Exam 2 - Electrocardiograms (ECG/EKG)

On EKG paper the small boxes are

.04 seconds

On EKG paper the large squares are

.2 seconds

On EKG paper 5 large squares equal

1 second

On EKG paper 15 large squares equal

3 seconds (black lines= indicator)

On EKG paper, box height equals

Voltage

What is the ventricular rhythm

R wave to R wave

How much variation is okay with ventricular rhythm

10% variation

How do you get atrial rhythm

P-P intervals

How do you get heart rate?

Count QRS complexes in 6 seconds, multiply by 10

What is the P wave?

Atrial depolarization

What should you ask about yourself with the P wave?

Are they present

Are they regular

Is there a p wave for each QRS

Are they all smooth, rounded and upright

What is the PR interval?

Beginning of P wave to beginning of QRS

What should you assess with the PR interval?

See if they're consistent

What is the QRS complex

Q to S

Normally the QRS complex is? But?

2-2.5 boxes

1 or 2 waves can be absent

All T waves are?

Symmetrical

What is the QT interval?

Beginning of QRS to end of T-Wave

-time for ventricles to depolarize and depolarize

The ST segment should be?

FLAT LINE

What is the ST segment

Line from end of QRS complex to beginning of T-Wave

What has a saw tooth appearance and has atrial contractions of excess of 200 beats/min

Atrial (Auricular) Flutter

With atrial flutter, there are multiple?

P-waves for each QRS

What do patients report with atrial flutter?

Racing heart

Shortness of breath

Dizziness

What is a heart rate of less than 60 bpm with a slow but normal ECG

Sinus bradycardia

What could cause sinus bradycardia

Good cardiovascular conditioning

Drugs

Heart block

What is quivering heartbeat and irregular spasms of the atria?

Atrial fibrillation

What shoes are chaotic ECG?

Atrial fibrillation

Atrial fibrillation can lead to?

Blood clots

Stroke

Heart failure

Patients describe what with atrial fibrillation

"Fluttering" in chest

How do you treat atrial fibrillation

Shocking the heart (pacemaker)

What is a PR interval longer than .20 seconds that is usually considered benign and symptomatic?

Heart Block 1st Degree

What can cause a heart block 1st degree

Conduction delay

What can cause the conduction delay that causes heart block 1st degree

Intrinsic atrial ventricular node disease

Enhanced vagal tone

Acute MI

Myocarditis

Hypokalemia

Hypomagneisa

Various drugs

What is a benign PR interval increases with each heart beat until a QRS is missed?

Heart Block 2nd Degree type 1

Wenchenback/Mobitz 1

What causes a heart block 2nd degree type 1

Conduction block at the level of the AV node

What do symptomatic patients of heart block 2nd type 1 show?

Feels like heart skips a beat

What is it when the PR interval stays the same but the QRS complex is dropped

Heart block 2nd degree type 2 (mobitz 2)

Heart block 2nd degree type 2 may progress to?

Complete heart block

What causes a heart block 2nd degree type 2?

Failure of conduction of His-Purkinje system

What can heart block 2nd degree type 2 cause?

Syncope and sudden death

What does a heart block 2nd degree type 2 require?

Permanent pacemaker

What is it when none of the P-waves are conducted to the AV node and the AV node generates its own rate?

Heart block 3rd degree

What causes heart block 3rd degree?

MI

Drugs

Degeneration of conduction system

What can heart block 3rd degree result in?

Syncope or sudden death

Heart block 3rd degree requires what?

Permanent pacemaker

What is a rapid regular heart rate with narrow QRS complexes

Supraventricular tachycardia (SVT)

With a supraventriuclar tachycardia, the rhythm originates?

At or above AV node

If symptomatic supraventriuclar tachycardia may result in?

Heart palpitation

The heart rate is so fast with SVT, what results?

Chambers don't relax or completely fill so can't supply enough blood for body even at rest

What is it when there is a rapid, relatively regular heart beat (up to 200bpm) and the source of beat is from the ventricles (NOT SA OR AV NODES)

Ventricular tachycardia

What is a result of ventricular tachycardia, therefore the symptoms?

Can't pump enough blood the body needs

Dizziness, palpitations, syncope, chest pain, LOC

What is complete loss of regular heart rhythm? A weak, rapid, irregular ventricular contraction

Ventricular fibrillation

Ventricular fibrillation can be?

Deadly

ST segment elevation indicates what?

Acute MI (patient is having a heart attack)

A patient with ST segment elevation presents with what?

Angina, dyspnea, nausea, vomitting, diaphoresis, fatigue, palpitations, syncope