the ventricle that it supplies
(note: can't read ischemia b/c BBB distort this)
if have L & R BBB = complete block
Digitalis Effect - ANS- shortened QT interval
- characteristic down-sloping ST depression (SCOOPING ST seg) EKG rhythms BASIC DYSRHYTHMIA-RELIAS 2024 EXAM DETAILED ANSWERS WITH RATIONALES VERIFIED ANSWERS ALREADY GRADED A+
First-degree AV block - ANS- PRI >5 boxes/.20 sec
- Fixed but prolonged PRI (consistent but long)
- normally get bradycardia here
Hypercalcemia - ANSShort/absent QT segment
(tooo healthy --> short QT (skinny))
Hyperkalemia - ANStall, peaked and narrow T
severe --> flattening of P wave, wide QRS, and tall T='sine wave'
Hypocalcemia - ANS(not healthy (not taking vit like Ca++) so look like a hipo which is large -> long QT)
Hypokalemia - ANS- flat T present - depressed ST seg
- U wave to prominent U wave
Idioventricular rhythm - ANS<40
*looks like vtach but slow*
- no P waves (from vent foci)
- Wide QRS
(serious, death like rhythm)
- called "dying heart" rhythm...occasional ventric beat b4 death (asystole)
Inferior wall - ANSII, III, aVF
- occlusion of right or left coronary artery
Injury - ANSST segment elevation (a sign of acute injury going on presently) (look for sad face)
- Injury indicates the acuteness of an infarct (acute or recent)
- can still save heart cells/reverse
Ischemia - ANS- T wave inversion - Ischemia is caused by a decrease in oxygen to the myocardial tissue (hypoxia/diminished blood supply)
- can still save heart cells/reverse
Junctional Escape beats - ANSretrograde atrial depolarization P' is inverted
Junctional rhythm - ANS40-60 Regular!
-impulse from AV node w/ retro/antegrade transmission
- P wave often inverted/buried/follow QRS
- slow rate
- narrow QRS (not wide like ventricular)
Junctional Tachycardia - ANS>60 bpm (ms. K; 150-250)
- KEY: will be regular (consistent)
- AV junction produces a rapid sequence of QRS-T cycles
- p-wave often inverted/buried/follow QRS
L atrial hypertrophy - ANSI --> wide P wave (biphasic)
