Practice EKG Strips 346 Happy Halloween

Identify the following rhythms.

HAPPY HALLOWEEN

1.

a. Sinus rhythm with pauses
b. Sinus rhythm with bigeminal PACs
c. Sinus arrhythmia
d. Wandering atrial pacemaker

2.

a. Ventricular standstill
b. Idioventricular rhythm
c. Junctional rhythm
d. Third degree heart block

3.

a. Sinus bradycardia with a pause
b. Sinus rhythm with sinus arrest
c. Sinus arrhythmia
d. Sinus bradycardia with a dropped PAC

4.

a. Normal sinus rhythm with unifocal PVCs
b. Normal sinus rhythm with multiform PVCs
c. Normal sinus rhythm with a couplet of PVCs
d. Normal sinus rhythm with bigeminal PVCs

5.

a. Normal sinus rhythm with a run of AIVR
b. Normal sinus rhythm with a run of SVT
c. Normal sinus rhythm with a run of ST
d. Normal sinus rhythm with a run of VT

6.

a. Normal sinus rhythm
b. Sinus bradycardia
c. Junctional rhythm
d. First degree block

7.

a. Normal sinus rhythm with unifocal PVCs
b. Sinus tachycardia with uniform PVCs
c. Sinus bradycardia with frequent PVCs
d. Normal sinus rhythm with quadrigeminal PVCs

8.

a. Accelerated Idioventricular rhythm changing to sinus rhythm
b. Atrial fibrillation converting to sinus rhythm
c. Accelerated junctional changing to sinus rhythm
d. Atrial flutter converting to sinus rhythm

9.

a. First degree block
b. Second degree block type I
c. Second degree block type II
d. Complete heart block

10.

a. Sinus bradycardia
b. Idioventricular rhythm
c. Agonal rhythm
d. Complete heart block


Answers

01. b. Sinus rhythm with bigeminal PACs.  The QRS complexes are narrow and the P waves are buried in the T waves of the preceding complexes.  This is what makes them look taller in appearance than the T waves of the ectopic beats.
02. d. Third degree heart block.  No association between the atrial impulses and the ventricular impulses.
03. a. Sinus bradycardia with a pause.  The sinus rhythm resumes after the pause
04. a. Normal sinus rhythm with unifocal PVCs.  The PVCs look similar and probably are from the same ectopic site.
05. d. Normal sinus rhythm with a run of VT.  This is seen better in the V1 lead.
06. b. Sinus bradycardia
07. d. Normal sinus rhythm with quadrigeminal PVCs. PVCs every fourth beat is identified as quadrigeminy. But NSR with unifocal PVCs is probably what you would hear most people call it.
08. c. Accelerated junctional changing to sinus rhythm. Retrograde or inverted P waves follow the QRS complexes. This converts to NSR on the last complex. The rate is around 75 beats/minute so this makes it an acceleratated junctional rhythm.
09. c. Second degree block type II.  I throw in a lot of heart blocks because they are the most challenging for people. Hope you don;t mind
10. d. Complete heart block. Should be one and only one P wave for every QRS complex (one atrial depolarization for every ventricular depolarization). In this rhythm you can see that the atrium and the ventricles are beating independently of one another.