Otterbein/Grant CRNA ECG III Quick Review

1. When identifying ischemia in the absence of LVH or LBBB, new ST elevation, or ST depression with T-wave changes must be identified in how many contiguous leads?

In order to identify ischemia in the absence of LVH or LBBB, new ST elevation or ST depression with T-wave changes must be identified in two contiguous leads. This means that the ST segment must be elevated or depressed in two leads that are next to each other on an ECG. This finding is important in diagnosing ischemia, as it indicates a lack of blood flow to a specific area of the heart.

Explanation

In order to identify ischemia in the absence of LVH or LBBB, new ST elevation or ST depression with T-wave changes must be identified in two contiguous leads. This means that the ST segment must be elevated or depressed in two leads that are next to each other on an ECG. This finding is important in diagnosing ischemia, as it indicates a lack of blood flow to a specific area of the heart.

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2. L BBB and LVH make the diagnosis of MI impossible (or rather difficult).

True

False

I'm not sure if it's just anterior and posterior or if it's all MI's...just remember to check for LVH and LBBB!

Explanation

I'm not sure if it's just anterior and posterior or if it's all MI's...just remember to check for LVH and LBBB!

3. Myocardial ischemia occurs when there is a relative lack of O2 supply to the myocardium and metabolite removal from the heart for a given O2 consumption; it is classically noted as symmetrical __ wave changes.

Myocardial ischemia occurs when there is a relative lack of oxygen supply to the myocardium and metabolite removal from the heart for a given oxygen consumption. It is classically noted as symmetrical T wave changes.

Explanation

Myocardial ischemia occurs when there is a relative lack of oxygen supply to the myocardium and metabolite removal from the heart for a given oxygen consumption. It is classically noted as symmetrical T wave changes.

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4. The majority of ischemia occurs intraoperatively.

True

False

80% occurs post-operatively

Explanation

80% occurs post-operatively

5. ECG changes are an early indicator of myocardial ischemia.

True

False

Ischemia cascade:
Shift to anaerobic metabolism
Diastolic dysfxn
Systolic dysfxn
Hemodynamic changes (dec. CO)
ECG changes
Angina

Explanation

Ischemia cascade:
Shift to anaerobic metabolism
Diastolic dysfxn
Systolic dysfxn
Hemodynamic changes (dec. CO)
ECG changes
Angina

6. Match the following

Subendocardial

Transmural

Subendocardial is more easily produced because the coronaries thin as they travel through the myocardium.

Explanation

Subendocardial is more easily produced because the coronaries thin as they travel through the myocardium.

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7. When examining an EKG for a suspected posterior MI, you would look for ST ______ in leads V1 and V2.

Elevation

Depression

When examining an EKG for a suspected posterior MI, you would look for ST depression in leads V1 and V2. This is because ST depression in these leads is indicative of ischemia or injury in the posterior wall of the heart. It suggests that the blood supply to the posterior region of the heart is compromised, possibly due to a myocardial infarction. Therefore, the presence of ST depression in leads V1 and V2 can help confirm the diagnosis of a posterior MI.

Explanation

When examining an EKG for a suspected posterior MI, you would look for ST depression in leads V1 and V2. This is because ST depression in these leads is indicative of ischemia or injury in the posterior wall of the heart. It suggests that the blood supply to the posterior region of the heart is compromised, possibly due to a myocardial infarction. Therefore, the presence of ST depression in leads V1 and V2 can help confirm the diagnosis of a posterior MI.