Rapid Interpretation of EKG's Dubin
Terms in this set (194)
Depolarization may be considered an advancing wave of what charges within the heart's myocytes?
What is the heart's dominant pacemaker?
What is the only conducting part between the atria and the ventricles?
Describe the P QRS T parts of the EKG.
P-wave is the atrial depolarization and simultaneous contraction
QRS Complex is ventricular depolarization/atrial repolarization and ventricular contraction
T-wave is the repolarization of the ventricles (rapid phase)
What does the PQ segment represent?
A brief pause due to slowed depolarization at when the wave of depolarization enters the AV node; allowing blood to enter ventricles from atria
While depolarization moves slowly through the AV Node, it shoots rapidly through the ventricular conduction system beginning where and then where?
Left and Right Bundle Branches and their branches
What does the ST segment represent?
The plateau phase of ventricular repolarization
If otherwise depressed or elevated at all from baseline it can be a sign of serious pathology
On the EKG when does ventricular systole begin and end?
Begins with QRS and persists until the end of the T wave
As a rule of thumb, the QT interval is considered normal when what?
When it is less than half of the R-to-R interval at normal rates
One small square on EKG paper is how big and how long in time?
Of the 12 EKG leads, 3 are bipolar limb leads. Describe leads I, II, & III
Lead I- horizontal: + left arm electrode and - right arm electrode
Lead II- - right arm electrode and + left leg electrode
Lead III- + left leg electrode and - left arm electrode
The 3 augmented limb leads are: AVF, AVL, AVR. Which limb has the positive electrode?
AVF- left leg/foot
AVL- left arm
How many chest leads are there? How are they positioned on the chest? What are their charges? How do they reflect on the EKG?
6 chest leads
Positioned from right to left on chest in the anatomical position
All six leads at +
From chest lead V1 to V6 the positive charge increases on the EKG to a full + upward wave on EKG
What is the main neurotransmitter of sympathetic and parasympathetic system?
What are vagal maneuvers? 2 Examples?
Things done to activate reflex tachycardia (activate the parasympathetic system) for diagnostic and therapeutic purposes
Ex. Induced Gagging & Carotid Sinus Massage
At rest, the Sinus Rhythm maintains a rate of how many beats per minute?
Define Sinus Bradycardia.
Sinus Rhythm rate less than 60/min
In what type of person due we often see sinus bradycardia?
Define Sinus Tachycardia. What is the most common cause of it?
Sinus Rhythm rate more than 100/min
What are the 3 automaticity foci and their inherent rates?
Atrial foci = 60-80 per min
Junctional foci = 40-60 per min
Ventricular foci = 20-40 per min
What are the two mechanisms to determine the rate on an EKG?
Triplets = 300-150-100-75-60-50
6 seconds on EKG (2 "3 second" hash-marks)- count the # of cycles and multiply by 10
How does the HR react to inspiration and expiration?
Inspiration = increase HR
Expiration = extremely minimal decrease in HR
TRUE or FALSE: Depolarization passing through the Purkinje fibers of the ventricular conduction system is too weak to record on EKG?
What part of the EKG represents ventricular contraction?
Begins and ends at the QT interval
What is seen on an EKG for Wandering Pacemaker?
Wandering Pacemaker is an irregular rhythm produced by the pacemaker activity wandering from the SA Node to nearby atrial automaticity foci
P' Wave shape varies
Atrial rate less than 100
Irregular ventricular rhythm
Describe Multifocal Atrial Tachycardia. What patients will often present with such a rhythm?
Three or more atrial foci are involved
Each individual atrial focus paces at its own inherent rate, but the total, combined pacing of multiple unsuppressed foci produces a rapid, irregular rhythm
Describe Atrial Fibrillation.
Continuous rapid-firing of multiple atrial automaticity foci. No single impulse depolarizes the atria completely AND only an occasional random atrial depolarization reaches the AV Node to be conducted to the ventricles
The multiple atrial foci are parasystolic, so they're all INSENSITIVE to overdrive suppression; therefore, they all pace at once
What is the difference between an escape rhythm and an escape beat?
Escape Rhythm- automaticity focus escapes overdrive suppression to pace at its inherent rate
Escape Beat- automaticity focus transiently escapes overdrive suppression to emit one beat
Atrial Escape Rhythm occurs when what happens with the SA Node?
Sinus Arrest- SA Node is very sick and ceases pacemaking completely
A Junctional Escape Rhythm usually conducts mainly to the ventricles; thus, producing a series of lone what?
