EKG Rhythm Strip Quiz 45
Identify the following rhythms.
1.
a. Agonal rhythm
b. Ventricular standstill
c. 3rd degree heart block
d. Junctional rhythm
2.
a. Demand atrial paced with PACs
c. Demand AV paced with multifocal PVCs
d. Demand biventricular pacing with unifocal PVCs
3.
a. Atrial flutter
b. 2nd degree heart block type I
c. Atrial fibrillation with slow ventricular response
d. Sinus tachycardia with sinus pauses
4.
a. Normal sinus rhythm with PACs and PVCs
c. Sinus bradycardia with PACs and PJCs
d. Sinus rhythm with multifocal premature junctional contractions
5.
a. Sinus bradycardia with junctional ectopic beats
b. Normal sinus rhythm with runs of ventricular tachycardia
c. Sinus tachycardia with frequent unifocal PVCs
d. Sinus rhythm with multifocal PACs
6.
a. Sinus bradycardia with trigeminal PACs
b. Normal sinus rhythm with bigeminal PVCs
c. Sinus tachycardia with frequent multiform PVCs
d. Sinus arrhythmia with an occasional PVC
7.
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8.
a. Complete heart block
b. Ventricular fibrillation
c. Agonal rhythm
d. Atrial fibrillation
9.
a. Bradycardia with sinus arrhythmia
b. Idioventricular rhythm
c. Complete heart block
d. Junctional rhythm
10.
a. Sinus bradycardia
b. Normal sinus rhythm with an occasional PAC
c. Sinus arrhythmia
d. Sinus tachycardia
Answers
1.
a. Agonal rhythm
2.
d. Demand biventricular pacing with unifocal PVCs. It is difficult to determine what the underlying rhythm is though it may be either a sinus with a 1st degree block or an atrial flutter. Biventricular pacer spikes appear on the paced beats as well as some demand atrial pacer spikes.
3.
a. Atrial flutter
4.
a. Normal sinus rhythm with PACs and PVCs The unifocal PVCs are easy to pick out. The 9th and 11th complexes are PACs There appears to be two aberrantly conducted complexes present, one before and one after the 2nd PVC. The first aberrantly conducted beat lands on the upstroke of the P wave. The second fusion beat looks like it may have a retrograde P wave present on that appears near the junction of the S wave and the T wave.
5.
b. Normal sinus rhythm with runs of ventricular tachycardia. This arterial blood pressure tracing provides some insight into the hemodynamics behind ventricular tachycardia. Notice on the arterial pressure tracing that there is a slight delay in the pressure waveform and the cardiac QRS complex. This represents the time that it takes the pressure wave to travel from the heart to arterial line transducer in either the radial or femoral artery. The graph numbers on the left side represent the arterial pressure (mm Hg). During the sinus beats, the patient's arterial pressure is running around 110/60. However, during periods of ventricular tachycardia, his arterial systolic pressures fall into the 60-70s are not detectable.
6.
b. Normal sinus rhythm with bigeminal PVCs
7.
b. Sinus arrhythmia. The R-R interval varies from beat to beat.
8.
b. Ventricular fibrillation
9.
c. Complete heart block. There is no association between the P waves and the QRS complexes. If you measure the P-P interval you will find that a P wave is hidden within the 1st, 4th, and 7th QRS complexes.
10.
a. Sinus bradycardia
Reviewed 6/3/14, 3/6/16
1.
a. Agonal rhythm
b. Ventricular standstill
c. 3rd degree heart block
d. Junctional rhythm
2.
c. Demand AV paced with multifocal PVCs
d. Demand biventricular pacing with unifocal PVCs
3.
a. Atrial flutter
b. 2nd degree heart block type I
c. Atrial fibrillation with slow ventricular response
d. Sinus tachycardia with sinus pauses
4.
c. Sinus bradycardia with PACs and PJCs
d. Sinus rhythm with multifocal premature junctional contractions
5.
a. Sinus bradycardia with junctional ectopic beats
b. Normal sinus rhythm with runs of ventricular tachycardia
c. Sinus tachycardia with frequent unifocal PVCs
d. Sinus rhythm with multifocal PACs
6.
a. Sinus bradycardia with trigeminal PACs
b. Normal sinus rhythm with bigeminal PVCs
c. Sinus tachycardia with frequent multiform PVCs
d. Sinus arrhythmia with an occasional PVC
7.
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a. Normal sinus
rhythm
b. Sinus
arrhythmia
c. Atrial
fibrillation
d. Accelerated junctional
rhythm
8.
a. Complete heart block
b. Ventricular fibrillation
c. Agonal rhythm
d. Atrial fibrillation
9.
a. Bradycardia with sinus arrhythmia
b. Idioventricular rhythm
c. Complete heart block
d. Junctional rhythm
10.
a. Sinus bradycardia
b. Normal sinus rhythm with an occasional PAC
c. Sinus arrhythmia
d. Sinus tachycardia
Answers
1.
2.
d. Demand biventricular pacing with unifocal PVCs. It is difficult to determine what the underlying rhythm is though it may be either a sinus with a 1st degree block or an atrial flutter. Biventricular pacer spikes appear on the paced beats as well as some demand atrial pacer spikes.
3.
4.
a. Normal sinus rhythm with PACs and PVCs The unifocal PVCs are easy to pick out. The 9th and 11th complexes are PACs There appears to be two aberrantly conducted complexes present, one before and one after the 2nd PVC. The first aberrantly conducted beat lands on the upstroke of the P wave. The second fusion beat looks like it may have a retrograde P wave present on that appears near the junction of the S wave and the T wave.
5.
b. Normal sinus rhythm with runs of ventricular tachycardia. This arterial blood pressure tracing provides some insight into the hemodynamics behind ventricular tachycardia. Notice on the arterial pressure tracing that there is a slight delay in the pressure waveform and the cardiac QRS complex. This represents the time that it takes the pressure wave to travel from the heart to arterial line transducer in either the radial or femoral artery. The graph numbers on the left side represent the arterial pressure (mm Hg). During the sinus beats, the patient's arterial pressure is running around 110/60. However, during periods of ventricular tachycardia, his arterial systolic pressures fall into the 60-70s are not detectable.
6.
b. Normal sinus rhythm with bigeminal PVCs
7.
b. Sinus arrhythmia. The R-R interval varies from beat to beat.
8.
b. Ventricular fibrillation
9.
c. Complete heart block. There is no association between the P waves and the QRS complexes. If you measure the P-P interval you will find that a P wave is hidden within the 1st, 4th, and 7th QRS complexes.
10.
a. Sinus bradycardia
Reviewed 6/3/14, 3/6/16
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