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Ekg Test Upload

M
Mark Silverberg

This document contains 43 EKG readings with interpretations provided by emergency medicine physicians. For each EKG, the rate, rhythm, axis, intervals, morphology, ST segments, and T waves are described and any abnormalities or clinical correlations are noted. The EKGs demonstrate a variety of normal and abnormal rhythms, conduction abnormalities, signs of ischemia, infarction and other cardiac pathologies.

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Mark Silverberg, MD MMB FACEP Vivian Tsai, MD MPH Kaedrea Jackson, MD MPH Department of Emergency Medicine SUNY Downstate Medical Center/ Kings County Hospital Brooklyn, NY
EKG 1
Answer: EKG 1 Rate: 70 Rhythm: NSR Axis: Normal, between -30 and 110 Intervals: Normal PR<200ms, QRS<120ms Morphology: No BBB pattern or chamber hypertrophy/dilation ST Segments: No elevation or depression T Waves: Not flipped or flat
EKG 2
Answer: EKG 2 Rate: 90 Rhythm: Sinus with paced ventricles Axis: -75 Intervals: PR=195ms, QRS=160ms Morphology: Neg. P in V1=LAE, Pacer ST Segments: C/W paced rhythm T Waves: C/W paced rhythm
EKG 3
Answer: EKG 3 Rate: 2 beats(1cuplet)/1.44 seconds, 42 bpm Rhythm: Bigemini Axis: +50 aberrancy Intervals: Beat 1 PR=150ms, QRS 70/100ms (beat 1/2) Morphology: First narrow, #2 aberrant ST Segments: No ischemic changes,#2 C/W aberrant beats T Waves: First no ischemia, #2 C/W aberrancy
EKG 4
Answer: EKG 4 Rate: Vent. response 48bpm Rhythm: Atrial flutter Axis: +50 Intervals: QRS 125ms Morphology: LBBB ST Segments: C/W LBBB T Waves: C/W LBBB
EKG 5
Answer: EKG 5 Rate: 56 bpm Rhythm: NSR Axis: +45 Intervals: PR=160ms, Wide QRS > 120 ms C/W BBB Morphology: LBBB ST Segments: C/W LBBB T Waves: C/W LBBB
EKG 6
Answer: EKG 6 Rate: Irregular tachycardia Rhythm: Multifocal atrial tachycardia Axis: +15 (averaged) Intervals: PR irregular, QRS 80ms but irreg. Morphology: Multiple P’s, QRS narrow ST Segments: No ischemic changes T Waves: No ischemic changes
EKG 7
Answer: EKG 7 Rate: Irregular tachycardia Rhythm: Atrial fibrillation Axis: -45 Intervals: Wide QRS > 120 ms C/W BBB Morphology: LBBB ST Segments: C/W LBBB T Waves: C/W LBBB
EKG 8
Answer: EKG 8 Rate: 90 bpm Rhythm: NSR Axis: +40 Intervals: PR=140ms, QRS with normal narrow complexes Morphology: No BBB or chamber enlargement patterns ST Segments: Diffuse ST elevation C/W pericarditis (Diffuse PR depression also) T Waves: No Ischemic changes
EKG 9
Answer: EKG 9 Rate: 250 bpm Rhythm: SVT Axis: +135 Intervals: No PR, Narrow QRS Morphology: Narrow, C/W SVT ST Segments: ? T Waves: Superimposed on QRS
EKG 10
Answer: EKG 10 Rate: 100 bpm Rhythm: NSR Axis: -10 Intervals: Normal PR, QRS=115ms Morphology: LAFB ST Segments: Elevation V1-V6, reciprocal ST depression inferiorly T Waves: WNL
EKG 11
Answer: EKG 11 Rate: 74 bpm Rhythm: NSR Axis: -75 Intervals: PR=160ms, QRS=120ms Morphology: RBBB + LAHB ST Segments: C/W BBB pattern T Waves: C/W BBB pattern
EKG 12
Answer: EKG 12 Rate: Atria 100 bpm, Ventricles 25 bpm Rhythm: Sinus with every 3 rd beat capture Axis: +75 Intervals: PR=520ms C/W 1 o AVB, QRS=170ms Morphology: LBBB ST Segments: C/W LBBB pattern T Waves: C/W LBBB pattern
EKG 13
Answer: EKG 13 Rate: 72 bpm Rhythm: NSR Axis: -30 Intervals: PR=160ms, QRS=120ms Morphology: LBBB ST Segments: C/W LBBB pattern T Waves: Peaked C/W hyperkalemia
EKG 14
Answer: EKG 14 Rate: 70 bpm Rhythm: NSR Axis: +45 Intervals: PR=160ms, QRS=80ms Morphology: Narrow, partial fused with ST ST Segments: Elevations inferiorly, reciprocal depressions laterally T Waves: No ischemic changes
EKG 15
Answer: EKG 15 Rate: 80 bpm (8 beats in 6 sec) Rhythm: Bigeminy – frequent regular PVCs Axis: + 4 Intervals: PR= 160ms, QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 16
Answer: EKG 16 Rate: 88 bpm Rhythm: NSR Axis: - 83 Intervals: PR= 160 ms, QRS= 120 ms Morphology: Wide QRS, no chamber enlargement, RBBB, LAHB ST segment: No ischemic changes T-waves: T-Inversion in V1-2 c/w Brugada syndrome
EKG 17
