UPAP Emergency Medicine EKG & Chest XR
Review
Order of cardiac conduction SA node, AV node, Bundle of His, Left and Right Bundle Branches,
Purkinje fibers
Anterior/Septal MI Artery Left Anterior Descending (LAD)
, Right Coronary Artery (RCA) 70% (or Left Circumflex)
Inferior MI Artery
Avoid nitrates!! - dont want to decrease preload in a right ventricle
infarction
Left Circumflex
Lateral MI Artery
or LAD diagonal branch
What is a heart rhythm that Sinus
originates at the SA node
called?
What is a heart rhythm that starts Junctional Rhythm
at the AV node called?
Regular rhythm 60-100 beats per minute, every beat is equally spaced
a rhythm that is abnormal but follows a pattern
Regularly irregular rhythm
not every beat is equally spaced
Irregularly irregular rhythm no consistent pattern to heart rhythm, usually implying atrial fibrillation
Normal PR interval 0.12-0.20 seconds (3-5 tiny boxes)
0.08-0.10 seconds
Normal QRS interval time
(2-2.5 tiny boxes)
Normal QT interval 0.35-0.45 seconds (about 2 large boxes)
Long QT risk torsades de pointes
Lead 1 and aVF
Which leads are used to assess
axis?
widened QRS (>0.12s); double
peaked QRS in V1 (best to look in
Right Bundle Branch Block V1 and V2); T wave can look
abnormal - inverted (does not
indicate ischemia)
UPRIGHT QRS in V1
"LBBB" a block in the electrical
conduction through the left bundle;
Left Bundle Branch Block
evidenced by a wide QRS in lead 1
and V6 with Downward QRS
Thickening of the right
Right Ventricular Hypertrophy
ventricle muscle V1 upright
QRS
Review
Order of cardiac conduction SA node, AV node, Bundle of His, Left and Right Bundle Branches,
Purkinje fibers
Anterior/Septal MI Artery Left Anterior Descending (LAD)
, Right Coronary Artery (RCA) 70% (or Left Circumflex)
Inferior MI Artery
Avoid nitrates!! - dont want to decrease preload in a right ventricle
infarction
Left Circumflex
Lateral MI Artery
or LAD diagonal branch
What is a heart rhythm that Sinus
originates at the SA node
called?
What is a heart rhythm that starts Junctional Rhythm
at the AV node called?
Regular rhythm 60-100 beats per minute, every beat is equally spaced
a rhythm that is abnormal but follows a pattern
Regularly irregular rhythm
not every beat is equally spaced
Irregularly irregular rhythm no consistent pattern to heart rhythm, usually implying atrial fibrillation
Normal PR interval 0.12-0.20 seconds (3-5 tiny boxes)
0.08-0.10 seconds
Normal QRS interval time
(2-2.5 tiny boxes)
Normal QT interval 0.35-0.45 seconds (about 2 large boxes)
Long QT risk torsades de pointes
Lead 1 and aVF
Which leads are used to assess
axis?
widened QRS (>0.12s); double
peaked QRS in V1 (best to look in
Right Bundle Branch Block V1 and V2); T wave can look
abnormal - inverted (does not
indicate ischemia)
UPRIGHT QRS in V1
"LBBB" a block in the electrical
conduction through the left bundle;
Left Bundle Branch Block
evidenced by a wide QRS in lead 1
and V6 with Downward QRS
Thickening of the right
Right Ventricular Hypertrophy
ventricle muscle V1 upright
QRS
