Monday, December 22, 2014

Practice EKG Strips 372

Identify the following rhythms.

1.











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

2.














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

3.













a. Sinus bradycardia with ST depression and a PVC
b. Sinus rhythm with ST depression and a PVC
c. Junctional rhythm with ST depression and a PVC
d. First degree block with ST depression and a PVC

4.












a. Ventricular tachycardia
b. Atrial fibrillation
c. Ventricular fibrillation
d. Ventricular standstill

5.











a. NSR with a PVC followed by more PVCs
b. NSR with a PVC followed by junctional escape beats
c. NSR with a PVC followed by atrial escape beats
d. NSR with a PVC followed by some PACs

Answers
1.  a. Normal sinus rhythm with a run of SVT. The run is fairly regular and there is an absence of P waves. The QRS complex is narrow so this is something from above the ventricles.
2. c. Sinus bradycardia. I should have put NSR instead of SB. Technically SB is less than 60 and here the rhythm is exactly 60 bpm. The rhythm is regular. There is an upright P wave before each QRS complex. No ectopic beats are seen.
3. a. Sinus bradycardia with ST depression and a PVC. There is a compensatory pause that follows the PVC. The rhythm is otherwise regular. There is one P wave for each QRS and they are upright so we are looking at something sinus in origin. The QRS complexes are narrow. That is good. There is some ST depression which is indicative of ischemia. That is not good. Lead II is an inferior lead so we have some ischemia in the RCA.
4. c. Ventricular fibrillation
5. b. NSR with a PVC followed by junctional escape beats. The rhythm starts out as sinus rhythm. A PVC is seen (the 8th complex) this is followed by a pause lasting 0.8 sec. The AV junction fires off with a escape beat. There is no P wave associated with the ectopic beat and the QRS is narrow so it is from the junctional area. This is followed by another pause of .92 seconds and the AV junction fires again with another junctional escape beat. Sinus rhythm resumes afterwards.

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