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Septal myocardial infarctions primarily involve the:
left coronary artery
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The diagonal arteries of the left coronary arteries supply blood to the:
anterilateral wall of the left ventricle
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Reciprocal changes that are seen in an inferior MI are most often:
I, aVL & or v5 & v6
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Which two drugs can affect preload in patients with right ventricular infarctions?
morphine & nitroglycerin only
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Anterior MIs most often involve which artery?
left coronary artery
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ST segment elevation in the face of an anteroseptal MI would involve elevation if 1mm or more in these leads:
v1, v2, v3, v4
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The condition caused by inadequate cardiac output (pump failure) is called:
cardiogenic shock
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ST elevation of 1mm or more in these leads is indicative of a posterior MI:
There are no leads facing leads for posterior MI.
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The leads that are reciprocal leads for a posterior MI are:
v1, v2, v3, v4
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All of the following are types of EKG leads except:
A) precordial
B) unipolar
C) bipolar
D) augmented
E) multipolar
E) multipolar (this multiple choice question has been scrambled)
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Metabolism that occurs in the absence of O2 is termed:
anaerobic
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A drug that is a naturally occurring catecholamine & stimulates both alpha & beta receptor site is:
epinehprine
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Drugs that can be given down the endotracheal tube include all of the following except:
A) valium
B) epinephrine
C) narcan
D) atropine
A) valium (this multiple choice question has been scrambled)
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The half-life of epinephrine is 3 to 4 minutes; the half life of vasopressin is:
10 to 20 minutes
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The generic name for intropin is:
dopamaine
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Mr. Johnson came to the hospital within the hour after his heart attack started. You would expect to see what indication of acute MI on his EKG?
ST segment elevation in the leads over the damaged area
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In a lateral wall MI, which coronary artery is occluded?
Circumflex
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The MI in Figure 20 is
extensive anterior (anterior-lateral)
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In Figure 21 there is evidence of
inferior MI
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Mrs. Campho had a previous inferior MI about 20 years ago. What would you expect to see on her EKG that would be consistent with her old inferior MI?
significant Q wave in II, III & AVF
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The order in shich an MI progresses through "the tree I's" is:
ischemia, injury, infarction
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AV dissociation is a hallmark of:
third-degree AV block
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The rhythm in Figure 18 is
third-degree AV block
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Wenchebach is characterized by
gradually prolonging PR intervals
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The rhythm in Figure 10 is
sinus rhythm w/ a sinus arrest & a ventricular escape beat
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Following PVCs is usually a(n)
complete compensatory pause
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For which of the following rhythms is electrical shock to be the heart NOT appropriate?
A) ventricular tachycardia
B) torsades de pointes
C) aystole
D) ventricular fibrillation
C) aystole (this multiple choice question has been scrambled)
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The rhythm in Figure 15 is
torsades de poines
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Idioventricular rhythm has a heart rate of:
20-40
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Multifocal PVCs are those that:
have different shaped QRS complexes
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EKG RULES
- 1) rate
- 2) rhythm/regularity
- 3) QRS complex
- 4) P waves
- 5) relationships & measurements
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Sinus Rhythms
- 1) normal sinus rhythm (sinus rhythm)
- 2) sinus bradycardia
- 3) sinus tachycardia
- 4) sinus arrhythmia
- 5) sinus arrest
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Normal Sinus Rhythm Characteristics
- 1) pacemaker site: SA node
- 2) rate: 60-100 bpm
- 3) P waves: upright in lead II, all look alike
- 4) PR interval: generally constant; 0.12-0.20 seconds
- 5) RR interval: usually regular
- 6) QRS complexes: usually normal apprearing & < 0.12 seconds, may be wide
- 7) P to QRS relationship: P precedes each QRS
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H's
- 1) Hypovolemia
- 2) Hypoxia
- 3) Hydrogen Ion
- 4) Hyper/Hypo-kalemia
- 5) Hypothermia
- 6) Hypo/Hyper-glycemia
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T's
- 1) Tablets/Toxins
- 2) Cardiac Tamponade
- 3) Tension Pneumo
- 4) Tamponade (AMI)
- 5) Thromboembolism
- 6) Trauma
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Right Coronary Artery Dristribution
- 1) AV node (90% of population)
- 2) Right Ventricle
- 3) Inferior wall of left ventricle
- 4) Posterior wall of left ventricle
- (RCA forms posterior descending branch & supplies inferior wall - 90% of population)
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Left Coronary Artery
- 1) Supplies bundle branches in 10% of people
- 2) Septal Wall of left ventricle
- 3) Anterior wall of left ventricle
- 4) Lateral wall of left ventricle
- 5) Posterior wall of left ventricle
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Lateral Wall Artery
Left Coronary Artery
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Inferior Wall Artery
Right Coronary Artery
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Septal Wall Artery
Left Coronary Artery
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Anterior Wall Artery
Left Coronary Artery
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Antidysrhythmics
- 1) atropine sulfate
- 2) lidocaine
- 3) procainamide
- 4) adenosine
- 5) amiodarone
- 6) verapamil
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Prinzmetal angina
also known as variant angina or angina inversa, is a syndrome typically consisting of angina (cardiac chest pain) at rest that occurs in cycles. It is caused by vasospasm, a narrowing of the coronary arteries caused by contraction of the smooth muscle tissue in the vessel walls rather than directly by atherosclerosis (buildup of fatty plaque and hardening of the arteries). It occurs more in younger women.
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5 Rules for a 3rd Degree Heart Block Strip
- 1) brady
- 2) regular P wave w/ no QRS correlation
- 3) P wave extra but maps out
- 4) PR interval varies
- 5) QRS wide
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trycyclic OD indication & treatemnt
1 amp Bicarb then 2 amps in 1 liter wide open (amp = 40 mEq)
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SLUDGE treatment
2-5mg Atropine
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SLUDGE
- Salivation
- Lacrimation (mamary gland)
- Urination
- Defication
- GI upset
- Emisis
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Procainamide stop points
- 1) up to 17mg/kg to effect
- 2) ectopy resolves
- 3) QRS complex widens > 50% from original
- 4) hypotension ensues
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