If the Junctional Automaticity Focus stimuli unexpectedly depolarizes the atria from below ("retrograde"), what is produced?
Inverted P' Waves with an upright QRS
Total failure of the SA Node and all automaticity foci above the ventricles is a rare and grave condition called?
"Downward displacement of the pacemaker"
What is Stokes-Adams Syndrome?
Pacing from a ventricular focus is often so slow (in ventricular escape rhythm) that blood flow to the brain is significantly reduced to the point of syncope.
Pt's. AIRWAY must be monitored and maintained
If there is a transient Sinus Block that makes the SA Node miss a pacing stimulus, a pause is produced. If this pause is longer than the inherent (pacing) cycle length of an automaticity focus what can happen?
Atrial Escape Beat (more often) but also a possible Junctional Escape Beat
Different P wave seen on EKG
A Ventricular Escape Beat typically produces what on the EKG?
An enormous ventricular (QRS) complex
TRUE or FALSE: Ventricular Escape Beats are rare?
Cardiac parasympathetic innervation inhibits the SA Node AND also inhibits the atrial and junctional foci, but NOT the ventricular foci
What are the world's most sensitive Oxygen sensors?
Ventricular automaticity foci
What are some reasons why atrial and junctional foci become irritable?
1. adrenaline (Epi) released by adrenal glands
2. presence of sympathetic stimulation
3. presence of caffeine, amphetamines, cocaine, or other beta-1 receptor stimulants
4. excess digitalis, some toxins, occasionally ethanol
7. To some extent, low oxygen
Define a Premature Atrial Beat (PAB); describing it on EKG too.
PAB originates in an irritable atrial automaticity focus
On EKG a PAB records as a P'....early and of different shape then others
TRUE or FALSE: The pacemaking activity resets in step with the premature beat.
TRUE only if the premature stimulus reaches the dominant pacing center
PAB should still depolarize the SA Node
For when ventricular conduction system is not fully receptive of the premature atrial beat, when one bundle branch may not be completely repolarized but the other is receptive. What is this called and what shows on the EKG?
Aberrant ventricular conduction
slightly widened QRS for the premature cycle ONLY
Define Atrial Bigeminy and Atrial Trigeminy.
Atrial Bigeminy- an irritable automaticity focus fires a PAB that couples to the end of a normal cycle, and repeats this process by coupling a PAB to the end of each successive normal cycle
Atrial Trigeminy-an irritable atrial focus prematurely fires after two normal cycles and the couplet repeats
What may make a ventricular focus become irritable?
1. Low Oxygen (obstruction, absence of air (near-drowning or suffocation), minimal blood oxygenation in lungs, preduced CO, poor to absent coronary blood supply)
2. Low K+ (hypokalemia)
3. Pathology: Mitral Valve Prolapse, stretch, myocarditis
In a clinical setting, most (but not all) "deadly" ventricular tachycardias are due to what?
Coronary insufficiency or infarction
What does a Premature Ventricular Contraction (PVC) produce on EKG?
A GIANT ventricular complex (usually opposite the polarity of the normal QRS's)
How many PVC are considered pathological?
6 or more
What should you suspect if you see PVCs that appear to be coupled to a long series of normal cycles?
-focus suffers from entrance block (not irritable), paces at its inherent rate
A single irritable focus may fire one spontaneous impulse, but if its oxygen supply decreases further, the focus may be provoked into firing a series of discharges in rapid succession. A run or 3 or more PVCs is really a run of what?
Ventricular Tachycardia (VT)
Mitral Valve Prolapse (MVP) causes what, but is considered a benign condition. What is the syndrome this is known as?
Causes PVCs, including runs of VT and multifocal PVCs
AKA Barlow Syndrome
Females with MVP typically have a slender body with a slight chest deformity, experience "dizzy" spells and are what prone?
Those with this phenomenon must be monitored closely for deadly arrhythmias.
R on T Phenomenon
PVC falls on the T wave (when the ventricles are vulnerable)
What are the rate ranges of:
Paroxysmal Tachycardia 150 to 250 /min
Flutter 250 to 350 /min
Fibrillation 350 to 450 /min
In patients with a Paroxysmal Atrial Tachycardia (PAT) with an (AV) Block, suspect what?
Digitalis excess or toxicity
Excess digitalis can provoke and atrial focus into such an irritable state that it suddenly paces rapidly and digitalis markedly inhibits the AV Node, so only every second stimulus conducts to the ventricles
Paroxysmal Ventricular Tachycardia often indicates what?
