Saturday, October 26, 2013

Practice EKG Rhythm Strips 216

Identify the following rhythms.

1.

2.














3.












4.


5.













Answers

1.
Complete heart block
The rhythm is regular with a ventricular rate of 38/min.   There are small upright P waves present but they are not associated with a QRS complex.   The QRS complexes are wide suggesting a ventricular origin.   No ectopic beats are seen.   PR:  ---,  QRS:  .16 sec,  QT:  .40 sec. Interpretation:  Complete heart block

2.
Normal sinus rhythm
The rhythm is regular.   The rate is 75/min.   There are upright P waves before each QRS complex. Lead II shows 3mm ST segment depression with an inverted T wave.   No ectopic beats are seen. PR:  .16 sec,  QRS:  .08 sec,  QT:  .36 sec.  Interpretation:  Normal sinus rhythm


3.
Normal sinus rhythm with a multifocal couplet
This strip shows an arterial blood pressure waveform in the 2nd lead.  The rhythm is irregular.
The P waves are upright and are associated with a QRS complex.   The P waves are wide suggesting left atrial enlargement.   There are multifocal PVCs present.   A multifocal couplet follows the 4th complex.  PR:  .18 sec,  QRS:  .12 sec,  QT:  .28 sec.   Interpretation:  Normal sinus rhythm with a multifocal couplet.   Notice the drop in the arterial blood pressure following the couplet.


4.
Sinus bradycardia, sinus arrhythmia with a PAC














The rhythm is irregular with a rate of 50/min.   There are upright P waves before each QRS.  The P wave of the 2nd complex has a different shape than the other P waves which indicates that it not a sinus P wave.   The early beat of the 2nd complex is a PAC.   The QRS complexes are narrow.  PR:  .16 sec,  QRS:  .08 sec,  QT:  .48 sec.   Interpretation:  Sinus bradycardia, sinus arrhythmia with a PAC
5.
Ventricular tachycardia








The rhythm is regular with a rate of 150/min.   No P waves are seen.   The QRS complex is wide suggesting a ventricular rhythm.   No ectopic beats are seen.  PR:  ---,  QRS:  .16 sec,  QT:  .36 sec.  Interpretation:   Ventricular tachycardia

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