Wednesday, July 31, 2013

Basic EKG Rhythm Test 10

Identify the following rhythms.

1.














2.














3.














4.













5.














6.














7.














8.














9.














10.













11.














12.













13.














14.















15.


16.


17.















18


19.
















20.














21.














22.













23.














24.














25.













Do you want to try another Basic EKG Rhythm Test? Click here


Answers


01.    1st degree block
02.    2nd degree AV block type I
03.    Accelerated junctional rhythm
04.    Atrial fibrillation with slow ventricular response
05.    Atrial paced
06.    Complete heart block
07.    Junctional rhythm
08.    Normal sinus rhythm with PJCs
09.    Supraventricular tachycardia
10.    Sinus bradycardia
11.    Torsades de pointe
12.    Ventricular paced
13.    Ventricular tachycardia changing to asystole
14.    2nd degree AV block type II
15.    Junctional tachycardia
16.    Agonal rhythm
17.    Atrial flutter
18.    Biventricular paced
19.    Idioventricular rhythm
20.    Sinus bradycardia with PACs
21.    Normal sinus rhythm with multifocal PVCs
22.    Sinus arrhythmia
23.    Sinus tachycardia
24.    Ventricular fibrillation
25.    Ventricular tachycardia

Tuesday, July 30, 2013

Practice EKG Rhythm Strips 171

Identify the following rhythms.

1.


2.


3.


4.


5.














Answers

1.
2nd degree AV block type I














The rhythm is irregular with a rate of 50/min.  There are upright P waves present but there is progressive lengthening of the PR interval.  A non-conducted P wave follows the 3rd complex.  No ectopic beats are present.  PR---,  QRS:  .08 sec,  QT:  .42 sec.

2.
Normal sinus rhythm with a couplet of junctional beats and trigeminal PVCs













The rhythm is irregular.   The rate is 80/min.  There are both upright and retrograde P waves present.   The P waves of the 2nd and 3rd complexes are negative while the P waves of the 5th, 6th, and 8th are sinus in origin.  There are trigeminal unifocal PVCs present.  PR:  .12 sec,  QRS:  .08 sec,  QT:  .40 sec.


3.
Normal sinus rhythm with biphasic P waves













The rhythm is regular with a rate of 78/min.   The P waves are biphasic.   No ectopic beats are noted.  PR:  .12 sec,  QRS:  .08 sec,  QT:  .30 sec.


4.
Sinus arrhythmia with a run of polymorphic ventricular tachycardia










The rhythm is irregular.   There are upright P waves present.  For the sinus beats the intervals are as follows:  PR:  .16 sec, QRS:  .08,  QT:  .72 sec.   There is T wave inversion.   There is a 13 beat run of polymorphic ventricular tachycardia.   The VT is precipitated by a R-on-T episode in which the VT begins on the up slope of the inverted T wave.  The long QT interval may also play a factor in the episode of polymorphic VT.


5.
Wandering atrial pacemaker




The rhythm is irregular with a rate of  90/min.   There are upright P waves present of differing morphology and varying PR intervals.  For this to be wandering atrial pacemaker there should be at least 3 P waves of varying morphology with a rate less than 100/min.  PR:  ---,  QRS:  .08 sec,  QT:  .36 sec

Monday, July 29, 2013

Practice EKG Rhythm Strips 170

Identify the following rhythms.

1.


2.


3.


4.


5.














Answers

1.
3rd degree heart block
The rhythm is irregular.   The atrial rate is 68/min and the ventricular rate is around 35/min.  The P waves are upright but are not associated with the QRS complexes.  The 1st QRS complex is much narrower than the 2nd and 3rd.   This may be represent some kind of junctional escape mechanism.  PR:  ---,  QRS:  .14 sec,  QT:  52 sec.

2.
Normal sinus rhythm 
The rhythm is regular with a rate of 60/min.  The P waves have a biphasic morphology.  No ectopic beats are noted. There is 6mm ST elevation in lead II and ST depression and large Q waves in V1.  PR:  .16 sec,  QRS:  .12 sec,  QT:  .40 sec.

3.
NSR with a PAC
The rhythm is irregular due to a PAC.   The rate is 70/min.  The P waves are upright and precede the QRS complexes.  The 5th QRS complex occurs early in the cardiac cycle and has a P wave morphology that is different from the other P waves.  PR:  .16 sec,  QRS:  .08 sec,  QT:  .42 sec.

4.
Sinus arrhythmia with a junctional escape beat
The rhythm is irregular.  The R-R interval between the 1st and 2nd complexes is 1.12 sec and the R-R interval between the 2nd and 3rd complexes is .96 sec. The rate is 50/min.  The P waves are present and upright on all the complexes except the 4th complex.  There is a 1 second pause between the 3rd and 4th complex.  The 4th complex appears late in the cardiac cycle and represents a junctional escape mechanism.  This is followed by another pause before a sinus beat is initiated.

5.
Sinus bradycardia


The rhythm is regular with a rate of 48/min.  The P waves are upright, uniform, and precede the QRS complexes.  No ectopic beats are present.  There is mild up slopping of the ST segment.  PR: .16 sec,  QRS:  .12 sec,  QT:  .44 sec.

Saturday, July 27, 2013

Practice EKG Rhythm Strips 169

Identify the following rhythms.

1.













2.


3.


4.

5.















Answers

1.
Junctional rhythm








The rhythm is regular.   The rate is 60.   The P waves are absent.  No ectopic beats are noted.
PR: ---,  QRS:  .12 sec,  QT:  .44 sec


2.
Multifocal atrial tachycardia













The rhythm is irregular due to the many PACs.   The rate is 140/min.   There are upright P waves present of differing morphology.   Some P waves are buried with the T wave of the previous complexes.  To be multifocal atrial tachycardia there needs to be at least three P waves of various morphology with a ventricular rate over 100/min.  PR---,  QRS:  .08,  QT:  .32 sec


3.
Normal sinus rhythm with sinus pause













The rhythm is irregular due to the pause.   The rate is 60/min.   The P waves are upright and are associated with a QRS complex.  There is some ST depression and inversion of the T wave.  No ectopic beats are present.  There is a 1.268 second pause following the 3rd complex.  PR:  .14 sec, QRS:  .08 sec.  QT:  .40 sec.

4.
Normal sinus rhythm with unifocal PVCs













The rhythm is irregular due to the unifocal PVCs.   The rate is 90/min.  There are upright P waves present.  Two unifocal PVCs are seen.   PR:  .12 sec,  QRS:  .08 sec,  QT:  .26 sec.


5.
Sinus bradycardia




The rhythm is regular.   The calculated rate is 48/min.   The P waves are upright and uniform.   No ectopic beats are noted.   The T wave is inverted.  PR:  .18 sec,  QRS:  .16 sec,  QT:  .44 sec.