Practice EKG Rhythm Strips 199
Identify the following rhythms.
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Answers
1.
The rhythm is irregular with a ventricular rate of 30 and an atrial rate of 88/min. The P waves and the QRS complexes are not associated. The wide QRS complex suggests an underlying ventricular escape rhythm. No ectopic beats are present. PR: ---, QRS; .12 sec, QT: ..60 sec.
2.
The rhythm is regular with a rate of 68. No P waves are noted. The QRS complex is very wide and the T waves are tall. No PVCs, PJCs, or PACs are present. PR: ---, QRS: .22 sec. QT: .56 sec. This patient was actually profoundly hyperkalemic. With severe hyperkalemia there is loss or flattening of the P wave, a nodal rhythm, bizarre and widened QRS complex that may have a sine wave appearance. To see more hyperkalemia rhythms, click on the hyperkalemia label at the bottom of the screen.
3.
The rhythm is irregular due to the PVCs. Small split P waves are present. A ventricular pacer spike is seen before each QRS complex. A multifocal couplet is present. PR: .20 sec, QRS: .16 sec, QT: .42 sec.
4.
The rhythm is regular at a rate of 71/min. Flutter waves are seen between the QRS complexes. No ectopic beats are present. PR: ---, QRS: .14 sec, QT: .40 sec.
5.
The rhythm is regular with a heart rate of 94/min. The P waves are uniform and upright. No ectopic beats are noted. PR: .24 sec, QRS: .08 sec, QT: .36 sec.
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4.
5.
Answers
1.
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| 3rd degree heart block |
The rhythm is irregular with a ventricular rate of 30 and an atrial rate of 88/min. The P waves and the QRS complexes are not associated. The wide QRS complex suggests an underlying ventricular escape rhythm. No ectopic beats are present. PR: ---, QRS; .12 sec, QT: ..60 sec.
2.
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| Accelerated idioventricular rhythm |
The rhythm is regular with a rate of 68. No P waves are noted. The QRS complex is very wide and the T waves are tall. No PVCs, PJCs, or PACs are present. PR: ---, QRS: .22 sec. QT: .56 sec. This patient was actually profoundly hyperkalemic. With severe hyperkalemia there is loss or flattening of the P wave, a nodal rhythm, bizarre and widened QRS complex that may have a sine wave appearance. To see more hyperkalemia rhythms, click on the hyperkalemia label at the bottom of the screen.
3.
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| Ventricular paced with a multifocal couplet |
The rhythm is irregular due to the PVCs. Small split P waves are present. A ventricular pacer spike is seen before each QRS complex. A multifocal couplet is present. PR: .20 sec, QRS: .16 sec, QT: .42 sec.
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| Atrial flutter |
The rhythm is regular at a rate of 71/min. Flutter waves are seen between the QRS complexes. No ectopic beats are present. PR: ---, QRS: .14 sec, QT: .40 sec.
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| 1st degree block |
The rhythm is regular with a heart rate of 94/min. The P waves are uniform and upright. No ectopic beats are noted. PR: .24 sec, QRS: .08 sec, QT: .36 sec.
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