Answer: EKG 17 Rate: 79 bpm Rhythm: NSR Axis: + 75 Intervals: PR= 160 ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST depression in II, III, aVF c/w inferior wall ischemia T-waves: Flattened T waves in V4-5, inverted T in V6 suggests possible lateral wall ischemia
EKG 18
Answer: EKG 18 Rate: 57bpm Rhythm: NSR Axis: + 20 Intervals: PR= 160 ms, QRS< 120 ms Morphology: Narrow QRS, LVH ST segment: Inf elevation & lat reciprocal depressions c/w inf AMI T-waves: Laterally inverted c/w reciprocal AMI changes
EKG 19
Answer: EKG 19 Rate: 47 bpm Rhythm: Junctional bradycardia Axis: + 60 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, inverted P between QRS and T waves ST segment: No ischemic changes T-waves: No ischemic changes
EKG 20
Answer: EKG 20 Rate: 60 – 100 bpm Rhythm: Dual chamber pacing Axis: Left axis deviation Intervals: PR= 200 ms, QRS= 120 ms Morphology: Wide QRS ST segment: N/A T-waves: N/A
EKG 21
Answer: EKG 21 Rate: 273 bpm Rhythm: SVT Axis: + 24 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS ST segment: c/w SVT T-waves: c/w SVT
EKG 22
Answer: EKG 22 Rate: 68 bpm Rhythm: A-flutter Axis: - 99 Intervals: No PR, QRS = 120ms Morphology: Wide QRS, no chamber enlargement, RBBB, LAHB ST segment: c/w a-flutter, RBBB, LAHB T-waves: c/w a-flutter, incomplete RBBB, LAHB
EKG 23
Answer: EKG 23 Rate: 105 bpm Rhythm: MFAT Axis: - 54 Intervals: PR= 120-160, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 24
Answer: EKG 24 Rate: 65 bpm Rhythm: First degree AV block Axis: + 68 Intervals: PR= 320 ms, QRS< 120 ms Morphology: Narrow QRS, LVH, no BBB ST segment: ST depression in V4-6 and slightly in II, III, aVF; upward sloping of ST segment c/w digitalis effect T-waves: No ischemic changes
EKG 25
Answer: EKG 25 Rate: 80 bpm Rhythm: NSR with PACs originating from focus inferior to SA node Axis: + 63 Intervals: PR= 200 ms, QRS< 120ms Morphology: Narrow QRS, occasional inverted P’s, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: T wave inversions in I, II, III, aVF, V3-V6 c/w possible inferior and lateral wall ischemia
EKG 26
Answer: EKG 26 Rate: 88 bpm Rhythm: NSR Axis: + 41 Intervals: PR= 160ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: Diffuse PR depression c/w pericarditis T-waves: No ischemic changes
EKG 27
Answer: EKG 27 Rate: 60 bpm Rhythm: Ventricular pacing Axis: - 45 Intervals: PR= 240ms, QRS> 120ms Morphology: Wide QRS ST segment: c/w ventricular pacing T-waves: c/w ventricular pacing
EKG 28
Answer: EKG 28 Rate: 79 bpm Rhythm: NSR Axis: + 39 Intervals: PR= 140ms, QRS= 120 ms Morphology: Wide QRS, RBBB, no chamber enlargement ST segment: No ischemic changes T-waves: T inversion in V1-3 c/w possible anterior septal ischemia T Waves
EKG 29
Answer: EKG 29 Rate: 143 bpm Rhythm: Sinus Tachycardia Axis: + 27 Intervals: PR= 140 ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 30
Answer: EKG 30 Rate: 71 bpm Rhythm: NSR w/ 1 dropped beat c/w SA block Axis: -22 Intervals: PR= 320ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: Lateral T wave flattening & inversion in I, aVL suggests possible lateral wall ischemia
EKG 31
Answer: EKG 31 Rate: 79 bpm Rhythm: NSR Axis: -37 Intervals: PR= 200ms, QRS< 120ms Morphology: Narrow QRS, no LVH, no BBB ST segment: ST elevation in II, III, aVF, V3-4 with reciprocal ST depression in I, aVL c/w anterior inferior acute MI T-waves: c/w acute anterior inferior MI
EKG 32
Answer: EKG 32 Rate: 33 bpm Rhythm: Paced rhythm; pacer fails to sense; Type II second degree block as underlying rhythm Axis: -73 Intervals: PR= 160ms (intrinsic), PR= 280ms (paced), QRS= 160ms Morphology: Wide QRS ST segment: c/w pacemaker malfunction; failure to sense T-waves: c/w pacemaker malfunction; failure to sense
EKG 33
Answer: EKG 33 Rate: 200 bpm Rhythm: SVT Axis: + 40 Intervals: No PR, QRS<120 ms Morphology: Narrow QRS ST segment: c/w SVT T-waves: c/w SVT
EKG 34
Answer: EKG 34 Rate: 214 bpm Rhythm: Wide complex tachycardia; PSVT with aberrancy vs. VT Axis: + 104 Intervals: No PR, QRS> 120 ms Morphology: Wide QRS ST segment: Wide complex tachycardia T-waves: Wide complex tachycardia
EKG 35
Answer: EKG 35 Rate: 71 bpm Rhythm: NSR Axis: + 60 Intervals: PR= 80ms, QRS= 120 ms Morphology: Wide QRS with delta wave c/w WPW, no chamber enlargement, intraventricular conduction delay ST segment: No ischemic changes T-waves: T inversion in I, aVL, V3-5 c/w possible anterior and high lateral wall ischemia
