Friday, March 13, 2015

Practice EKG Strips 429

Identify the following rhythms.

1.













a. Sinus bradycardia with a pause
b. Sinus arrhythmia
c. Sinus rhythm with a dropped PAC
d. Sinus rhythm with an exit block

2.











a. Atrial paced
b. Biventricular paced
c. Dual paced
d. Ventricular paced

3.













a. Junctional rhythm
b. Idioventricular rhythm
c. Torsades de pointes
d. Complete heart block

4




.a. Atrial flutter
b. Atrial fibrillation
c. 2nd degree heart block type II
d. NSR with PACs
5.










a. NSR with run of AIVR
b. NSR with run of VT
c. NSR with run of MAT
d. NSR with run of SVT

Answers
1. a. Sinus bradycardia with a pause.   The rhythm is irregular due to the pause.  The sinus rhythm does not resume at it's expected rhythm so this appears to be pause rather than an exit block.

2. d. Ventricular paced.  The pacer spike appears before each QRS complex.  The rate is around 71 bpm.

3. b. Idioventricular rhythm. Irregular rhythm. No P waves. Very wide, bizarre-looking QRS complexes. This heart is on the way out.

4. a. Atrial flutter. The rhythm is regular with a rate of 53 bpm. 4:1 Flutter waves are present. No ectopic beats are seen.

5.  b. NSR with run of VT. The underlying rhythm is sinus. Uniform, upright P waves are seen before each QRS complex. The QRS complexes are narrow. A 8 beat run of VT is present. PR: .20 sec, QRS: 08 sec, QT: .36 sec.  What distinguishes SVT from VT will be the width of the QRS complexes. Any rhythm arising from the ventricles will be wide, >.12 sec. SVT will almost always have a narrow QRS complex. The exception will be if the patient has an underlying BBB or some other conduction delay. That will make an SVT rhythm appear wide and a wide complex looking tachycardia.


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