8 Integrated ECG Case Practice Free Online FlashCards

What should be assessed before interpreting an ECG?

Assess responsiveness, airway and breathing, pulse, blood pressure, perfusion, mental status, chest discomfort, and signs of heart failure.

Which findings indicate cardiopulmonary compromise during tachyarrhythmia?

Hypotension, shock, acute altered mental status, ischemic chest discomfort, or acute heart failure indicate cardiopulmonary compromise.

What is the general priority for unstable tachyarrhythmia with a pulse?

Unstable tachyarrhythmia with a pulse generally calls for prompt synchronized cardioversion.

What is the immediate pathway for pulseless VF or VT?

Begin CPR and follow the cardiac-arrest algorithm; pulseless ventricular fibrillation or pulseless ventricular tachycardia calls for unsynchronized defibrillation.

What features belong in a systematic ECG read?

Confirm patient, calibration, and lead placement; assess rate, regularity, P-wave and QRS relationships, QRS width, axis, intervals, and ST–T changes.

When should a 12-lead ECG be obtained for suspected ACS?

In suspected ACS, obtain and interpret a 12-lead ECG promptly, targeting within 10 minutes of first medical contact. Repeat it if symptoms persist or the first tracing is nondiagnostic.

What is the general ST-elevation threshold for suspected STEMI?

ST elevation is generally significant at least 1 mm in two contiguous leads other than V2–V3; thresholds in V2–V3 vary by age and sex.

What rhythm-directed options may be considered for stable regular narrow-complex tachycardia?

For a stable regular narrow-complex tachycardia, assess and monitor; consider vagal maneuvers and, when appropriate under protocol, adenosine.

How should atrial fibrillation with rapid ventricular response and shock be prioritized?

The described rhythm is atrial fibrillation with rapid ventricular response. When the tachyarrhythmia is causing instability, urgent synchronized cardioversion is generally indicated.

What does ST elevation in V4R add to an inferior STEMI pattern?

ST elevation in II, III, and aVF indicates an inferior STEMI pattern; elevation in V4R supports right-ventricular involvement.

How should regular wide-complex tachycardia be approached?

Treat regular wide-complex tachycardia as potentially ventricular tachycardia while obtaining expert help and assessing for ischemia or other causes.

When may adenosine be considered for wide-complex tachycardia?

Adenosine is considered only for regular, monomorphic wide-complex tachycardia.