Download ekgs_2


Normal EKG
– P wave: Atrial depolarization
– PR interval: < 0.20 sec
– QRS complex: ventricular depolarization
– QRS interval
 < 0.10 sec SA
 0.10 – 0.12 supraventricular
 > 0.12 sec ventricular
Sinus Bradycardia
Sinus tachycardia
Pathophysiology: none. It’s a sign of
something else.
 Criteria:

– Rate > 100 bpm
– Rhythm: sinus
– PR: < 0.20
– QRS: normal

Fever, exercise, hypovolemia, adrenergic
stimulation.
Sinus Tachycardia
Sinus Arrhythmia
Atrial Fibrillation/Flutter

Pathophysiology: Atrial impulses faster that
SA. Reentry pathway
 Criteria:
– Rate: depends on atrial conduction
– Rhythm: irregularly irregular
– PR: cant diagnose. No P waves
– QRS: narrow

CAD, CHF, vavular disease, hypoxia, drugs
Atrial Fibrillation
Atrial Flutter
PSVT

Pathophysiology: Reentry
 Criteria:
– Rate: > 150 bpm
– Rhythm: regular
– PR interval: cant see P waves
– QRS: Narrow.

Accessory conduction pathway, CAD,
COPD, CHF
Paroxysmal Supraventricular Tach
Multifocal Atrial Tach

Pathophysiology: Increased areas of
automaticity.
 Criteria:
–
–
–
–

Rate: greater than 120 bpm
Rhythm: irregular
PR: variable (3 or more P waves)
QRS: narrow
COPD
Multifocal Atrial Tachycardia
1st degree block

Pathophysiology: slowed conduction
 Criteria
– Rate: slow < 60 bpm
– Rhythm: regular
– PR: > 0.20 second
– QRS: narrow

Drugs (av nodal blockers, β-blockers, Ca+2
channel blockers, inferior MI.
1st degree heart block
2nd degree block I

Pathophysiology: AV node
 Criteria
– Rate: Regular or < 60 bpm
– Rhythm: Regular with pause
– PR: Progressive lengthing
– QRS: narrow (until dropped)

Drugs, parasympathetic tone, RCA
2nd degree type I - mobitz 1 - wenckebach
2nd degree block II

Pathophysiology: Below the AV node
 Criteria
– Rate: Different between atrial and ventricular
– Rhythm: Atrial – regular, vent – irregular
– PR: normal
– QRS: narrow (dropped beat)

ACS (LCA)
2nd degree heart block type II – mobitz 2
3rd degree block

Pathophysiology: no impulses from Atria
 Criteria
– Rate: Atrial – 60, ventricular – 40
– Rhythm: regular
– PR: none
– QRS: narrow or wide

ACS (LCA)
3rd degree heart block – complete heart block
Premature Ventricular Contraction - PVC
Multi focal PVC
Bigeminy
Couplets and Triplets
R on T phenomenon
Ventricular Tachycardia
Ventriucular Fibrillation
Asystole