EKG 36
Answer: EKG 36 Rate: 142 bpm (9 beats in 3.8 sec) Rhythm: Atrial fibrillation Axis: + 32 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: Non-specific ST/T changes T-waves: T wave inversion in I, II, III, aVL, V4-V6, c/w inferior lateral wall ischemia
EKG 37
Answer: EKG 37 Rate: 71 bpm Rhythm: Paced atrial rhythm Axis: + 74 Intervals: PR= 200ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, incomplete RBBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 38
Answer: EKG 38 Rate: 43 bpm Rhythm: Complete heart block with junctional rhythm Axis: + 60 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, LVH, no BBB ST segment: P waves in between QRS’ and T waves, no ischemic changes T-waves: No ischemic changes
EKG 39
Answer: EKG 39 Rate: 30 bpm (~intrinsic rate of AV node) Rhythm: Junctional escape Axis: -12 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS complexes, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 40
Answer: EKG 40 Rate: 150 bpm Rhythm: A-flutter Axis: - 7 Intervals: PR= 160ms, QRS > 120 ms Morphology: Wide QRS, no chamber enlargement, LBBB, poor R wave progression ST segment: c/w LBBB T-waves: c/w LBBB
EKG 41
Answer: EKG 41 Rate: 43 bpm Rhythm: AV dissociation with junctional rhythm Axis: + 45 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST elevation in II, III, aVF, V3-6 with reciprocal ST depression in I, aVL c/w acute inferior lateral wall infarction T-waves: c/w acute inferior lateral wall infarction
EKG 42
Answer: EKG 42 Rate: 83 bpm Rhythm: NSR Axis: +33 Intervals: PR=160 ms, QRS= 120 ms Morphology: Wide QRS, no chamber enlargement, IVCD ST segment: ST elevation in I, II, aVL, aVF, V1-V6 c/w acute inferior, anterioseptal and lateral wall infarction T-waves: c/w acute inferior, anterioseptal and lateral wall infarction
EKG 43
Answer: EKG 43 Rate: 65 bpm Rhythm: NSR Axis: + 27 Intervals: PR=160 ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 44
Answer: EKG 44 Rate: 150 bpm Rhythm: A-flutter Axis: + 90 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, LVH, no BBB ST segment: c/w LVH T-waves: c/w LVH
EKG 45
Answer: EKG 45 Rate: 120 bpm Rhythm: Regular Axis: NA Intervals: No PR, QRS> 120ms Morphology: Sinusoidal wave forms c/w extreme hyperkalemia ST segment: c/w extreme hyperkalemia T-waves: c/w extreme hyperkalemia
EKG 46
Answer: EKG 46 Rate: 83 bpm Rhythm: NSR with sinusoidal PVC (post treatment of EKG 45) Axis: +90 Intervals: PR= 200 ms, QRS< 120ms Morphology: Narrow QRS, flattened P’s, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 47
Answer: EKG 47 Rate: 71 bpm Rhythm: Sinus with first degree AV block Axis: + 48 Intervals: PR= 300 ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 48
Answer: EKG 48 Rate: 117 bpm Rhythm: A-fib Axis: +45 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, no LVH, no BBB ST segment: c/w a-fib T-waves: c/w a-fib
EKG 49
Answer: EKG 49 Rate: 115 bpm Rhythm: Junctional tachycardia Axis: + 63 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB, inverted P following QRS c/w junctional rhythm ST segment: No ischemic changes T-waves: No ischemic changes
EKG 50
Answer: EKG 50 Rate: 63 bpm Rhythm: NSR with PACs Axis: - 6 Intervals: PR= 120 ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: Biphasic Ts in V2-3 suggest possible left main stenosis (Wellen’s)
EKG 51
Answer: EKG 51 Rate: 75 bpm Rhythm: Atrial flutter Axis: + 53 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: T wave inversion in V4-6 c/w possible lateral wall ischemia
EKG 52
Answer: EKG 52 Rate: 38 bpm Rhythm: Sinus bradycardia Axis: + 17 Intervals: PR= 200 ms, QRS< 120 ms Morphology: Narrow QRS, LVH, right atrial enlargement, no BBB ST segment: No ischemic changes T-waves: T wave inversion in I, II, III, aVF, V5-V6 c/w possible inferior lateral wall ischemia
EKG 53
Answer: EKG 53 Rate: 107 bpm Rhythm: Sinus tachycardia Axis: - 27 Intervals: PR= 180ms, QRS= 120 ms Morphology: Wide QRS, LVH, IVCD ST segment: No ischemic changes T-waves: Non specific changes asso w/ LVH
