Saturday, November 30, 2013

Basic EKG Rhythm Test 14

Identify the following rhythms.

1.













2.





3.



4.















5.













6.














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11.













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13.














14.














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22.


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24.













25.


26.


27.


28.


29.

30.















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Answers
1.    1st degree AV block
2.    Junctional rhythm
3.    2nd degree AV block type II
4.    Asystole with pacer spikes
5.    Atrial fibrillation with slow ventricular response
6.    Atrial paced
7.    Dual paced
8.    Idioventricular rhythm
9.    Junctional tachycardia
10.  Sinus rhythm with a triplet of PVCs
11.  Torsades de pointe
12.  Sinus bradycardia
13.  Sinus bradycardia with a pause
14.  Supraventricular tachycardia
15.  P wave asystole
16.  Ventricular fibrillation
17.  2nd degree AV block type I
18.  Normal sinus rhythm
19.  Agonal rhythm
20.  Atrial fibrillation with unifocal PVCs
21.  Atrial flutter
22.  3rd degree heart block
23.  Accelerated junctional rhythm
24.  Atrial fibrillation with bigeminal PVCs
25.  Sinus rhythm with trigeminal PACs
26.  Sinus arrhythmia
27.  Sinus tachycardia with a couplet
28.  Sinus rhythm with trigeminal PVCs
29.  Ventricular paced with PVCs and PJCs
30.  Ventricular tachycardia

Friday, November 29, 2013

Practice EKG Rhythm Strips 234

Identify the following rhythms.

1.


2.

3.


4.


5.














Answers


1.
Normal sinus rhythm changing to SVT













The rhythm is irregular.   The rate is 110/min.   The P waves are upright and associated with a QRS complex.   But after the 4th complex the rhythm changes to a narrow complex tachycardia and the P waves are no longer seen.  The QRS complex remains narrow throughout the strip.  No ectopic beats are seen.  PR:  .16 sec,  QRS:  .08 sec,  QT:  .36 sec.  Interpretation:  Normal sinus rhythm changing to SVT


2.
Normal sinus rhythm with PACs












The rhythm is irregular.   The rate is 90/min.   There are upright P waves which are associated with a QRS complex.   The QRS complex is narrow.  There are PACs seen, the 2nd, 4th, 6th, and 9th complex.  The P waves of the PACs are merged with the T wave of the preceding complexes.  PR:  .20 sec,  QRS:  .08 sec,  QT:  .36 sec.  Interpretation:  Normal sinus rhythm with PACs

3.
Normal sinus rhythm with unifocal PVCs.











The rhythm is irregular with a rate of 80/min.  The P waves have a corresponding QRS complex. There are unifocal PVCs present every 5th beat, pentageminy.  PR:  .12 sec,  QRS:  .08 sec.  QT:  .36 sec.  Interpretation: Normal sinus rhythm with unifocal PVCs.


4.
1st degree block with PACs













The rhythm is irregular and the heart rate is 100/min.  There are upright P waves present.  Each P wave is associated with a QRS complex.  The PR interval is prolonged.  The QRS complexes are narrow.  The 2nd, 4th, and 8th complexes are PACs.   PR:  .28 sec,  QRS:  .08 sec,  QT:  .32 sec.  Interpretation:  1st degree block with PACs

5.
 Ventricular paced with PJCs and PVCs














The rhythm is irregular.  The rate is 90/min.  The P waves are associated with a QRS complex.  There are two PJCs present, the 5th and 7th complexes.  Notice the inverted P waves associated with the PJCs.  There are also two unifocal PVCs present.   Ventricular pacer spikes are also seen. PR:  .12 sec,  QRS:  .16 sec,  QT:  . 36 sec.  Interpretation:  Ventricular paced with PJCs and PVCs

Thursday, November 28, 2013

Practice EKG Rhythm Strips 233

Identify the following rhythms.

1.

2.

3.

4.

5.




Answers


1.
Atrial flutter with variable ventricular response













The rhythm is irregular.   The heart rate is 90/min.   There are flutter waves present.   The QRS complexes are narrow.   No ectopic beats are seen.   PR:  ---,  QRS:  .08 sec,  QT:  .32 sec.   Interpretation:   Atrial flutter with variable ventricular response

2.
Dual paced













The rhythm is regular with a rate of 75/min.  The P waves are preceded by a atrial pacer spike and the QRS complex is preceded by a biventricular pacer spike.   Ideally, one should only see one ventricular pacer spike.   Where there is only ventricular pacer spike seen then it is probably a sensitivity problem with the monitor as there are no demand settings for either chamber.   Interpretation:  Dual paced

3.
Normal sinus rhythm












The rhythm is regular.   The heart rate is 65/min.   The P waves are upright and precede the QRS complex.   The wide and tall P waves suggest biatrial enlargement.   The QRS complex is also wide.  The Q wave in lead II may represent an old MI.  No ectopic beats are seen.   PR:  .20 sec,  QRS:  .12 sec.  QT:  .44 sec.  Interpretation:  Normal sinus rhythm



4.
Polymorphic VT changing to sinus bradycardia













The rhythm is irregular.  It begins with a run of polymorphic ventricular tachycardia and transitions into sinus bradycardia.   The complex after the VT has a negative P wave so it may represent a junctional ectopic beat.   It is followed by a sinus beat.   PR:  .16 sec.  QRS:  .08 sec.  QT:  .52 sec.  The  prolonged QT interval may be a factor in the polymorphic VT.  Interpretation: Polymorphic VT changing to sinus bradycardia


5.
Sinus bradycardia with a sinus pause










The rhythm is irregular.   The heart rate is 40/min.  The P waves have a corresponding QRS complex and are positive.   There is a 2 sec pause that follows the 1st complex.   No ectopic beats are seen.  PR:  .20 sec,  QRS:  .08 sec.  QT:  .40 sec.   Interpretation:  Sinus bradycardia with a sinus pause