Practice EKG Rhythm Strips 199

Identify the following rhythms.

1.


2.


3.


4.



5.













Answers


1.
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.
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.
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.


4.
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.


5.
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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