EKG Rhythm Strips 75
Identify the following rhythms.
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Answers
1.
The rhythm is irregular with a rate of 50/min. The P waves are upright and uniform but there are some dropped P waves after the 2nd and 4th complexes. The PR interval gets progressively longer. No ectopic beats are noted. PR: .22/.24 sec (3rd & 4th complexes), QRS: .08 sec, QT: .40 sec. This patient had an underlying 1st degree block but often she would transition in to a Mobitz I block of varying cycles of 3-5 grouped beats.
2.
The rhythm is regular with a rate of 55/min. The P waves are upright and have a corresponding QRS complex. The wide P waves suggest a left atrial enlargement. There are both single and double pacer spikes seen before the QRS complexes. I am not sure if the monitor is sensing each pacer spike correctly. The pacer spike on the first complex is wide but it is a biventricular spike. The second complex shows only one pacer spike. PR: .16 sec, QRS: .16 sec, QRS: .56 sec.
3.
The rhythm is irregular with a rate of 40/min. The P waves are small and upright. No ectopic beats are seen. The R-R interval between the 1st and 2nd complex is 1.72 sec and the R-R interval between the 3rd and 4th complex is 1.16 sec. No ectopic beats are present. PR: .12 sec, QRS: .08 sec, QT: .44 sec.
4.
The rhythm is irregular due the PVC. The rate is 60/min. The P waves are small, upright, and are associated with a QRS complex. A single PVC is present. There is ST depression in lead II and 3mm ST elevation in lead V1 (measure 0.4 sec after the J point). PR: .12 sec, QRS: .12 sec, QT: .44 sec.
5.
The rhythm is irregular with bigeminal atrial ectopic complexes. The rate is 80/min. The P waves are associated with a QRS complex. The P wave of the PACs has a morphology that differs from the sinus P waves. PR: .16 sec, QRS: .08 sec, QT; .44 sec.
Reviewed 3/8/16
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2.
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4.
5.
Answers
1.
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| 2nd Degree Heart Block Type I |
The rhythm is irregular with a rate of 50/min. The P waves are upright and uniform but there are some dropped P waves after the 2nd and 4th complexes. The PR interval gets progressively longer. No ectopic beats are noted. PR: .22/.24 sec (3rd & 4th complexes), QRS: .08 sec, QT: .40 sec. This patient had an underlying 1st degree block but often she would transition in to a Mobitz I block of varying cycles of 3-5 grouped beats.
2.
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| Sinus bradycardia with biventricular pacing |
The rhythm is regular with a rate of 55/min. The P waves are upright and have a corresponding QRS complex. The wide P waves suggest a left atrial enlargement. There are both single and double pacer spikes seen before the QRS complexes. I am not sure if the monitor is sensing each pacer spike correctly. The pacer spike on the first complex is wide but it is a biventricular spike. The second complex shows only one pacer spike. PR: .16 sec, QRS: .16 sec, QRS: .56 sec.
3.
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| Bradycardia with sinus arrhythmia |
The rhythm is irregular with a rate of 40/min. The P waves are small and upright. No ectopic beats are seen. The R-R interval between the 1st and 2nd complex is 1.72 sec and the R-R interval between the 3rd and 4th complex is 1.16 sec. No ectopic beats are present. PR: .12 sec, QRS: .08 sec, QT: .44 sec.
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| Normal Sinus Rhythm with a PVC |
The rhythm is irregular due the PVC. The rate is 60/min. The P waves are small, upright, and are associated with a QRS complex. A single PVC is present. There is ST depression in lead II and 3mm ST elevation in lead V1 (measure 0.4 sec after the J point). PR: .12 sec, QRS: .12 sec, QT: .44 sec.
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| Atrial Bigeminy |
The rhythm is irregular with bigeminal atrial ectopic complexes. The rate is 80/min. The P waves are associated with a QRS complex. The P wave of the PACs has a morphology that differs from the sinus P waves. PR: .16 sec, QRS: .08 sec, QT; .44 sec.
Reviewed 3/8/16
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