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EKG

Terms in this set (26)

Small square
0.04 seconds
Big square
0.20 seconds
Normal PR interval
0.12-0.20 seconds (3-5 small boxes)
Normal QRS complex
0.8 - 1 seconds
Normal QT interval
0.34-0.43 seconds
What can cause a prolonged QT interval?
V tach or v fib
Psych drugs
EKG can show
Structural changes
Conduction disturbances
Ischemia or infarction
Electrolyte imbalances
Drug toxicity
Junctional Dysrhythmias
Start in the AV node to the bundle of His (AV junction)
AV node moves backwards
Abnormal p wave before, during, or after QRS complex
Causes of junctional dysrhythmias
CAD
HF
cardiomyopathy
Electrolyte imbalance
Inferior MI
Rheumatic heart disease
Meds - digoxin, caffeine, amphetamines, nicotine
Junctional Escape Rhythm
Rate: 40 to 60bpm
Regularity: Regular
No p wave
Treatment: atropine if symptomatic, stop med or whatever is causing it; if no symptoms just monitor
Accelerated Junctional Rhythm
No p wave
HR: 61-100 bpm
Junctional Tachycardia
No p waves
HR: 101-180 bpm
Treatment for accelerated Junctional abs Junctional tachycardia
Beta blocker
Ca channel blocker
Amiodarone
(They control the rate)

*don't do cardio version because you have to have a functioning SA node for it to work
decreased CO symptoms
C - chest pain
A - altered LOC
S - syncope, SOB
H - hypotension

"If you've got the cash, buy the drugs!"
First degree AV block
PR interval > 0.20 sec (bigger than 1 big square)
Seen in young healthy athletes
Usually asymptomatic - monitor them because it's usually not serious
2nd degree type 1 mobitz 1 or wenckebach
Gradual lengthening of PR interval

Bradycardia
Causes of mobitz 1 or wenckebach
Digoxin, beta blockers
CAD
MI
Myocardial ischemia
Treatment of Mobitz 1 or wenckebach
Asymptomatic - observe closely

Symptomatic - atropine or temporary pacemaker

Stop any drugs that may be causing
2nd degree type 2 mobitz 2
P wave and consistent PR interval
Usually a block in a bundle branch

QRS dropped in a 2:1 or 3:1 ratio

More serious -> can progress to a type 3rd degree block

Decreases HR - decreased CO result = hypotension and myocardial ischemia

Regular p wave, r wave is irregular

Not cyclic
Causes of mobitz 2
Rheumatic heart disease
CAD
ant MI
Drug toxicity
Treatment for a mobitz 2
Permanent pacemaker
Correct drug toxicity
3rd degree AV block (complete heart block)
Atrial and ventricular rhythm are unrelated to each other
PR interval variable with no relation between P wave and QRS complex
Causes of 3rd degree AV block
CAD
MI
myocarditis
Cardiomyopathy
Scleroderma
BB, CCB, digoxin
QRS complex in 3rd degree AV block
Normal - block is at the bundle of his or higher

Widened - block below bundle of His
Complications of a 3rd degree AV block
Decreased cardiac output with ischemia heart failure and shock
Possible syncope
Treatment for 3rd degree AV block
Pacemaker
Dopamine and Epi IV drip
- support HR and BP
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