EKG Rhythm Strip Quiz 50
Identify the following rhythms.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Answers
1.
b. 2nd degree heart block type I. You can usually identify the rhythm by the grouped beats. It can occur in cycles of 2- 4 beats. The second set of grouped beats has an R-R interval that is longer than the first set of grouped beats and there is also a slight variation in the PR intervals between the two sets of grouped beats.
2.
b. Sinus rhythm changing to a junctional rhythm
3.
d. Atrial fibrillation with multifocal PVCs. This rhythm does not fit neatly into the atrial fibrillation or atrial flutter category. If you were thinking atrial flutter with variable rate then you would also be correct. The two ectopic complexes that follow the 2nd PVC are narrow and probably represent some kind aberrantly conducted beats.
4.
c. Sinus rhythm with 1st degree block and an occasional PAC.
5.
b. Normal sinus rhythm with some trigeminal PVCs. The first PVC has a P wave and represents a fusion beat. The SA node fired creating the P wave, then before the impulse reaches the ventricles, an ectopic site within the ventricle fires. Notice that this does not change the character of the arterial blood pressure tracing as compared to the other PVCs. Because of the atrial depolarization in the first P wave, the atrium fill and empty into the ventricles normally so there is little change in the stroke volume and arterial pressure. By comparison, the last two PVCs have lost the "atrial kick" or the normal atrial filling pressure and this decreases the stroke volume as evidenced by the decrease in the arterial blood pressure.
6.
a. Atrial paced with multifocal PVCs
7.
b. Ventricular fibrillation
8.
a. Normal sinus rhythm with 1st degree block. The PR interval is .32 sec.
9.
b. Normal sinus rhythm with trigeminal PVCs. A compensatory pause follows each PVC. The bottom waveform is an arterial pressure reading. You can see a slight drop in the arterial pressure with each PVC.
10.
c. Demand AV pacing with multifocal PVCs.
Reviewed 6/4/13, 3/6/16
1.
a. Sinus rhythm
with an occasional PJC
b. 2nd
degree heart block type I
c. Sinus rhythm
with junctional escape beats
d. Sinus rhythm
with sinus pauses and an occasional PVC
2.
a. Normal sinus
rhythm with sinus pauses
b. Sinus rhythm
changing to a junctional rhythm
c. Sinus
arrhythmia with PJCs
d. Sinus
bradycardia with atrial escape beats
3.
a. Normal sinus
rhythm with multifocal PVCs
b. Sinus
arrhythmia with multifocal PVCs
c. Atrial
tachycardia with multifocal PVCs
d. Atrial fibrillation with multifocal PVCs
4.
a. Sinus rhythm
with 1st degree block and an occasional PJC
b. Sinus
arrhythmia with 1st degree block and an occasional PJC
c. Sinus rhythm
with 1st degree block and an occasional PAC
d. Sinus rhythm
with 1st degree block and an occasional PVC
5.
a. Sinus
bradycardia with atrial ectopic beats
b. Normal sinus
rhythm with some trigeminal PVCs
c. Sinus
tachycardia with frequent unifocal PVCs
d. Sinus rhythm
with multifocal PJCs
6.
a. Atrial paced with multifocal PVCs
b. Ventricular
paced with unifocal PACs
c. AV pacing with unifocal
PJCs
d. Biventricular
pacing with unifocal PVCs
7.
a. Asystole
b. Ventricular
fibrillation
c. Atrial
fibrillation
d. Ventricular
standstill
8.
a. Normal sinus
rhythm with 1st degree block
b. Sinus
bradycardia with 1st degree block
c. Sinus
arrhythmia with 1st degree block
d. 2nd degree
heart block type II
9.
a. Sinus
bradycardia with trigeminal PVCs
b. Normal sinus
rhythm with trigeminal PVCs
c. Sinus
tachycardia with frequent bigeminalPVCs
d. Sinus rhythm
with quadrigeminal PVCs
10.
a. Demand atrial paced with unifocal PVCs
b. Demand ventricular paced with unifocal PACs
c. Demand AV pacing with multifocal PVCs
d. Demand biventricular pacing with unifocal PVCs
Answers
1.
b. 2nd degree heart block type I. You can usually identify the rhythm by the grouped beats. It can occur in cycles of 2- 4 beats. The second set of grouped beats has an R-R interval that is longer than the first set of grouped beats and there is also a slight variation in the PR intervals between the two sets of grouped beats.
2.
b. Sinus rhythm changing to a junctional rhythm
3.
d. Atrial fibrillation with multifocal PVCs. This rhythm does not fit neatly into the atrial fibrillation or atrial flutter category. If you were thinking atrial flutter with variable rate then you would also be correct. The two ectopic complexes that follow the 2nd PVC are narrow and probably represent some kind aberrantly conducted beats.
4.
5.
b. Normal sinus rhythm with some trigeminal PVCs. The first PVC has a P wave and represents a fusion beat. The SA node fired creating the P wave, then before the impulse reaches the ventricles, an ectopic site within the ventricle fires. Notice that this does not change the character of the arterial blood pressure tracing as compared to the other PVCs. Because of the atrial depolarization in the first P wave, the atrium fill and empty into the ventricles normally so there is little change in the stroke volume and arterial pressure. By comparison, the last two PVCs have lost the "atrial kick" or the normal atrial filling pressure and this decreases the stroke volume as evidenced by the decrease in the arterial blood pressure.
6.
a. Atrial paced with multifocal PVCs
7.
b. Ventricular fibrillation
8.
a. Normal sinus rhythm with 1st degree block. The PR interval is .32 sec.
9.
b. Normal sinus rhythm with trigeminal PVCs. A compensatory pause follows each PVC. The bottom waveform is an arterial pressure reading. You can see a slight drop in the arterial pressure with each PVC.
10.
c. Demand AV pacing with multifocal PVCs.
Reviewed 6/4/13, 3/6/16
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