EKG 54
Answer: EKG 54 Rate: 140 bpm Rhythm: Multifocal atrial tachycardia Axis: -40 Intervals: PR= 120-160 ms, QRS <120ms Morphology: Narrow QRS, no LVH, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 55
Answer: EKG 55 Rate: 214 bpm Rhythm: Ventricular tachycardia Axis: +150 Intervals: No PR, QRS> 120ms Morphology: Wide QRS c/w v-tach ST segment: c/w v-tach T-waves: c/w v-tach
EKG 56
Answer: EKG 56 Rate: 45 bpm Rhythm: Third degree heart block Axis: - 5 Intervals: No PR, QRS < 120ms Morphology: Narrow QRS, LVH, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 57
Answer: EKG 57 Rate: 47 bpm Rhythm: Sinus bradycardia w/ ectopic atrial pacemaker Axis: -135 Intervals: PR= 200ms, QRS> 120ms Morphology: Wide QRS, flattened P waves c/w hyperkalemia ST segment: c/w hyperkalemia T-waves: c/w hyperkalemia
EKG 58
Answer: EKG 58 Rate: 34-70 bpm Rhythm: Atrial pacer with failure to capture; PVCs Axis: + 19 Intervals: PR= 200ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 59
Answer: EKG 59 Rate: 72 bpm Rhythm: Sinoatrial block Axis: + 34 Intervals: PR= 200ms, QRS< 120ms Morphology: Narrow QRS, LVH, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 60
Answer: EKG 60 Rate: 88 bpm Rhythm: Ectopic atrial pacemaker Axis: + 72 Intervals: PR= 180ms, QRS> 120ms Morphology: Wide QRS, no chamber enlargement, RBBB ST segment: c/w RBBB T-waves: c/w RBBB
EKG 61
Answer: EKG 61 Rate: 115 bpm Rhythm: Sinus tachycardia Axis: + 61 Intervals: PR= 160ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 62
Answer: EKG 62 Rate: 89 bpm Rhythm: Wandering atrial pacemaker Axis: + 45 Intervals: PR= 200ms, QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST elevation in II, III, aVF, V3-6 with ST depression in aVL, V1-2 c/w acute inferior, anterior, lateral wall infarction and possible septal ischemia T-waves: c/w acute inferior, anterior, lateral wall infarction
EKG 63
Answer: EKG 63 Rate: 167 bpm Rhythm: Supraventricular tachycardia Axis: + 40 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB, Q waves in V1-2 c/w possible septal infarction ST segment: ST depression in I, II, aVF, V3-6 c/w possible inferior-lateral ischemia T-waves: c/w possible inferior-lateral ischemia
EKG 64
Answer: EKG 64 Rate: 214 bpm Rhythm: Ventricular tachycardia Axis: N/A Intervals: No PR, QRS> 120ms Morphology: Wide QRS c/w v-tach ST segment: c/w v-tach T-waves: c/w v-tach
EKG 65
Answer: EKG 65 Rate: 77 bpm Rhythm: Dual chamber pacing Axis: - 47 Intervals: PR= 160 ms, QRS> 120ms Morphology: Wide QRS, LVH, LBBB c/w right ventricular pacer ST segment: c/w LVH T-waves: T inversion in I, aVL, V6 c/w possible lateral wall ischemia
EKG 66
Answer: EKG 66 Rate: 94 bpm Rhythm: NSR Axis: + 90 Intervals: PR= 200ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB, R in V2, R/S in V2, V3 approaches 1, c/w posterior wall infarct ST segment: ST elevation in II, III, aVF with reciprocal ST depression in I, aVL, V2-6 c/w acute inferior wall infarction T-waves: c/w acute posterior and inferior wall infarction
EKG 67
Answer: EKG 67 Rate: 86 bpm Rhythm: NSR Axis: - 6 Intervals: PR= 160 ms, QRS< 120ms Morphology: Narrow QRS, LVH, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 68
Answer: EKG 68 Rate: 59 bpm Rhythm: Junctional bradhycardia Axis: + 90 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST elevation in V2-3 c/w possible anterior septal ischemia T-waves: possible anterior septal ischemia
EKG 69
Answer: EKG 69 Rate: 63 bpm Rhythm: Wandering pacemaker Axis: + 45 Intervals: PR= 140-160, QRS< 120ms Morphology: Narrow QRS ST segment: ST elevation in II, aVF, V4-6 with ST depression in V1-2 c/w acute inferior lateral wall infarction T-waves: c/w acute inferior lateral wall infarction
EKG 70
Answer: EKG 70 Rate: 100-167 bpm Rhythm: SVT with intervention Axis: N/A Intervals: PR=180, QRS< 120 ms Morphology: Narrow QRS ST segment: ST depression in aVF T-waves: c/w SVT
EKG 71
Answer: EKG 71 Rate: 107 bpm Rhythm: Sinus tachycardia Axis: +30 Intervals: PR=160 ms, QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB, poor R wave progression ST segment: No ischemic changes T Wave: Hyperacute T waves c/w hyperkalemia
EKG 72