Coronary insufficiency, causing poor oxygenation of the heart (and ventricular foci)
NEVER give medications for SVT (Supraventricular Tachycardia) to a patient with what?
How do you distinguish between Wide QRS complex SVT and Ventricular Tachycardia?
Pt. with coronary disease or infarction (very common in VT not SVT)
QRS width (less than .14 sec for SVT but larger in VT)
AV dissociation showing captures or fusions (rare in SVT but yes in VT)
Extreme R Axis Deviation (rare in SVT, yes in VT)
Torsades de Pointes, rapid ventricular rhythm often looks like a twisted ribbon is caused by what?
Low potassium, medications that block potassium channels, or congenital abnormalities
Atrial flutter is characteristic of what on EKG?
back to back "flutter" waves
appearance of the teeth of a saw or a "saw tooth" baseline
Ventricular flutter hardly gives enough time to fill- even partially the ventricles. What does the EKG show?
A rapid series of smooth sine-waves of similar amplitude
Ventricular Flutter rarely self-resolves and is nearly always a prelude to what?
A deadly arrhythmia
TRUE or FALSE: Fibrillation can simply be said that multiple foci are discharging rapidly.
What is more of an emergency situation: A-fib or V-fib?
V-fib- no pumping action by heart (ventricles are only twitching erratically)
require immediate CPR and fibrillation with some type of electrical defibrillator
What are the two computerized defibrillators?
AED (portable unit)
ICD (implanted under the chest skin to automatically defibrillate appropriate patients as needed)
What do you see on EKG for Wolff-Parkinson-White Syndrome?
Shortened PR interval due to a delta wave (shows as lengthened QRS) due to an accessory Bundle of Kent pathway
WPW syndrome patients can have what?
What is Lown-Ganong-Levine (LGL) Syndrome?
when one has an extension of the Anterior Internodal Tract (James bundle) that causes the AV node to be bypasses; atrial depolarization are conducted directly to the His Bundle without delay
Can pose a serious problem with rapid atrial arrhythmias like atrial flutter (ventricles are driving at very rapid rates)
What is Dubin's 5 part method to interpret EKGs?
Which of the 12 leads are usually the "Rhythm Strips"?
Sinus Tachycardia can aggravate what?
Ischemia (bringing on chest pain) and infarction, particularly those with cardiovascular disease
Sinus Dysrhythmia may be associated with what?
Palpitations, dizziness, and syncope
What is the most prominent characteristic of sinus arrest in ECG rhythm ?
What are all of the possible Atrial Dysrhythmias?
Wandering Atrial Pacemaker
Premature Atrial Complex (PAC)
Multifocal Atrial Tachycardia (MAT)
Supraventricular Tachycardia (SVT)
What is the normal duration of the P wave?
0.06 to 0.10 seconds
When we have a tachycardia with normal QRS complexes but without recognizable P waves we can refer to it as what?
In Wandering Atrial Pacemaker (WAP), what happens?
Pacemaker changes location from site to site producing a slightly irregular rhythm
There are several difference P waves
TRUE or FALSE: WAP is a Normal finding in children, older adults, and well-conditioned athletes?
How many different P wave configurations (seen in the same lead) are needed to diagnose a dysrhythmia as wandering atrial pacemaker?
At least 3
What is the only difference between WAP and MAT (Multifocal Atrial Tachycardia)?
WAP- 60-100 BPM
MAT- 120-150 BPM
What are some causes of MAT?
COPD, CHF, and acute mitral regurgitation
What is the rate most often of atrial flutter?
250-350 BPM- atrial beats
What is the rate of atrial fibrillation?
TRUE or FALSE: Atrial Fibrillation have P waves that may be indiscernible & the rhythm is almost always irregularly irregular.
Atrial Fibrillation can cause what to form in atria?
How is AF (Atrial Fibrillation) treated?
1. Ablation of reentry tract by electrophysiologist with cardiac cath
2. Rate control (controls Vent rate)
Calcium channel blockers
3. Rhythm control (to NSR)
4. Anticoagulation to prevent CVA (warfarin)
O2 for SOB
What are some medications used to treat AF via AF anticoagulation?
ASA and Plavix or
New anticoagulants like dibigatram
Coumadin to INR between 2-3
What type of bleeding in response to AF treatment is a leading cause of malpractice lawsuits?
What is happening if there are inverted P' waves?
