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Flashcards in EKG fun Deck (20)
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1
Q

In what direction is left axis deviation?

A

superiorly to the left

2
Q

in what direction is right axis deviation?

A

inferiorly to the right

3
Q

in what direction is extreme right axis deviation?

A

superiorly to the right

4
Q

in what leads do you look to detect deviation?

A

Lead I and aVF

5
Q

Lead I and AVF both have upward QRS?

A

NORMAL deviation

6
Q

Lead I and AVF both have downward QRS?

A

Extreme right axis deviation

7
Q

Lead I has downward QRS and AVF has upward QRS?

A

right axis deviation

8
Q

Lead I has upward QRS and AVF has downward QRS?

A

Left axis deviation

9
Q

What if (e.g.) Lead III has a QRS complex that is biphasic and equiphasic?

A

The axis is perpendicular to Lead III

this is AVR, and is either at +30 or -150 degrees.

If AVR has an upward QRS, that means it’s +30 (normal)

If AVR has a downward QRS, that means it’s -150 (extreme R axis deviation)

10
Q

How do you measure rhythm?

A

Measure from the vertical line of one QRS to another

11
Q

How do you measure HR?

A

300 rule

12
Q

What does poor R wave progression indicate in the precordial leads?

A

Scar tissue in the interventricular septum or anterior heart is very likely.

Probably a pt who had an MI at some point in the past

13
Q

What is you have a biphasic and equiphasic QRS complex in Lead I?

A

This means the axis is perpendicular to lead I… therefore is AVF

AVF can be either +90 (if the wave is positive in AVF - normal to R axis deviation) or -90 (if the wave is negative in AVF - left axis to extreme R axis deviation).

14
Q

How do you assess for premature atrial contraction (PAC)?

A

in Lead II, some of the P waves will be early and will just look weird

15
Q

When would you see a p wave greater than 2.5 boxes high in lead II?

(also often seen in leads III and avf)

A

R atrial enlargement

16
Q

When would you see a biphasic p wave in V1 that has a greater downward portion (>1mm in width in depth)

A

Left atrial enlargement

17
Q

How do you determine if a patient has LVH based on the precordial leads?

A

1. RV5 of V6 + SV1 or V2 > 35mm*

  1. RV5 alone > 26mm
  2. RV6 alone > 18mm
  3. RV6 > RV5

only need one, but the more you have, the more likely it is LVH

18
Q

How do you tell if a patient has LVH based on the limb leads?

A
  1. Ravl > 13mm
  2. Ravf > 21mm
  3. Rlead1 > 14mm

4. Rlead1 + Slead3 > 25mm*

19
Q

What does a patient have if you see R > S in V1

and/or

S > R in V6?

A

RVH

20
Q

What deviation must you have for RVH to be true?

A

Some type of R axis deviation