Health Education Assets Library (HEAL)
 
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TitleDescriptionSubjectCollection
176 2nd degree AV block, type I, with accelerated junctional escapes and a ladder diagramThe ladder diagram illustrates a Wenckebach type AV block by the increasing PR intervals before the blocked P wave. After the blocked P wave, however, a rev-ed up junctional pacemaker terminates the pause. Note that the junctional beats have a slightly different QRS morphology from the sinus beats...Knowledge Weavers ECG
177 Atrial tachycardia with exit block and AV blockThe ectopic P waves, easily seen in this example,occur in groups, separated by short pauses. This is likely due to an exit block just distal to the atrial pacemaker. Because not all of the P waves make it to the ventricles, there is also 2nd degree AV block. Therefore, two levels of block are pre...Knowledge Weavers ECG
178 LVHIn this example of LVH, the precordial leads don't meet the usual voltage criteria or exhibit significant ST segment abnormalities. The frontal plane leads, however, show voltage criteria for LVH and significant ST segment depression in leads with tall R waves. The voltage criteria include 1) R in a...Knowledge Weavers ECG
179 A nonconducted PAC causes an unexpected pauseUnexpected pauses in rhythm have several causes, the most frequent being a nonconducted PAC. In this example the nonconducted PAC is seen in the ST segment of the pause. Note the change in the ST-T compared to the other ST-T waves.Knowledge Weavers ECG
180 Giant TU fusion wavesTU fusion waves are often seen in long QT syndromes. The differential diagnosis of this ECG abnormality includes electrolyte abnormalities -hypokalemia, CNS disease, e.g., subarachnoid hemorrhage; hereditary long QT syndromes, and drugs such as quinidine.Knowledge Weavers ECG
181 Left anterior fascicular block (LAFB)LAFB is the most common of the intraventricular conduction defects. It is recognized by 1) left axis deviation; 2) rS complexes in II, III, aVF; and 3) small q in I and/or aVL.Knowledge Weavers ECG
182 Atrial flutter with 2:1 AV conduction: lead V1The arrows point to two flutter waves for each QRS complex. Atrial rate = 280; ventricular rate = 140.Knowledge Weavers ECG
183 Long QT Interval and Giant Negative T WavesLong QT Interval and Giant Negative T WavesKnowledge Weavers ECG
184 Frontal plane QRS axis = -15 degreesFrontal plane QRS axis = -15 degreesKnowledge Weavers ECG
185 Ventricular pacemaker rhythmNote the small pacemaker spikes before the QRS complexes in many of the leads. In addition, the QRS complex in V1 exhibits ventricular ectopic morphology; i.e., there is a slur or notch at the beginning of the S wave, and>60ms delay from onset to QRS to nadir of S wave. This rules against a suprav...Knowledge Weavers ECG
186 Acylation of carnitine by a long chain fatty acyl CoALong chain fatty acyl CoA cannot cross the inner mitochondrial membrane to participate in beta-oxidation. The fatty acyl group is therefore transferred to a carrier, carnitine, in a reversible reaction catalyzed by carnitine acyl transferase I. The resulting fatty acyl carnitine crosses the membra...Knowledge Weavers Fatty Acids
187 Diffuse anterolateral T wave abnormalitiesDiffuse anterolateral T wave abnormalitiesT Wave AbnormalitiesKnowledge Weavers ECG
188 Four systems for denoting fatty acidsThere are four commonly used ways of designating fatty acids. The first two columns show samples of names, and the last two columns show systems of abbreviating these names.NomenclatureKnowledge Weavers Fatty Acids
189 Frontal plane QRS axis = -45 degreesFrontal plane QRS axis = -45 degreesKnowledge Weavers ECG
190 Marked sinus arrhythmia - marquetteMarked sinus arrhythmia - marquetteKnowledge Weavers ECG
191 Muscle tremor artifact - marquetteMuscle tremor artifact - marquetteKnowledge Weavers ECG
192 RBBB + LAFB: bifascicular blockRBBB + LAFB: bifascicular blockKnowledge Weavers ECG
193 Reduction of 2-enoyl acyl carrier peptideA 2-enoyl acyl group on the acyl carrier peptide is reduced by NADPH in a reaction catalyzed by enoyl acyl carrier peptide reductase.Knowledge Weavers Fatty Acids
194 ECG of the century: A most unusual 1st degree AV blockOn Day 1, at a heart rate of 103 bpm the P waves are not clearly defined suggesting an accelerated junctional rhythm. However, on Day 2, at a slightly slower heart rate the sinus P wave suddenly appears immediately after the QRS complex. In retrospect, the sinus P wave in Day 1 was found burried i...Knowledge Weavers ECG
195 RBBB plus mobitz II 2nd degree AV blockThe classic rSR' in V1 is RBBB. Mobitz II 2nd degree AV block is present because the PR intervals are constant. Statistically speaking, the location of the 2nd degree AV block is in the left bundle branch rather than in the AV junction. The last QRS in the top strip is a junctional escape, since...Knowledge Weavers ECG
196 Left axis deviation: QRS axis = -60 degreesLead aVR is isoelectric; leads II and III are mostly negative. The QRS axis, therefore, is -60 degrees.Knowledge Weavers ECG
197 QRS axis = +30 degreesLead III is isoelectric; leads I and II are positive. The QRS axis, therefore, is +30 degrees.Knowledge Weavers ECG
198 methylmalonyl CoA racemase reactionIn the metabolism of propionyl CoA, D-methylmalonyl CoA is produced by a carboxylase reaction. This product must be converted to L-methylmalonyl CoA in order to be metabolized further. The conversion is catalyzed by methylmalonyl CoA racemase.Knowledge Weavers Fatty Acids
199 Pacemaker failure to sense - marquettePacemaker failure to sense - marquetteKnowledge Weavers ECG
200 Pacemaker fusion beat - marquettePacemaker fusion beat - marquetteKnowledge Weavers ECG
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