Answer: EKG 72 Rate: 50 bpm Rhythm: Sinus bradycardia Axis: - 45 Intervals: PR= 160 ms, QRS=120 ms Morphology: Wide QRS, no chamber enlargement, RBBB, LAHB ST segment: ST elevation in I, aVL, V2,5,6 c/w acute anterior lateral wall MI T Wave: biphasic T in V3, nonspecific T inversion in III
EKG 73
Answer: EKG 73 Rate: 100 bpm Rhythm: bigemini Axis: 0 Intervals: PR= 120ms, QRS=80, 120 ms Morphology: First QRS narrow followed by wide PVC, no chamber enlargement, no BBB ST segment: No ischemic changes T Wave: No ischemic changes
EKG 74
Answer: EKG 74 Rate: 150 bpm Rhythm: A-flutter Axis: 0 Intervals: No PR, QRS=120 ms, QTc=379 ms Morphology: Wide QRS, no chamber enlargement, LBBB ST segment: No ischemic changes T Wave: Non-specific T wave changes associated with LBBB
EKG 75
Answer: EKG 75 Rate: 45 bpm Rhythm: Sinus bradycardia Axis: -23 Intervals: PR=220 ms, QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T Wave: No ischemic changes
EKG 76
Answer: EKG 76 Rate: 167 bpm Rhythm: supraventricular tachycardia Axis: +45 Intervals: No PR, QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB, Q waves in V1-2 ST segment: ST depression in I,II, aVF, V3-6 c/s with inferior lateral wall ischemia T Wave: c/w inferior lateral wall ischemia
EKG 77
Answer: EKG 77 Rate: 69 bpm Rhythm: Bigemini Axis: 0 Intervals: PR=160 ms, QRS=80, 120 ms Morphology: First QRS narrow followed by wide PVC, no chamber enlargement, no BBB ST segment: No ischemic changes T Wave: No ischemic changes
EKG 78
Answer: EKG 78 Rate: 58-68 bpm Rhythm: Sinus Axis: Intervals: PR=160 ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST elevation in II, III, aVF, V4-6 with reciprocal ST depression V1, V2, aVL c/w acute inferior lateral MI T Wave: c/w acute inferior lateral MI
EKG 79
Answer: EKG 79 Rate: 100 bpm Rhythm: NSR Axis: +104 Intervals: PR=140 ms, QRS= 80 ms Morphology: Narrow QRS, right atrial enlargement, LAHB ST segment: No ischemic changes T Wave: No ischemic changes
EKG 80
Answer: EKG 80 Rate: 136 bpm Rhythm: Junctional tachycardia Axis: -4/12 Intervals: No PR, QRS<120 ms Morphology: Narrow QRS, LVH, no BBB ST segment: No ST elevation or depression T Wave: T wave inversion in I, aVL, V6 c/w possible lateral wall ischemia
EKG 81
Answer: EKG 81 Rate: 150 bpm Rhythm: A-flutter Axis: 0 Intervals: No PR, QRS= 160ms Morphology: Wide QRS, No chamber enlargement, IVCD, poor R wave progression ST segment: No ischemic changes T-waves: No ischemic changes
EKG 82
Answer: EKG 82 Rate: 68 bpm Rhythm: NSR Axis: + 63 Intervals: PR= 200 ms, QRS= 200 ms Morphology: Wide QRS, no chamber enlargement, RBBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 83
Answer: EKG 83 Rate: 88 bpm Rhythm: NSR with PVCs Axis: + 18 Intervals: PR= 240 ms, QRS< 120ms Morphology: Narrow QRS with wide QRS c/w PVCs ST segment: No ischemic changes T-waves: No ischemic changes
EKG 84
Answer: EKG 84 Rate: 100 bpm Rhythm: NSR Axis: - 10 Intervals: PR= 160ms, QRS= 120 ms Morphology: Wide QRS, LVH, LBBB ST segment: Non specific J point elevation and ST depression in I, aVL, V5-6 c/w possible lateral wall ischemia T-waves: T inversion in I, aVL, V5-6 c/w possible lateral wall ischemia
EKG 85
Answer: EKG 85 Rate: 96 bpm Rhythm: A-fib Axis: + 36 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 86
Answer: EKG 86 Rate: 102 bpm Rhythm: NSR with 2 PACs in between the sinus beats Axis: + 35 Intervals: PR = 220 ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: non-specific flattened T in I, V5-6; T inversion in aVL, V1-4
EKG 87
Answer: EKG 87 Rate: 167 bpm Rhythm: V-Tachycardia Axis: N/A Intervals: No PR, QRS>120 ms Morphology: Wide QRS ST segment: c/w V-Tach T-waves: c/w V-Tach
EKG 88
Answer: EKG 88 Rate: 75 bpm Rhythm: A-Flutter Axis: + 53 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: c/w a-flutter T-waves: c/w a-flutter
EKG 89
Answer: EKG 89 Rate: 67 bpm Rhythm: NSR Axis: + 41 Intervals: PR= 160 ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST depression in II, III, aVF c/w possible inf wall ischemia T-waves: No inversion or flattening
EKG 90
Answer: EKG 90 Rate: 45 bpm Rhythm: Junctional bradycardia Axis: + 62 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: Non-specific biphasic T in V2
