EKG Interpretation Cheat Sheet & Heart Arrhythmias Guide (2020 Update) - Free Printable
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Step-by-step solution for: EKG Interpretation Cheat Sheet & Heart Arrhythmias Guide (2020 Update)
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Step-by-step solution for: EKG Interpretation Cheat Sheet & Heart Arrhythmias Guide (2020 Update)
The image provided is an EKG Interpretation Cheat Sheet that outlines various arrhythmias, their descriptions, causes, and treatments. Below is a detailed explanation of each arrhythmia listed in the sheet:
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- Description:
- Atrial rhythm is regular.
- Ventricular rhythm is irregular.
- Atrial rate exceeds ventricular rate.
- PR interval progressively lengthens until a QRS complex is dropped.
- After the dropped beat, the PR interval resets to its shortest duration.
- Causes:
- Severe coronary artery disease.
- Anterior wall myocardial infarction (MI).
- Acute myocarditis.
- Digoxin toxicity.
- Treatment:
- Atropine, epinephrine, and dopamine for symptomatic bradycardia.
- Temporary or permanent pacemaker for symptomatic bradycardia.
- Discontinuation of digoxin if appropriate.
---
- Description:
- Atrial rhythm is regular.
- Ventricular rhythm is regular but slower than the atrial rate.
- No relationship between P waves and QRS complexes.
- No constant PR interval.
- QRS complexes are normal (nodal pacemaker) or wide and bizarre (ventricular pacemaker).
- Causes:
- Inferior or anterior wall MI.
- Congenital abnormalities.
- Rheumatic fever.
- Treatment:
- Atropine, epinephrine, and dopamine for symptomatic bradycardia.
- Temporary or permanent pacemaker for symptomatic bradycardia.
---
- Description:
- Atrial rhythm is regular.
- Ventricular rhythm is irregular.
- QRS complex is premature, usually followed by a compensatory pause.
- QRS complexes are wide and distorted, typically >0.14 seconds.
- PVCs can occur singly, in pairs, or in threes; they may alternate with normal beats.
- Ominous when clustered or multifocal, with R wave on T pattern.
- Causes:
- Heart failure, old or acute myocardial ischemia, infarction, or contusion.
- Myocardial irritation by ventricular catheters such as a pacemaker.
- Hypercapnia, hypokalemia, hypocalcemia.
- Drug toxicity by cardiac glycosides, aminophylline, tricyclic antidepressants, beta-adrenergic agents.
- Caffeine, tobacco, or alcohol use.
- Psychological stress, anxiety, pain.
- Treatment:
- If warranted, procainamide, lidocaine, or amiodarone IV.
- Treatment of underlying cause.
- Discontinuation of drug causing toxicity.
- Potassium chloride IV if PVC induced by hypokalemia.
- Magnesium sulfate IV if PVC induced by hypomagnesemia.
---
- Description:
- Ventricular rate is 140–220 bpm, regular or irregular.
- QRS complexes are wide, bizarre, and independent of P waves.
- P waves are not discernible.
- May start and stop suddenly.
- Causes:
- Myocardial ischemia, infarction, or aneurysm.
- Coronary artery disease.
- Rheumatic heart disease.
- Mitral valve prolapse, heart failure, cardiomyopathy.
- Ventricular catheters.
- Hypokalemia, hypercalcemia.
- Pulmonary embolism.
- Digoxin, procainamide, epinephrine, quinidine toxicity, anxiety.
- Treatment:
- If pulseless: Initiate CPR, follow ACLS protocol for defibrillation.
- If with pulse: If hemodynamically stable, follow ACLS protocol for administration of amiodarone; if ineffective, initiate synchronized cardioversion.
---
- Description:
- Ventricular rhythm is rapid and chaotic.
- QRS complexes are wide and irregular, with no visible P waves.
- Causes:
- Myocardial ischemia or infarction.
- R-on-T phenomenon, untreated ventricular tachycardia.
- Hypokalemia, hyperkalemia, hypercalcemia, alkalosis, electric shock, hypothermia.
- Digoxin, epinephrine, or quinidine toxicity.
- Treatment:
- If pulseless: Start CPR, follow ACLS protocol for defibrillation, ET intubation, and administration of epinephrine or vasopressin, lidocaine, or amiodarone; if ineffective, consider magnesium sulfate.
---
- Description:
- No atrial or ventricular rate or rhythm.
- No discernible P waves, QRS complexes, or T waves.
- Causes:
- Myocardial ischemia or infarction.
- Aortic valve disease, heart failure, hypoxemia, hypokalemia, severe acidosis, electric shock, ventricular arrhythmias, AV block, pulmonary embolism, heart rupture, cardiac tamponade, hyperkalemia, electromechanical dissociation.
- Cocaine overdose.
- Treatment:
- Start CPR.
---
This cheat sheet provides a concise overview of common arrhythmias, their defining characteristics on an EKG, potential causes, and recommended treatments. Understanding these patterns is crucial for accurate diagnosis and timely intervention in clinical settings.