Retrograde depolarization of atria
The impulse conducts upward (backward) through the heart instead of downward.
What are the causes of more P waves than QRS Complexes?
2nd-degree AV heart block (Types I and II)
3rd-degree AV heart block
Blocked premature atrial complexes (PACs)
Describe a 2nd Degree AV Block.
Not all the sinus beats are conducted through to the ventricles.
Results in more P waves than QRS complexes and a slower ventricular rate.
2 P waves to 1 QRS complex
Describe a 3rd Degree AV Block.
Block occurs with complete blockage of AV node
The atria are stimulated to contract by an impulse that originates from the SA node while the ventricles they are stimulated to contract by an escape pacemaker.
3 to 1 P wave-QRS complex and wide QRS
What are the rates of Ectopic Pacemakers: Atrial Tachycardia, Ventricular Tachycardia and Junctional Tachycardia?
Generally 150-250 BPM
Generally 150-250 BPM
Generally 100-180 BPM
A term we can use if the origin of narrow QRS complex tachycardia cannot be determined.
Arises from above the ventricles but cannot be definitively identified as atrial or junctional tachycardia because the P' waves cannot be seen sufficiently
Call it SVT if it is:
narrow QRS, and you
cannot see p waves because it is too fast
150-250 is the most published numbers
Describe Premature Atrial Complexes (PACs).
Produce an irregularity in the rhythm
Have P' waves that are upright (in lead II) preceding each QRS complex but have a different morphology (appearance) than the P waves of underlying rhythm
Followed by a noncompensatory pause
What is AF with RVR?
Atrial Fibrillation with Rapid Ventricular Response
Define a sinus block.
A sinus block is when an unhealthy SA Node may temporarily fail to pace for at least one cycle
TRUE or FALSE: After the pause of a Sinus Block, pacing resumes at the same rate (And timing) as prior to the block.
Sick Sinus Syndrome most often occurs in elderly individuals who have heart disease and is usually characterized by marked Sinus what, but without normal escape mechanisms of atrial and juntional foci? SSS may also present as recurrent episodes of Sinus Block or Sinus what?
What it is called when patients with SSS develop intermittent episodes of SVT mingled with the Sinus Bradycardia?
What do you see on an EKG with 1st degree AV Block?
Prolonged PR interval (should be less than one large square = .2 seconds)
What are the two Types of 2nd degree AV Block?
Type I - Wenckebach
Type II - Mobitz
Describe Wenckebach block.
Produces a series of cycles with progressive blocking of AV Node conduction until the final P wave is totally blocked in the AV Node, eliminating the QRS response.
Describe Mobitz block.
Usually produces a series of cycles consisting of one normal P-QRS-T cycle preceded by a series of paced P waves that fail to conduct through the AV Node (No QRS complex).
TRUE or FALSE: With Mobitz, every cycle that is missing its QRS has a regular, punctual P wave-- but never a premature P' wave.
Which 2nd degree AV block is considered pathological?
How can you differentiate between Wenckebach and Mobitz?
Wenckebach has PR interval that is lengthened and QRS that is normal
Mobitz has normal PR interval, but QRS complex is widened
By applying vagal maneuvers to determine if it is Wenckebach or Mobitz what happens?
If Wenckebach, with maneuver there are more cycles/series
If Mobitz, with maneuver it becomes 1:1 conduction
Describe a complete 3rd degree AV Block.
When the conduction of supraventricular depolarizations to the ventricles is totally blocked....an automaticity focus escapes to pace the ventricles at its inherent rate
How does a complete AV Block show on EKG?
a usually normal P wave rate superimposed over an independent, slower QRS rate
What is it called when in a 3rd degree AV Block the ventricular rate may be so slow that blood flow to the brain is inadequate, and the patient may lose consciousness (Syncope)?
What else in terms of serum can produce same EKG findings like downward displacement of the pacemaker?
With Bundle Branch Blocks, what is it often that you see on EKG?
Wide QRS with two waves (separate ventricular depolarization)(R & R')
How large must a QRS complex be in order to diagnose Bundle Branch Block?
At least 3 small squares wide (.12)
When look at an EKG how do we tell if it is RBBB or LBBB?
If there a widened QRS complex with two depolarizations (R and R') in leads V1 and V2 it is RBBB and if it is in V5 & V6 it is LBBB
Also RBBB looks like normal QRS shape but LBBB is almost just an R
The Left Bundle Branch has two subdivisions (fascicles) of which can cause what type of blocks?
