Cardiology Cards fr 10-25
Card Set Information
Cardiology Cards fr 10-25
Cardiology cards for 10-25
The left anterior descending artery supplies the ____ ____ .
Ischemia involving the L anterior descending artery can be seen in what EKG leads?
1, AVL, V1-V6
V2 – V4
V1 – V3
Probs w/the left anterior descending artery cause infarct in what part of the heart?
L ventricle, anterior wall
Probs w/ the L anterior descending artery cause what 3 hemodynamic consequences?
Papillary muscle rupture
What dysrhythmias are common to the L anterior descending artery?
2nd degree Mobitz 2 or 3rd degree blocks
The L circumflex artery supplies what parts of the heart?
L atrium & ventricle
40-50% of the SA Node
8-10 % of the AV Node
Bundle of his
Infarct locations related to the L circumflex artery are what?
Lateral wall, L ventricle
Issues w/ the L circumflex show up in what leads?
1, AVL, V4-V6
The hemodynamic consequences of a problem w/the L circumflex are what?
What common dysrhythmia can be related to the L circumflex?
The R coronary artery supplies what parts of the heart?
R atrium & ventricle
Posterior L ventricle
50-60% of the SA node
Bundle of His
Infarct locations related to the R coronary artery are what?
Ischemia related to the R coronary artery can be seen in what EKG leads?
Hemodynamic consequences related to the R coronary artery include. . . .
Some unique findings that show w/a prob w/ the R coronary artery are what?
Can present w/isolated R failure
Common dysrhythmias caused by a prob w/R coronary artery are what?
1st degree or 2nd degree mobitz I blocks
Hemiblock is short for ____ ____ & occurs when?
When 1 or more fascicles of the LBB is/are blocked
Hemiblocks increase the risk for complete heart block under what 2 circumstances?
When combined w/1st or 2nd degree block
2 hemiblocks aka bifasicular
Leads V1-V6 are know as ____ leads & view the chest in a ____ ____.
Posterior precordial leads (V8,V9) are located where?
V8 = 5th IC space Mid scapular
V9 = 5th IC between V8 & spine
A TCA OD presents how & in what lead?
Wide QRS in AVR
What are the 6 rules for interpreting a 12 lead?
Identify underlying rhythm
Determine the axis
Locate & ID ectopic beats
Eval clinical & EKG evidence for cardiac ischemia &/or infarct
Localize cardiac ischemia/infarct
Look for BBB, Hemiblocks, Hypertrophy
What does the axis of the heart indicate?
Predominant flow of electricity thru the heart
Give 6 causes of left axis deviation. . .
Mechanical shift of the heart
Give 6 causes of right axis deviation. . . .
Mechanical Shift of the heart
Right ventricular hypertrophy
A normal axis is between ____ & ____.
0 & +90
A left shoulder axis is between ____ & ____.
0 & -90
A right shoulder axis is between ____ & ____.
+ - 180 & -90
A right axis is between ____ & ____.
+90 & + - 180
A normal axis presents in Leads I, II, III as what?
Lead I = up
Lead II = up
Lead III = up
A physiologic L axis presents how in Leads I, II, III?
I = up
II= up/ even up & down
III = down
Pathological L axis presents what in Leads I, II, III & shows an ____ ____.
I = up
II = down
III = down
An R axis presents how in Leads I, II, III & shows a ____ ____.
I = down
II = up/ even up & down
III = up
An extreme R axis (aka ___ ___ ___) presents how in Leads I, II, III & is often __ __ __.
I = down
III = down
Ventricular in Origin
How does a hemi block present anteriorly?
QRS is normal or RBBB
L axis deviation
Sm qR wave in Lead I
rS wave in lead III
What are the clinical correlates of an anterior hemiblock?
Anterior & inferior MI
A posterior hemiblock presents with?
QRS normal or RBBB
R axis deviation
Sm qR wave in lead III
Lg rS wave in lead I
What are the clinical correlates of a posterior hemiblock?
Has dual blood supply so requires extensive cardiac damage to injure
What exactly is a hemiblock?
Block of 1 of the fascicles of the LBB
What is a bifasicular block?
Block where 2 fascicles are occluded; RBBB & anterior (most common) OR posterior hemiblock
Until proven otherwise all axis deviations are assumed to represent a ____ so ____ ____ are contraindicated if the pt has what or what.
Class I Antidysrhythmic
Anykind of AV block or BBB
What are some problems (5) w/pts w/a bifasicular block?
Much sicker than an uncomplicated MI
May drop BP precipitously
May go into V Fib or tach w/o warning
May go into complete heart block
Should not receive Class I antidysrhythmics
Describe a trifasicular block.
A bifasicular block plus a 1st degree block
What 3 things can cause damage to the bundles/
Myocardial infarction or ischemia
Post RF ablation
Anterior/posterior myocardial infarction/ischemia cause bundle damage where?
Anterior MI RBBB
Posterior MI LBBB
The ___ ___ ___ conducts across the rt ventricle.
Right bundle branch
The Left bundle branch is divided in to what 3 parts & conducts across where?
Anterior, posterior & septal (minor)
Across the left ventricle
What happens in a bundle branch block?
Branches of the bundle of his become damaged
What could happen to conduction thru an area w/a BBB?
It could be slowed, partially blocked or completely blocked
What are the hallmarks of a bundle branch block?
QRS > 0.12 (widest in leads closest to block)
Abnormal QRS morphology
T polarity opposite of QRS
How do we recognize BBB’s?
QRS >0.12 in V1
Circle J point
Draw line back into complex then up or down w/terminal deflection
Shade in triangle made by line
Arrow up = R turn signal = RBBB
Arrow down = L turn signal = LBBB
What are the 6 steps in a V Tach algorithm?
ERAD + Pos V1 OR
QRS morphology in V1 or V6 OR
RAD + Neg V1 OR
RS interval (V lead) is > 100ms OR
QRS > 0.14 sec
What is the effect of cardiac ischemia on the Q waves?
it creates a deep wide Q wave that is a permanent sign of the event
An ST segment elevation is indicative of what?
May be associated w/ peaked T waves in acute state
Abnormal T waves are ____, ____ & ____.
What is seen in deep T wave inversion?
Seen in leads reflecting ischemia
ST segment preceding T Waves is commonly coved upward
Septal infarcts involve ___ ___ ___ & show where on the EKG?
Left Anterior Descending
Leads V1 & V2
An infarct localized in an Anterior Wall involves the ___ ___ ___ artery and shows on leads ___ & ___.
Left Anterior descending
V3 & V4
A lateral wall infarct shows in what arteries & what leads?
Left Anterior Descending &/or Left Circumflex
1, V5, V6
AVL = High Lateral Wall
Anterolateral wall infarct involves what 2 arteries & shows in what leads?
Left Anterior Descending & Left Circumflex
1, aVL, V3-V6
An inferior wall infarct affects what arteries & shows in what leads?
Rt coronary or Left Circumflex
2, 3 & aVF
A posterior wall infarct involves what arteries & shows how on EKG?
Distal Left block or posterolateral branch
Leads V1 - V4