EKG Rhythm Strips 61
Identify the following rhythms.
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Answers
1.
The rhythm is irregular. The rate is 100/min. P waves are not seen. There are multifocal PVCs present. The T wave is inverted in lead II. The QRS complex in V1 has an rSR pattern suggestive of a right bundle branch block. PR: ---, QRS: .12 sec, QT: .32 sec.
2.
The rhythm is irregular due to the paced and demand beats. The rate is 70/min. Flutter waves are seen between the QRS complexes. There are ventricular pacer spikes with the 2nd - 5th complexes. The 5th and 7th complexes look like fusion beats. PR: ---, QRS: .16 sec, QT: .52 sec.
3.
The rhythm is irregular with a ventricular rate of 70/min. There are some inverted P waves noted with the 1st, 2nd, 3rd, 6th, 7th, 8th, and 9th complexes. The pacemaker is not sensing as there are pacer spikes that follow the 2nd and 7th complexes. The ST segment is down slopping in lead II. PR: ---, QRS: .10 sec, QT: .40 sec.
4.
The rhythm is regular. The rate is 88/min. The P waves are upright and precede the QRS complex. No ectopic beats are seen. There is 1mm ST depression with inversion of the T wave in lead II. PR; .16 sec, QRS: .08 sec, QT: .32 sec.
5.
In this strip we have ST depression in lead II with ST elevation in lead V1. In a patient with an anterior MI there will ST elevation in the precordial leads V1-V4 with reciprocal ST depression in the inferior leads II, III and AVF. This patient had positive serum troponins which substantiated the diagnosis of acute myocardial infarction.
Reviewed 3/2/16
1.
2.
3.
4.
5.
Answers
1.
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Atrial fibrillation with unifocal PVCs |
The rhythm is irregular. The rate is 100/min. P waves are not seen. There are multifocal PVCs present. The T wave is inverted in lead II. The QRS complex in V1 has an rSR pattern suggestive of a right bundle branch block. PR: ---, QRS: .12 sec, QT: .32 sec.
2.
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| Atrial flutter with ventricular paced beats |
The rhythm is irregular due to the paced and demand beats. The rate is 70/min. Flutter waves are seen between the QRS complexes. There are ventricular pacer spikes with the 2nd - 5th complexes. The 5th and 7th complexes look like fusion beats. PR: ---, QRS: .16 sec, QT: .52 sec.
3.
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| Failure to sense |
The rhythm is irregular with a ventricular rate of 70/min. There are some inverted P waves noted with the 1st, 2nd, 3rd, 6th, 7th, 8th, and 9th complexes. The pacemaker is not sensing as there are pacer spikes that follow the 2nd and 7th complexes. The ST segment is down slopping in lead II. PR: ---, QRS: .10 sec, QT: .40 sec.
4.
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| NSR with T wave inversion |
The rhythm is regular. The rate is 88/min. The P waves are upright and precede the QRS complex. No ectopic beats are seen. There is 1mm ST depression with inversion of the T wave in lead II. PR; .16 sec, QRS: .08 sec, QT: .32 sec.
5.
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| Sinus bradycardia with ST depression |
In this strip we have ST depression in lead II with ST elevation in lead V1. In a patient with an anterior MI there will ST elevation in the precordial leads V1-V4 with reciprocal ST depression in the inferior leads II, III and AVF. This patient had positive serum troponins which substantiated the diagnosis of acute myocardial infarction.
Reviewed 3/2/16
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