EKG 91
Answer: EKG 91 Rate: 43 bpm Rhythm: Sinus bradycardia Axis: + 71 Intervals: PR= 200 ms , QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes U-wave c/w hypokalemia
EKG 92
Answer: EKG 92 Rate: 94 bpm Rhythm: Paced + intrinsic sinus rhythm Axis: - 12 Intervals: PR= 160ms, QRS= 100-120 Morphology: Wide paced QRS, LVH, no BBB ST segment: No ischemic changes T-waves: T inversion in I, aVL c/w possible high lateral ischemia
EKG 93
Answer: EKG 93 Rate: 39 bpm Rhythm: Third degree heart block Axis: + 40 Intervals: No PR, QRS>120 ms Morphology: Wide QRS, LVH, LBBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 94
Answer: EKG 94 Rate: 136 bpm Rhythm: A-fib w/ rapid ventricular response Axis: + 31 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 95
Answer: EKG 95 Rate: 64 bpm Rhythm: NSR Axis: + 6 Intervals: PR=140 ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST depression in II, aVF, V3-6 c/w inferior lateral wall ischemia T-waves: c/w inferior lateral wall ischemia
EKG 96
Answer: EKG 96 Rate: 43 bpm Rhythm: Sinus bradycardia Axis: + 68 Intervals: PR=180 ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
EKG 97
Answer: EKG 97 Rate: 114 bpm Rhythm: MFAT Axis: - 70 Intervals: PR= 160-200ms, QRS>120 ms Morphology: Wide QRS, LVH, RBBB, LAHB ST segment: c/w LVH, RBBB, LAHB T-waves: c/w LVH, RBBB, LAHB
EKG 98
Answer: EKG 98 Rate: 73 bpm Rhythm: NSR with non-conducted ectopic atrial beats Axis: - 39 Intervals: PR= 200 ms, QRS< 120 ms Morphology: Narrow QRS, LVH, no BBB ST segment: c/w LVH T-waves: c/w LVH
EKG 99
Answer: EKG 99 Rate: 115 bpm Rhythm: Sinus tachycardia Axis: + 79 Intervals: PR= 160ms, QRS<120 ms Morphology: Narrow QRS, LVH, no BBB ST segment: No ischemic changes T-waves: peaked T waves c/w hyperkalemia
EKG 100
Answer: EKG 100 Rate: 94 bpm Rhythm: NSR Axis: - 20 Intervals: PR= 160ms, QRS= 120ms Morphology: Wide QRS, no chamber enlargement, LBBB ST segment: c/w LBBB T-waves: c/w LBBB
EKG 101
Answer: EKG 101 Rate: 75 bpm Rhythm: sinus Axis: - 130 Intervals: PR= < 200 ms , QRS= 100 ms Morphology: Narrow QRS with delta wave c/w WPW ST segment: diffuse ST depressions T-waves: no T wave changes

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Ekg Test Upload

  • 1. Mark Silverberg, MD MMB FACEP Vivian Tsai, MD MPH Kaedrea Jackson, MD MPH Department of Emergency Medicine SUNY Downstate Medical Center/ Kings County Hospital Brooklyn, NY
  • 3. Answer: EKG 1 Rate: 70 Rhythm: NSR Axis: Normal, between -30 and 110 Intervals: Normal PR<200ms, QRS<120ms Morphology: No BBB pattern or chamber hypertrophy/dilation ST Segments: No elevation or depression T Waves: Not flipped or flat
  • 5. Answer: EKG 2 Rate: 90 Rhythm: Sinus with paced ventricles Axis: -75 Intervals: PR=195ms, QRS=160ms Morphology: Neg. P in V1=LAE, Pacer ST Segments: C/W paced rhythm T Waves: C/W paced rhythm
  • 7. Answer: EKG 3 Rate: 2 beats(1cuplet)/1.44 seconds, 42 bpm Rhythm: Bigemini Axis: +50 aberrancy Intervals: Beat 1 PR=150ms, QRS 70/100ms (beat 1/2) Morphology: First narrow, #2 aberrant ST Segments: No ischemic changes,#2 C/W aberrant beats T Waves: First no ischemia, #2 C/W aberrancy
  • 9. Answer: EKG 4 Rate: Vent. response 48bpm Rhythm: Atrial flutter Axis: +50 Intervals: QRS 125ms Morphology: LBBB ST Segments: C/W LBBB T Waves: C/W LBBB
  • 10. EKG 5
  • 11. Answer: EKG 5 Rate: 56 bpm Rhythm: NSR Axis: +45 Intervals: PR=160ms, Wide QRS > 120 ms C/W BBB Morphology: LBBB ST Segments: C/W LBBB T Waves: C/W LBBB
  • 12. EKG 6
  • 13. Answer: EKG 6 Rate: Irregular tachycardia Rhythm: Multifocal atrial tachycardia Axis: +15 (averaged) Intervals: PR irregular, QRS 80ms but irreg. Morphology: Multiple P’s, QRS narrow ST Segments: No ischemic changes T Waves: No ischemic changes
  • 14. EKG 7
  • 15. Answer: EKG 7 Rate: Irregular tachycardia Rhythm: Atrial fibrillation Axis: -45 Intervals: Wide QRS > 120 ms C/W BBB Morphology: LBBB ST Segments: C/W LBBB T Waves: C/W LBBB
  • 16. EKG 8
  • 17. Answer: EKG 8 Rate: 90 bpm Rhythm: NSR Axis: +40 Intervals: PR=140ms, QRS with normal narrow complexes Morphology: No BBB or chamber enlargement patterns ST Segments: Diffuse ST elevation C/W pericarditis (Diffuse PR depression also) T Waves: No Ischemic changes