If you have any specific questions about any of these arrhythmias or need further clarification, feel free to ask!
---
1. Second-Degree AV Block (Mobitz Type I - Wenckebach)
- Description:
- Atrial rhythm is regular.
- Ventricular rhythm is irregular.
- Atrial rate exceeds ventricular rate.
- PR interval progressively lengthens until a QRS complex is dropped.
- After the dropped beat, the PR interval resets to its shortest duration.
- Causes:
- Severe coronary artery disease.
- Anterior wall myocardial infarction (MI).
- Acute myocarditis.
- Digoxin toxicity.
- Treatment:
- Atropine, epinephrine, and dopamine for symptomatic bradycardia.
- Temporary or permanent pacemaker for symptomatic bradycardia.
- Discontinuation of digoxin if appropriate.
---
2. Third-Degree AV Block (Complete Heart Block)
- Description:
- Atrial rhythm is regular.
- Ventricular rhythm is regular but slower than the atrial rate.
- No relationship between P waves and QRS complexes.
- No constant PR interval.
- QRS complexes are normal (nodal pacemaker) or wide and bizarre (ventricular pacemaker).
- Causes:
- Inferior or anterior wall MI.
- Congenital abnormalities.
- Rheumatic fever.
- Treatment:
- Atropine, epinephrine, and dopamine for symptomatic bradycardia.
- Temporary or permanent pacemaker for symptomatic bradycardia.
---
3. Premature Ventricular Contraction (PVC)
- Description:
- Atrial rhythm is regular.
- Ventricular rhythm is irregular.
- QRS complex is premature, usually followed by a compensatory pause.
- QRS complexes are wide and distorted, typically >0.14 seconds.
- PVCs can occur singly, in pairs, or in threes; they may alternate with normal beats.
- Ominous when clustered or multifocal, with R wave on T pattern.
- Causes:
- Heart failure, old or acute myocardial ischemia, infarction, or contusion.
- Myocardial irritation by ventricular catheters such as a pacemaker.
- Hypercapnia, hypokalemia, hypocalcemia.
- Drug toxicity by cardiac glycosides, aminophylline, tricyclic antidepressants, beta-adrenergic agents.
- Caffeine, tobacco, or alcohol use.
- Psychological stress, anxiety, pain.
- Treatment:
- If warranted, procainamide, lidocaine, or amiodarone IV.
- Treatment of underlying cause.
- Discontinuation of drug causing toxicity.
- Potassium chloride IV if PVC induced by hypokalemia.
- Magnesium sulfate IV if PVC induced by hypomagnesemia.
---
4. Ventricular Tachycardia (VT)
- Description:
- Ventricular rate is 140–220 bpm, regular or irregular.
- QRS complexes are wide, bizarre, and independent of P waves.
- P waves are not discernible.
- May start and stop suddenly.
- Causes:
- Myocardial ischemia, infarction, or aneurysm.
- Coronary artery disease.
- Rheumatic heart disease.
- Mitral valve prolapse, heart failure, cardiomyopathy.
- Ventricular catheters.
- Hypokalemia, hypercalcemia.
- Pulmonary embolism.
- Digoxin, procainamide, epinephrine, quinidine toxicity, anxiety.
- Treatment:
- If pulseless: Initiate CPR, follow ACLS protocol for defibrillation.
- If with pulse: If hemodynamically stable, follow ACLS protocol for administration of amiodarone; if ineffective, initiate synchronized cardioversion.
---
5. Ventricular Fibrillation (VF)
- Description:
- Ventricular rhythm is rapid and chaotic.
- QRS complexes are wide and irregular, with no visible P waves.
- Causes:
- Myocardial ischemia or infarction.
- R-on-T phenomenon, untreated ventricular tachycardia.
- Hypokalemia, hyperkalemia, hypercalcemia, alkalosis, electric shock, hypothermia.
- Digoxin, epinephrine, or quinidine toxicity.
- Treatment:
- If pulseless: Start CPR, follow ACLS protocol for defibrillation, ET intubation, and administration of epinephrine or vasopressin, lidocaine, or amiodarone; if ineffective, consider magnesium sulfate.
---
6. Asystole
- Description:
- No atrial or ventricular rate or rhythm.
- No discernible P waves, QRS complexes, or T waves.
- Causes:
- Myocardial ischemia or infarction.
- Aortic valve disease, heart failure, hypoxemia, hypokalemia, severe acidosis, electric shock, ventricular arrhythmias, AV block, pulmonary embolism, heart rupture, cardiac tamponade, hyperkalemia, electromechanical dissociation.
- Cocaine overdose.
- Treatment:
- Start CPR.
---
Summary
This cheat sheet provides a concise overview of common arrhythmias, their defining characteristics on an EKG, potential causes, and recommended treatments. Understanding these patterns is crucial for accurate diagnosis and timely intervention in clinical settings.
If you have any specific questions about any of these arrhythmias or need further clarification, feel free to ask!
Parent Tip: Review the logic above to help your child master the concept of printable heart rhythm strips.
