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Cardiology Flash Cards
Cardiology Flash Cards
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Conduction System
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Analyzing EKG
Step by step
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Analysis of Rhythm
!
A third degree block exists when the P and the QRS waves are
entirely disassociated. These blocks often result from interference
along some part of the His-Purkinje system which can usually be
located by examining the chest leads such as Vl-V6 to determine
if it is a right or left bundle branch block as well as its type.
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AXIS IN A GLANCE
! both
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MI,
! Digitalis toxicity
! Hyperkalemia
! Increased vagal tone
! Acute rheumatic fever
! Myocarditis.
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2 A-V Block
When some of the atrial impulses fail to
reach the ventricle because of impaired
caonduction.
! Types:
!
"
"
Type I Wenckeback
Type II Mobitz
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Rheumatic HD
Acute inferior MI
Digitalis or Propranolol effect.
Chronic Ischemic HD
Aortic Valve disease.
Mitral Valve Prolapse.
ASD Atrial Septal Defect
Amyloidosis.
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Type II Mobitz II
! Its
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Type II Mobitz II
" It can occur after an acute anterior MI due to damage
in the bifurcation or the bundle branches.
" It is more serious than the type I block.
" Treatment is usually artificial pacing.
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"
"
"
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Hemi-Block
Anterior Hemi-Block
1. LAD (-60)
2. Small Q Lead (I)
Small R Lead (III)
Deep S Lead (III)
3. Normal QRS
4. Delayed internsicoid
in aVL
Posterior Hemi-Block
1. RAD (+120)
2. Small R Lead (I)
Small S Lead (III)
Small Q Lead (III)
3. Normal QRS
4. No evidence of RVH
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HINTS:
LEAD
LI
L aVL
L II
L III
L aVF
Anterior
AHB
Posterior
PHB
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RBBB
V1 late intrinscoid, M
shaped QRS (RSR)
sometimes wide (R)
V6 Early intrinscoid,
wide (S) wave
L1 Wide (S) wave
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! Prolonged
QT Interval
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1.
2.
3.
4.
Premature (early).
Different looking (P) wave.
Followed by long internal but not a fully
compensatory pause.
Can result in drop (P), with Nonconducting APB
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PVCs {CONT.}
! Another
! Timing
of occurance:
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150-250 / Min
! QRS: Normal in configuration.
! P wave: not visible.
! After accompanied by non-specific ST-T
wave changes.
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Atrial Tachycardia
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Atrial Flutter
!
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Atrial Flutter
!
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Atrial Fibrillation
!
!
!
!
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An extra connection
(accessory pathway) is
present between the
upper chamber (atrium)
and lower chamber
(ventricle). Patients with
such a connection are
said to have the WolffParkinson-White
syndrome (WPW). The
extra connection is
shown here during
normal sinus rhythm.
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WPW-Orthodromic Reciprocating
Tachycardia-Common
Here, the extra connection
is seen being used to
complete a circuit which
causes the tachycardia.
The electrical impulse
flows down the normal
AV node from the atrium
to the ventricle, then
returns back to the
atrium via the accessory
pathway, which acts as
a "short circuit" to
perpetuate the
arrhythmia.
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Ventricular Tachycardia
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Ventricular Fibrillation
!
Ventricular fibrillation
occurs when parts of the
ventricles depolarize
repeatedly in an erratic,
uncoordinated manner.
The EKG in ventricular
fibrillation shows random,
apparently unrelated
waves. Usually, there is
no recognizable QRS
complex
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Atrial enlargment
!
!
!
!
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Normal EKG
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Sinus Tachycardia
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Important Mimikar
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What is that?
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Acute Inferior MI
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Acute Anterior MI
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Old Inferior MI
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