  • 18. EKG 9
  • 19. Answer: EKG 9 Rate: 250 bpm Rhythm: SVT Axis: +135 Intervals: No PR, Narrow QRS Morphology: Narrow, C/W SVT ST Segments: ? T Waves: Superimposed on QRS
  • 21. Answer: EKG 10 Rate: 100 bpm Rhythm: NSR Axis: -10 Intervals: Normal PR, QRS=115ms Morphology: LAFB ST Segments: Elevation V1-V6, reciprocal ST depression inferiorly T Waves: WNL
  • 23. Answer: EKG 11 Rate: 74 bpm Rhythm: NSR Axis: -75 Intervals: PR=160ms, QRS=120ms Morphology: RBBB + LAHB ST Segments: C/W BBB pattern T Waves: C/W BBB pattern
  • 25. Answer: EKG 12 Rate: Atria 100 bpm, Ventricles 25 bpm Rhythm: Sinus with every 3 rd beat capture Axis: +75 Intervals: PR=520ms C/W 1 o AVB, QRS=170ms Morphology: LBBB ST Segments: C/W LBBB pattern T Waves: C/W LBBB pattern
  • 27. Answer: EKG 13 Rate: 72 bpm Rhythm: NSR Axis: -30 Intervals: PR=160ms, QRS=120ms Morphology: LBBB ST Segments: C/W LBBB pattern T Waves: Peaked C/W hyperkalemia
  • 29. Answer: EKG 14 Rate: 70 bpm Rhythm: NSR Axis: +45 Intervals: PR=160ms, QRS=80ms Morphology: Narrow, partial fused with ST ST Segments: Elevations inferiorly, reciprocal depressions laterally T Waves: No ischemic changes
  • 31. Answer: EKG 15 Rate: 80 bpm (8 beats in 6 sec) Rhythm: Bigeminy – frequent regular PVCs Axis: + 4 Intervals: PR= 160ms, QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 33. Answer: EKG 16 Rate: 88 bpm Rhythm: NSR Axis: - 83 Intervals: PR= 160 ms, QRS= 120 ms Morphology: Wide QRS, no chamber enlargement, RBBB, LAHB ST segment: No ischemic changes T-waves: T-Inversion in V1-2 c/w Brugada syndrome
  • 35. Answer: EKG 17 Rate: 79 bpm Rhythm: NSR Axis: + 75 Intervals: PR= 160 ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST depression in II, III, aVF c/w inferior wall ischemia T-waves: Flattened T waves in V4-5, inverted T in V6 suggests possible lateral wall ischemia
  • 37. Answer: EKG 18 Rate: 57bpm Rhythm: NSR Axis: + 20 Intervals: PR= 160 ms, QRS< 120 ms Morphology: Narrow QRS, LVH ST segment: Inf elevation & lat reciprocal depressions c/w inf AMI T-waves: Laterally inverted c/w reciprocal AMI changes
  • 39. Answer: EKG 19 Rate: 47 bpm Rhythm: Junctional bradycardia Axis: + 60 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, inverted P between QRS and T waves ST segment: No ischemic changes T-waves: No ischemic changes
  • 41. Answer: EKG 20 Rate: 60 – 100 bpm Rhythm: Dual chamber pacing Axis: Left axis deviation Intervals: PR= 200 ms, QRS= 120 ms Morphology: Wide QRS ST segment: N/A T-waves: N/A
  • 43. Answer: EKG 21 Rate: 273 bpm Rhythm: SVT Axis: + 24 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS ST segment: c/w SVT T-waves: c/w SVT
  • 45. Answer: EKG 22 Rate: 68 bpm Rhythm: A-flutter Axis: - 99 Intervals: No PR, QRS = 120ms Morphology: Wide QRS, no chamber enlargement, RBBB, LAHB ST segment: c/w a-flutter, RBBB, LAHB T-waves: c/w a-flutter, incomplete RBBB, LAHB
  • 47. Answer: EKG 23 Rate: 105 bpm Rhythm: MFAT Axis: - 54 Intervals: PR= 120-160, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 49. Answer: EKG 24 Rate: 65 bpm Rhythm: First degree AV block Axis: + 68 Intervals: PR= 320 ms, QRS< 120 ms Morphology: Narrow QRS, LVH, no BBB ST segment: ST depression in V4-6 and slightly in II, III, aVF; upward sloping of ST segment c/w digitalis effect T-waves: No ischemic changes
  • 51. Answer: EKG 25 Rate: 80 bpm Rhythm: NSR with PACs originating from focus inferior to SA node Axis: + 63 Intervals: PR= 200 ms, QRS< 120ms Morphology: Narrow QRS, occasional inverted P’s, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: T wave inversions in I, II, III, aVF, V3-V6 c/w possible inferior and lateral wall ischemia
  • 53. Answer: EKG 26 Rate: 88 bpm Rhythm: NSR Axis: + 41 Intervals: PR= 160ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: Diffuse PR depression c/w pericarditis T-waves: No ischemic changes
  • 55. Answer: EKG 27 Rate: 60 bpm Rhythm: Ventricular pacing Axis: - 45 Intervals: PR= 240ms, QRS> 120ms Morphology: Wide QRS ST segment: c/w ventricular pacing T-waves: c/w ventricular pacing