What are you seeing in an EKG that has a R and R' in a QRS of normal duration?
An intermittent Mobitz is the heart's warning that eventually it will need what?
An artificial pacemaker to drive the ventricles at a normal rate
What refers to the direction of the movement of depolarization, which spreads throughout the heart to stimulate the myocardium to contract?
A vector represents what?
Both direction and magnitude of depolarization....bigger vectors represent greater magnitude
What is the direction of the mean QRS vector?
Downward and the (patient's) left between 0 & +90 degrees
Which leads are used to determine the axis of the mean QRS vector in the frontal plane?
Limb leads not chest leads
I, II, III, AVR, AVL, AVF
If the heart is displaced, the Mean QRS vector is also displaced. In tall, slender individuals the heart may be moved toward the right, known as?
In obese people, due to the diaphragm being pushed up along with the heart, they may have what "type" of heart?
What happens to the mean QRS vector with ventricle hypertrophy?
The Vector displaces toward the hypertrophied side
In myocardial infarction there is a necrotic area of the heart and it does not depolarize; thus the unopposed vectors from the other side draw the Mean QRS vector away or toward the infarct?
Myocardial infarction occurs when?
When a branch of one of the coronary arteries (the heart's own source of blood supply) becomes occluded
As the positive wave of depolarization moves toward a positive electrode, what type of deflection is recorded on the EKG?
Upward deflection (+)
If the QRS is negative (downward deflection on EKG), it is what type of Axis Deviation?
Right Axis Deviation
Which lead is best to see Right Axis Deviation?
TRUE or FALSE: If the QRS is upright in both lead I and AVF, the vector is within the normal range.
How would Left Axis Deviation show on EKG?
Upward QRS in Lead I but downward QRS in AVF
If you see two downward QRS on EKG Lead I and AVF, what type deviation is that?
Describe an isoelectric QRS on EKG.
Records equal magnitudes of upward (+) and negative (downward) deflection
To determine changes ("rotation") of the Mean QRS vector in the horizontal plane, we examine which leads?
What is the placement of chest lead V2?
front of the heart
4th L ICS just anterior to the AV node
When considering the V2 lead on EKG, the QRS is usually what?
Negative (leads move away from the positive V2 electrode toward the thicker and more posteriorly positioned left ventricle)
Which lead is the most informative for the determination of both anterior and posterior infarction of left ventricle?
Lead V2 due to position
In chest leads, there is a gradual transition from what to what?
Shift from generally negative QRS V1 to generally positive QRS of V6
Which chest leads are most isoelectric ("transitional zone")?
V3 & V4
Where is the tail of a vector for chest leads located?
V3 & V4 is the normal chest axis rotation, if the vector rotates toward V1 & V2 what type of rotation is this? What type is it if it rotates towards V5 & V6?
Toward V1 & V2 (Rightward rotation)
Toward V5 & V6 (Leftward rotation)
Use the V3 and V4 to estimate (should be iso-electric)
Axis deviation is in what plane? Axis Rotation is in what plane?
Which lead is directly over the atria and the P wave in this lead is our best source of information for atrial enlargement?
What type of P wave do you see with Atrial Enlargement?
Diphasic P wave (both and positive and negative)
For Right Atrial Enlargement, which component of the Diphasic P wave must be larger?
The initial component
If the terminal component of the diphasic P wave is larger and wide which enlargement is it?
Left Atrial Enlargement
What causes left atrial enlargement? What is the most common cause?
Most common: systemic HTN
The QRS complex reflects ventricular depolarization and should reflect any hypertrophy of ventricles. In Right Ventricular Hypertrophy which wave of the QRS complex is larger in V1?
In V1 the S wave should be larger because the complex is mostly negative, BUT
this will should a large R wave in V1- there is more + depolarization toward toward the V1 electrode--> the other chest leads will have smaller R waves
With Right Ventricular Hypertrophy what type of deviation and rotation is present and why?
Right Axis Deviation (bigger/thicker ventricle moves vector toward it)
Rightward Rotation (more + toward leads V1 & V2)
What is characteristic on EKG of the QRS for Left Ventricular Hypertrophy?
Great big QRS deflections in chest leads--- more depolarization is going downward toward the left of patient's chest away from positive V1 (S wave is even deeper)
V5- large R wave
With Left Ventricular Hypertrophy what type of deviation and rotation is present?
Left Axis Deviation
Which lead is positioned over the L ventricle?
What is a calculation used to determine LVH?
