Health Education Assets Library (HEAL)
 
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TitleDescriptionSubjectCollection
226 Two Wrongs Sometimes Make a RightThe question mark is over a normal looking QRS that occurs during 2:1 AV block with RBBB. Following this QRS a ventricular escape rhythm takes over. The normal looking beat is actually a fusion beat resulting from simultaneous activation of the ventricles; the sinus impulse enters the left ventric...Knowledge Weavers ECG
227 WPW type preexcitationNote the short PR and the subtle delta wave at the beginning of the QRS complexes. The delta wave represents early activation of the ventricles in the region where the AV bypass tract inserts. The rest of the QRS is derived from the normal activation sequence using the bundle branches.Knowledge Weavers ECG
228 Long QT intervalThe QT interval duration is greater than 50% of the RR interval, a good indication that it is prolonged in this patient. Although there are many causes for the long QT, patients with this are at risk for malignant ventricular arrhythmias, syncope, and sudden death.Knowledge Weavers ECG
229 Wandering atrial pacemakerWandering atrial pacemaker is a benign rhythm change where the pacemaker site shifts from the sinus node into the atrial tissues. P-wave morphology varies with the pacemaker site.Knowledge Weavers ECG
230 QRS axis = +60 degreesLead aVL is isoelectric; leads II and III are mostly positive. The QRS axis, therefore, is +60 degrees.Knowledge Weavers ECG
231 Electronic ventricular pacemaker rhythm - marquetteElectronic ventricular pacemaker rhythm - marquetteKnowledge Weavers ECG
232 High lateral wall MI (seen in aVL)High lateral wall MI (seen in aVL)Knowledge Weavers ECG
233 Atrial tachycardia - marquetteAtrial tachycardia - marquetteKnowledge Weavers ECG
234 LVH with StrainLVH with StrainKnowledge Weavers ECG
235 PAC's with RBBB aberrant conductionPAC's are identified by the arrows. Note that the PP interval surrounding the PAC is less than 2x the basic sinus cycle indicating that the sinus node has been reset by the ectopic P wave. The pause after the PAC, therefore, is incomplete.Knowledge Weavers ECG
236 1st degree AV blockThe normal PR interval is 0.12 - 0.20 sec, or 120 -to- 200 ms. 1st degree AV block is defined by PR intervals greater than 200 ms. This may be caused by drugs, such as digoxin; excessive vagal tone; ischemia; or intrinsic disease in the AV junction or bundle branch system.Knowledge Weavers ECG
237 Sore thumbsTwo funny looking premature beats are seen in this rhythm strip. Beat A is preceded by a PAC which distorts the T wave, making this an aberrantly conducted PAC. Beat B is a PVC. The notch on the down slope of the QRS complex clearly identifies this as a PVC and not aberrancy.Knowledge Weavers ECG
238 AV dissociation by defaultIf the sinus node slows too much a junctional escape pacemaker may take over as indicated by arrows. AV dissociation is incomplete, since the sinus node speeds up and recaptures the entricles.Knowledge Weavers ECG
239 Atrial tachycardia with 2:1 AV block: a manifestation of digitalis intoxicationAtrial tachycardia with 2:1 AV block: a manifestation of digitalis intoxicationKnowledge Weavers ECG
240 Accelerated junctional rhythm - marquetteAccelerated junctional rhythm - marquetteKnowledge Weavers ECG
241 First degree AV block - marquetteFirst degree AV block - marquetteKnowledge Weavers ECG
242 AV sequential pacemaker - marquette(Summary)Knowledge Weavers ECG
243 Postero-lateral MI: Fully EvolvedThe true posterior MI is recognized by pathologic R waves in leads V1-2. These are the posterior equivalent of pathologic Q waves (seen from the perspective of the anterior leads). Tall T waves in these same leads are the posterior equivalent of inverted T waves in this fully evolved MI. The loss o...Knowledge Weavers ECG
244 Atrial tachycardia with 3:2 and 2:1 AV blockThe ectopic atrial rate is 150 bpm. Some of the ectopic P waves are easily seen and indicated by the arrows. Other P waves are burried in the T waves and not so easily identified. Atrial tachycardia with AV block is often a sign of digitalis intoxication. 3:2 and 2:1 AV block is seen in this examp...Knowledge Weavers ECG
245 RBBB with primary ST-T wave abnormalitiesRBBB is recognized by 1) rR' in V1; 2) QRS duration>0.12s; 3) terminal QRS forces oriented rightwards and anterior. In RBBB the ST-T waves should be oriented opposite to the terminal QRS forces. In this example there areprimary ST-T wave abnormalitiesin leads I, II, aVL, V5, V6. In these leads th...Knowledge Weavers ECG
246 What are those funny looking beats????The differential diagnosis of funny-looking-beats, or FLB's, primarily considers beats of supraventricular origin with aberrant conduction and ventricular ectopic beats. In this example the two FLB's have an easily seen ectopic P wave before them; therefore these are PAC's with RBBB aberration.Knowledge Weavers ECG
247 Conceptual framework: aArrhythmias and conduction abnormalitiesConceptual framework: aArrhythmias and conduction abnormalitiesKnowledge Weavers ECG
248 Atrial flutter with variable AV block - marquetteAtrial flutter with variable AV block - marquetteKnowledge Weavers ECG
249 Compensatory vs. non-compensatory pauses - marquetteCompensatory vs. non-compensatory pauses - marquetteKnowledge Weavers ECG
250 Propionyl CoA production from odd-chain fatty acidsBeta-oxidation of fatty acids with an odd number of carbons inthe chain yields the three-carbon propionyl CoA as the final fragment.BiosynthesisKnowledge Weavers Fatty Acids
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