NYU EKG EXAM WITH CORRECT ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
ANSWERS
normal sinus rhythm - correct answers✔✔Regular; rate 60-100, p waves present, PR interval
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
0.12-0.20, QRS <0.12 narrow ||\\||\\ ||\\||\\ ||\\||\\
sinus bradycardia - correct answers✔✔Regular; rate <60, p waves present, PR interval 0.12-
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
0.20, QRS <0.12||\\||\\ ||\\||\\
causes: increased vagal tone, inferrior wall MI, hypothyroidism, beta blockers, morphine
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
tx: only if symptomatic, stop above meds
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
*provide ADE(atropine, dopamine, epi) ||\\||\\ ||\\||\\ ||\\||\\
-temporary pacemaking ||\\||\\
Sinus Tachycardia - correct answers✔✔Regular; rate 101-160, p waves present, PR interval
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
0.12-0.20, QRS <0.12 ||\\||\\ ||\\||\\
cause: "tachy hearts" ||\\||\\ ||\\||\\
Temp elevation ||\\||\\
Aerobic exercise ||\\||\\
Cardiac disease ||\\||\\
Hyperthyroidism
Yelp-pain
Hemorrage/hypovolemic shock ||\\||\\
Emotional stress/fear ||\\||\\
Anemia
Resp conditions
||\\||\\
,Therapeutics-atropine,albuterol, etc ||\\||\\
Stimulants
tx: identify and treat underlying cause
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
significance:increased 02 requirement is warning sign ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Sinus Arrhythmia - correct answers✔✔IRREGULAR; rate 60-100, p waves present, PR interval
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
0.12-0.20, QRS <0.12 ||\\||\\ ||\\||\\
QT interval varies slightly
||\\||\\ ||\\||\\ ||\\||\\
cause: normal variation with respiratory cycle ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
no tx ||\\||\\
SVT - correct answers✔✔Regular; rate >160, UNABLE to visualize p waves, UNABLE to
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
measure PR interval, QRS <0.12 ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
causes: alcohol, caffeine, tobacco, digoxin toxicity, hypoxia, electrolyte imbalance, COPD
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
tx: if unstable vagal maneuvers, adenosine, cardioversion, ablation
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A flutter - correct answers✔✔Regular/Irregular; rate atrial 250-400, ventricular varies, p
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
waves = abnormal "SAWTOOTH" more p's than QRS, unable to measure PR interval, QRS
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
<0.12
P:QRS ratio 3:1, 4:1 ||\\||\\ ||\\||\\ ||\\||\\
causes: hypertension, cardiomyopathy, hypoxia, pulmonary disease, post open heart surgery
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
tx: if unstable= control HR!
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
cardioverion, digoxin, beta blockers, ca channel blockers (to slow AV node) ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
special considerations pulse deficit(heart beats faster than palpable distal and apical pulses)
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A fib - correct answers✔✔IRREGULAR; atrial >400 ventricular varies, rhythm IRREGULAR, p
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
waves,not present before QRS, unable to measure PR interval, QRS <0.12 ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
, causes: hypertension,cardiomyopathy, hypoxia, pulmonary disease, post cardiac surgery
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
tx: if unstable restore sinus rhythm by cardioversion or consider anti arrhythmic drugs,
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
consider anticoagulation ||\\||\\
special considerations: pulse deficit, loss of atrial contraction ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
V tach - correct answers✔✔Regular; rate >100, no p waves, no PR interval, QRS wide >0.12
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
causes: post mi, ischemia, cardiomyopathy, mitral valve prolapse, chf, digoxin toxicity,
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
electrolyte imbalance ||\\||\\
tx: stable- amiodarone, lidocaine, procainamide
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
unstable-cardio version ||\\||\\
pulseless-defribrillation
sustained v tach with pulse - correct answers✔✔asses LOC ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
call rapid ||\\||\\
get emergency cart ||\\||\\ ||\\||\\
administer o2 ||\\||\\
establish iv ||\\||\\ ||\\||\\
if stable treat with meds
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
if unstable prepare foor cardioversion
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Torsades de pointes - correct answers✔✔IRREGULAR; Type of v tach, rate 250-350, no p ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
waves, no PR interval, wide QRS >0.12 ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
cause: quinidine, procinamide, tricyclic antidepressants, decreased Mg
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
tx: Mg,overdrive pacing, defibrillate
||\\||\\ ||\\||\\ ||\\||\\
V fib - correct answers✔✔Irregular; ventricles quiver, decreased CO, chaotic rapid rhythm, no
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
rate, no p waves , no or interval, no QRS
