ECG Abnormal Findings

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Right Atrial Enlargement: Lead II

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Description and Tags

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1

Right Atrial Enlargement: Lead II

tall peaked P wave (>2.5mm)

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2

RAE: V1

biphasic P wave

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3

LAE Lead II

wide notched prolonged P wave (.12s)

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4

LAE V1

biphasic P wave with negative side larger than positive

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5

RVH V1 & V2

tall R waves

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6

RVH V5 & V6

deep S waves

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7

RVH Lead I

negative QRS

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8

RVH V1

Positive QRS

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9

RVH all leads

ST depression, T wave inversion

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10

RVH mean axis

right axis deviation

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11

LVH equation

S wave in V1/V2 + R wave in V5/V6 >35mm

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12

LVH all leads

St depression and T wave inversion

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13

LVH V1-V6

R wave amplitude greater or equal to 25mm

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14

LVH aVL

R wave more than or equal to 11-13mm

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15

1st degree AV block

Long PR segment with QRS following (>.2s)

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16

2nd degree AV block Type I

Pr intervals progressively increase until QRS is dropped

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17

2nd degree AV block Type II

PR intervals are constant with dropped QRS

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18

3rd degree AV block

complete dissociation between P waves and QRS complexes, unchanged PR intervals

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19

RBBB V1

wide positive QRS, rabbit ears

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20

RBBB Lead I

S wave present (shouldn't be wider than half a box)

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21

LBBB V1/V2

wide notched negative QRS (in most leads)

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22

LBBB all leads

ST-T changes opposite of the R waves proceeding them

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23

LBBB V5/V6

tall notched positive R waves

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24

LBBB I, aVL, V5, V6

absence of small normal Q waves

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25

LBBB mean axis

possible left axis deviation

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26

STEMI ST elevation

aVL, I, V2, V4, V6

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27

STEMI ST depression

II, III, aVF *reciprocal findings

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28

STEMI Q waves

pathologic findings: 1/3 height of QRS, .4s long

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29

NSTEMI all leads

ST depression

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30

NSTEMI reciprocal findings

NONE.

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31

Artifact

NOT A PATIENT CONDITION

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32

Artifact causes

patient movement,poor skin prep, old electrodes

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33

Low voltage limb leads

QRS <5mm in all

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34

Low voltage precordial lead

none with a total voltage of >15mm

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35

Low voltage ecg calibration

must be properly calibrated to have this finding

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36

Types of ST segment change

ST depression and ST elevation

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37

ST depression due to oxygen demands

heart rate, wall stress, contractility

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38

ST depression due to oxygen supply

blood flow

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39

ST depression due to exercise ischemia

heart vessels are partially occluded which is made obvious by exercise, higher need for blood causes less blood to get through

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40

T wave inversion reasons

coronary heart disease, angina pectoris

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41

Digitalis effect

messes with baseline ST segments, cannot read for ischemia, causes sloping ST segment

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42

Prinzmetal Angina

ST elevation

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43

Ventricular Aneurysm

ST elevation, T wave inversion

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44

Pericarditis all leads except aVR

ST elevation

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45

Pericarditis all leads

PR segments are depressed

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46

Early repolarization

ST elevation in normal hearts

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47

Juvenile Pattern V1-V4

T wave inversion

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48

Hypocalcemia

QT interval prolongation (>.44)

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49

Hypercalcemia

QT interval shortened

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50

Hypokalemia

prominent U wave (only visible during bradycardia)

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51

Hyperkalemia

Tall, tented, peaked T wave, moves toward ventricular fibrillation

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52

Normal Sinus Rhythm

Rhythm: regular Rate: 60-100bpm P waves (in LII): max .12s PR interval: .12-.2s QRS: less than .1

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53

Sinus Arrhythmias

Rhythm: irregular & sinus Rate: any rate P waves, PR interval, QRS normal

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54

Sinus Arrhythmias Breathing

Decreases on expiration, increases on inspiration

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55

Sinus tachycardia

Rhythm: regular Rate: higher than 100bpm P waves: normal PR interval: normal QRS: normal

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56

Sinus bradycardia

Rhythm: regular Rate: less than 60 bpm P wave, PR interval, QRS: normal

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57

Sinus Exit Block

Dropped beat, beat comes back in line with rhythm from before

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58

Sinus exit block PR intervals

PR intervals are normal and regular

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59

Sinus Arrest

Dropped beat, rhythma before and after the pause do not line up

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60

Premature Atrial Contraction (PAC)

Premature beat, narrow QRS complex

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61

Blocked PAC

Look at T wave prior (big/different than others in same lead) & beat after

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62

Blocked PAC physiology

PAC happens so quickly that heart cells are in absolute refractory period, unable to conduct impulse

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63

Premature Junctional Contractions Three P wave options

Absent, inverted, retrograde

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64

PJC: Absent P wave

atria and ventricles depolarize at same time

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65

PJC: Inverted P wave

in correct sport, upside down, beat started at AV junction

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66

PJC: Retrograde P wave

Ventricles depolarize between atria

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67

Accelerated Junctional Rhythm: multiple leads

inverted P wave, P wave after QRS OR no P wave

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68

Accelerated Junctional Rhythm: BPM

60-100 bpm

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69

Atrial Tachycardia: all leads

three or more PAC that occur consecutively

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70

Atrial Tachycardia: BPM

200 +/- 50 bpm

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71

ST elevation

aneurysm, evolving MI, pericarditis, Prinzmetal angina, early repolarization

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72

ST depression

ischemia, reciprocal change of MI, NSTEMI, R/L BBB, Digitalis, R/L VH

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73

Left Anterior Hemiblock Lead I

small Q wave

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74

Left Anterior Hemiblock Lead III

small R

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75

Left Anterior Hemiblock QRS

QRS normal or widened to .1s

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76

Left Anterior Hemiblock mean electrical axis

Left shift of electrical axis: -45 to -90

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77

Left Posterior Hemiblock Lead I

small R wave

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78

Left Posterior Hemiblock Lead III

Small Q wave

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79

Left Posterior Hemiblock QRS

normal or widened to .1s

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80

Left Posterior Hemiblock electrical axis

Rightward shift of electrical axis: 120 to 180

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