Depth (in mm) of S wave in Lead V1 plus the height of R wave in Lead V5....if greater than 35 mm, there is LVH.
With LVH there is often what type of T-wave?
T wave often shows inversion and asymmetry
Ventricular Hypertrophy may be associated with what pattern?
Strain pattern- ST segment may be depressed and humped
Which lead provides the most info. concerning hypertrophy of the heart's chambers?
The myocardium's own blood supply is provided exclusively by what?
What is the more common term for "myocardial infarction"/"Coronary occlusion"?
What part of the heart suffers from myocardial infarction commonly?
What is the myocardial infarction triad?
BUT any of the three may occur alone
Hypoxia means decreased oxygen; this is usually caused by what in the heart?
What is ischemia characterized by on EKG?
On EKG there are inverted T waves
Cardiac ischemia can cause what alone?
Chest pain (angina)
Any inverted T waves in leads V2 through V6 is considered what?
What syndrome is hallmarked by marked T wave inversion in leads V2 & V3?
Wellens Syndrome (alerts us to stenosis of anterior descending coronary)
What indicates the acuteness of an infarct? What shows on the EKG?
Elevation of ST segment
What is "Prinzmetal's" angina?
Angina without exertion which can cause transient ST elevation in the absence of an infarction
The ST segment does not return to baseline with time in chest leads when the patients has what?
How does Pericarditis show on EKG?
ST segment elevation that may also elevate the T wave off the baseline
What syndrome does this describe: hereditary and can cause sudden death in persons w/o heart disease; RBBB w/ ST segment elevation in V1-V3 (sudden cardiac arrest w/o coronary obstruction).
During an angina attack, the ST segment may be temporarily what?
Any ST depression (in leads with QRS is upright) indicates what?
Compromised coronary blood flow until proven otherwise
Which wave makes the diagnosis of infarction?
Q Waves that are what size are significant to indicate necrosis of a myocardial infarction?
At least one small square wide or 1/3 of entire QRS amplitude
To check for an infarction, we scan which leads?
All leads (except AVR) for Q waves and ST elevation (anterior infarction) (or depression- posterior infarction)
On EKG, an anterior infarction will show Q Waves on which leads?
TRUE or FALSE: Anterior infarctions are very deadly, but fortunately immediate Tx with IV thrombolytic medications or angioplasty with stenting has improved the survival rate substantially
Q Waves in lateral leads, I and AVL are what type of infarctions?
Inferior infarction is diagnosed by Q waves in which leads?
Inferior leads, II, III, and AVF
In acute posterior infarction, there is what on EKG?
A large R Wave in V1 & V2 w/ ST depression
When you do reversed trans-illumination and mirror tests, to confirm posterior infarctions what should you see?
Q waves and ST elevation
Which coronary dominance is by far the most common in humans?
Right Coronary Dominance
What EKG finding helps diagnose Anterior Hemiblock?
Q in Lead I and/or deep S Wave in Lead III
TRUE or FALSE: Isolated Posterior Hemiclock is common.
FALSE: They are rare b/c the posterior division is short, thick, and commonly has a dual blood supply
An unusually deep or unusually wide S in Lead I and Q wave in Lead III, shows what?
COPD often produces what on EKG? What other conditions shows the same?
low voltage amplitude in all leads & usually RAD
Hypothyroidism and Chronic Obstructive Pericarditis
On EKG, what shows for Pulmonary Embolus?
Large S Wave in lead I
ST depression lead II
Large Q wave in Lead III (W/ T wave inversion)
T Wave inversion in V1-V4
What is the most striking and classic feature of elevated serum potassium on EKG? What else is on EKG?
Peaked T Waves
On EKG, the P Wave widens and flattens and nearly disappears
With hypokalemia, what shows on EKG?
T wave flat or inverted and a U Wave
What causes a gradual downward curve of ST segment? Medication
Supraventricular foci are exceptionally sensitive to digitalis and tends to cause what?
Atrial & Junctional premature beats
PAT with block
Digitalis Toxicity can cause what?
Atrial & Junctional tachy-arrhythmias
Ventricular Bigeminy, Trigeminy
Episodes of what can result from quinidine toxicity?
Episodes of Torsades de Pointes
What type of pacemaker is programmed with an "inherent rate" that is overdrive-suppressed by normal Sinus pacing?
What gets left in a heart transplant in the recipient?
Leaves portions of the recipient patient's "native" atria in place of which contains the patient's own SA Node
Patient will end with two SA Nodes which each produce P waves