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
ANSWERS
normal sinus rhythm - correct answers✔✔Regular; rate 60-100, p waves present, PR interval
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
0.12-0.20, QRS <0.12 narrow ||\\||\\ ||\\||\\ ||\\||\\
sinus bradycardia - correct answers✔✔Regular; rate <60, p waves present, PR interval 0.12-
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
0.20, QRS <0.12||\\||\\ ||\\||\\
causes: increased vagal tone, inferrior wall MI, hypothyroidism, beta blockers, morphine
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
tx: only if symptomatic, stop above meds
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
*provide ADE(atropine, dopamine, epi) ||\\||\\ ||\\||\\ ||\\||\\
-temporary pacemaking ||\\||\\
Sinus Tachycardia - correct answers✔✔Regular; rate 101-160, p waves present, PR interval
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
0.12-0.20, QRS <0.12 ||\\||\\ ||\\||\\
cause: "tachy hearts" ||\\||\\ ||\\||\\
Temp elevation ||\\||\\
Aerobic exercise ||\\||\\
Cardiac disease ||\\||\\
Hyperthyroidism
Yelp-pain
Hemorrage/hypovolemic shock ||\\||\\
Emotional stress/fear ||\\||\\
Anemia
Resp conditions
||\\||\\
,Therapeutics-atropine,albuterol, etc ||\\||\\
Stimulants
tx: identify and treat underlying cause
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
significance:increased 02 requirement is warning sign ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Sinus Arrhythmia - correct answers✔✔IRREGULAR; rate 60-100, p waves present, PR interval
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
0.12-0.20, QRS <0.12 ||\\||\\ ||\\||\\
QT interval varies slightly
||\\||\\ ||\\||\\ ||\\||\\
cause: normal variation with respiratory cycle ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
no tx ||\\||\\
SVT - correct answers✔✔Regular; rate >160, UNABLE to visualize p waves, UNABLE to
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
measure PR interval, QRS <0.12 ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
causes: alcohol, caffeine, tobacco, digoxin toxicity, hypoxia, electrolyte imbalance, COPD
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
tx: if unstable vagal maneuvers, adenosine, cardioversion, ablation
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A flutter - correct answers✔✔Regular/Irregular; rate atrial 250-400, ventricular varies, p
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
waves = abnormal "SAWTOOTH" more p's than QRS, unable to measure PR interval, QRS
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
<0.12
P:QRS ratio 3:1, 4:1 ||\\||\\ ||\\||\\ ||\\||\\
causes: hypertension, cardiomyopathy, hypoxia, pulmonary disease, post open heart surgery
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
tx: if unstable= control HR!
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
cardioverion, digoxin, beta blockers, ca channel blockers (to slow AV node) ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
special considerations pulse deficit(heart beats faster than palpable distal and apical pulses)
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
A fib - correct answers✔✔IRREGULAR; atrial >400 ventricular varies, rhythm IRREGULAR, p
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
waves,not present before QRS, unable to measure PR interval, QRS <0.12 ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
, causes: hypertension,cardiomyopathy, hypoxia, pulmonary disease, post cardiac surgery
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
tx: if unstable restore sinus rhythm by cardioversion or consider anti arrhythmic drugs,
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
consider anticoagulation ||\\||\\
special considerations: pulse deficit, loss of atrial contraction ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
V tach - correct answers✔✔Regular; rate >100, no p waves, no PR interval, QRS wide >0.12
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
causes: post mi, ischemia, cardiomyopathy, mitral valve prolapse, chf, digoxin toxicity,
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
electrolyte imbalance ||\\||\\
tx: stable- amiodarone, lidocaine, procainamide
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
unstable-cardio version ||\\||\\
pulseless-defribrillation
sustained v tach with pulse - correct answers✔✔asses LOC ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
call rapid ||\\||\\
get emergency cart ||\\||\\ ||\\||\\
administer o2 ||\\||\\
establish iv ||\\||\\ ||\\||\\
if stable treat with meds
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
if unstable prepare foor cardioversion
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
Torsades de pointes - correct answers✔✔IRREGULAR; Type of v tach, rate 250-350, no p ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
waves, no PR interval, wide QRS >0.12 ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
cause: quinidine, procinamide, tricyclic antidepressants, decreased Mg
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
tx: Mg,overdrive pacing, defibrillate
||\\||\\ ||\\||\\ ||\\||\\
V fib - correct answers✔✔Irregular; ventricles quiver, decreased CO, chaotic rapid rhythm, no
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
rate, no p waves , no or interval, no QRS
||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\ ||\\||\\
