1.
Is the P-wave to P-wave spacing consistent? No
Is the QRS to QRS spacing consistent? No?
Is there a P-wave for every QRS complex? No.
The QRS complex is early = Ventricular issue = PVC
2. (top)
P-P consistent? No.
QRS-QRS consistent? No.
P for every QRS? No.
PVC
Are there 3 in a row? Yes. = Ventricular Tachycardia
(bottom: all QRS waves are bizarre except for the one with the arrow so this one is also Ventricular Tachycardia?)
3.
The T-wave can go down (below baseline) or above it and still be considered normal.
Here we have a double QRS with no P-wave.
There are 2 in a row,
The QRS complexes are weird, so this means it is a ventricular issue.
They are also early, so they are premature.
There are 2 abnormal QRS's in a row, but not 3, so it's PVC and you should note it as "2 PVC's seen" on your homework.
4. is missing, I don't know why.
5.
Remember that when given all the leads, lead II is the only one we read.
6.
(top image)
P-P distance consistent? No
QRS-QRS distance consistent? No
All P's and QRS's look normal, they just speed up and slow down.
=Sinus Arrhythmia
(bottom image)
Also sinus arrhythmia, it's just not as long of a readout.
7.
(top)
P-P distance consistent? No
QRS-QRS distance consistent? No
QRS's look bizarre, they have a Sigmoid curve look (like an "S" laid on it's side). This indicates a ventricular issue.
Is it premature or late? Measure between two normal waves to the left and right of the weird one, and the weird one should be right in the middle. This one was early/premature.
And there's only one, so it's a PVC.
(bottom)
The same thing, only this time there are more than 3 in a row, so it's Ventricular Tachycardia.
8.
Is the P-P interval consistent? It's hard to tell.
The ventricles aren't as quick as the atria.
The ventricles are showing an escape beat.
This shows a 3rd degree AV block.
There are 3 P-waves without QRS complexes.
It's like the P's are on their own cycle.
9.
Here the sizes of the QRS complexes are changing.
They aren't bizarre looking, though.
Is the P-P interval the same? No? It's hard to distinguish the P-waves.
Is the QRS-QRS interval the same? No
Is there a P for every QRS and vice versa? Don't know, hard to distinguish the P's.
The QRS's have no rhythm, they are randomly spaced.
This indicates an atrial issue.
It is atrial fibrillation (jungle drums).
10.
There is no way to get a rate from this lead.
P-P interval consistent? No, can't identify the P-waves
QRS-QRS consistent? No, can't identify the QRS complexes.
P for every QRS? No, can't identify them.
=Ventricular fibrillation
(it could also be quivering or shaking)
11.
(top)
P-P interval is hard to see, but normal.
QRS-QRS interval is normal.
If the P-P and QRS-QRS is normal you can rule out arrhythmias.
The baseline is moving. This indicate the patient is moving, this is not caused by the heart.
This is an artifact caused by tremor or purring.
12.
You can't identify anything in this ECG.
It's abnormal, but the same height and distance the whole way; it's very predictable.
If you count the rate it'd be 3600Bpm.
This is an artifact caused by electrical interference.
13.
(top)
P-P consistent? Yes?
QRS-QRS consistent? No
P for every QRS? No, not in between beats.
QRS's are not bizarre looking.
The P's are weird, though, so this indicates an atrial issue.
Are the P's premature? Yes
APC if less than 3 in a row, atrial fibrillation if 3 or more in a row.
14.
P-P consistent? Can't tell, they can't be identified for sure.
QRS-QRS consistent? No
P for every QRS? No, can't identify the P-waves.
=Atrial fibrillation. You can't identify normal P-waves and there are random QRS's.