  • 57. Answer: EKG 28 Rate: 79 bpm Rhythm: NSR Axis: + 39 Intervals: PR= 140ms, QRS= 120 ms Morphology: Wide QRS, RBBB, no chamber enlargement ST segment: No ischemic changes T-waves: T inversion in V1-3 c/w possible anterior septal ischemia T Waves
  • 59. Answer: EKG 29 Rate: 143 bpm Rhythm: Sinus Tachycardia Axis: + 27 Intervals: PR= 140 ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 61. Answer: EKG 30 Rate: 71 bpm Rhythm: NSR w/ 1 dropped beat c/w SA block Axis: -22 Intervals: PR= 320ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: Lateral T wave flattening & inversion in I, aVL suggests possible lateral wall ischemia
  • 63. Answer: EKG 31 Rate: 79 bpm Rhythm: NSR Axis: -37 Intervals: PR= 200ms, QRS< 120ms Morphology: Narrow QRS, no LVH, no BBB ST segment: ST elevation in II, III, aVF, V3-4 with reciprocal ST depression in I, aVL c/w anterior inferior acute MI T-waves: c/w acute anterior inferior MI
  • 65. Answer: EKG 32 Rate: 33 bpm Rhythm: Paced rhythm; pacer fails to sense; Type II second degree block as underlying rhythm Axis: -73 Intervals: PR= 160ms (intrinsic), PR= 280ms (paced), QRS= 160ms Morphology: Wide QRS ST segment: c/w pacemaker malfunction; failure to sense T-waves: c/w pacemaker malfunction; failure to sense
  • 67. Answer: EKG 33 Rate: 200 bpm Rhythm: SVT Axis: + 40 Intervals: No PR, QRS<120 ms Morphology: Narrow QRS ST segment: c/w SVT T-waves: c/w SVT
  • 69. Answer: EKG 34 Rate: 214 bpm Rhythm: Wide complex tachycardia; PSVT with aberrancy vs. VT Axis: + 104 Intervals: No PR, QRS> 120 ms Morphology: Wide QRS ST segment: Wide complex tachycardia T-waves: Wide complex tachycardia
  • 71. Answer: EKG 35 Rate: 71 bpm Rhythm: NSR Axis: + 60 Intervals: PR= 80ms, QRS= 120 ms Morphology: Wide QRS with delta wave c/w WPW, no chamber enlargement, intraventricular conduction delay ST segment: No ischemic changes T-waves: T inversion in I, aVL, V3-5 c/w possible anterior and high lateral wall ischemia
  • 73. Answer: EKG 36 Rate: 142 bpm (9 beats in 3.8 sec) Rhythm: Atrial fibrillation Axis: + 32 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: Non-specific ST/T changes T-waves: T wave inversion in I, II, III, aVL, V4-V6, c/w inferior lateral wall ischemia
  • 75. Answer: EKG 37 Rate: 71 bpm Rhythm: Paced atrial rhythm Axis: + 74 Intervals: PR= 200ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, incomplete RBBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 77. Answer: EKG 38 Rate: 43 bpm Rhythm: Complete heart block with junctional rhythm Axis: + 60 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, LVH, no BBB ST segment: P waves in between QRS’ and T waves, no ischemic changes T-waves: No ischemic changes
  • 79. Answer: EKG 39 Rate: 30 bpm (~intrinsic rate of AV node) Rhythm: Junctional escape Axis: -12 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS complexes, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 81. Answer: EKG 40 Rate: 150 bpm Rhythm: A-flutter Axis: - 7 Intervals: PR= 160ms, QRS > 120 ms Morphology: Wide QRS, no chamber enlargement, LBBB, poor R wave progression ST segment: c/w LBBB T-waves: c/w LBBB
  • 83. Answer: EKG 41 Rate: 43 bpm Rhythm: AV dissociation with junctional rhythm Axis: + 45 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST elevation in II, III, aVF, V3-6 with reciprocal ST depression in I, aVL c/w acute inferior lateral wall infarction T-waves: c/w acute inferior lateral wall infarction
  • 85. Answer: EKG 42 Rate: 83 bpm Rhythm: NSR Axis: +33 Intervals: PR=160 ms, QRS= 120 ms Morphology: Wide QRS, no chamber enlargement, IVCD ST segment: ST elevation in I, II, aVL, aVF, V1-V6 c/w acute inferior, anterioseptal and lateral wall infarction T-waves: c/w acute inferior, anterioseptal and lateral wall infarction
  • 87. Answer: EKG 43 Rate: 65 bpm Rhythm: NSR Axis: + 27 Intervals: PR=160 ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 89. Answer: EKG 44 Rate: 150 bpm Rhythm: A-flutter Axis: + 90 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, LVH, no BBB ST segment: c/w LVH T-waves: c/w LVH
  • 91. Answer: EKG 45 Rate: 120 bpm Rhythm: Regular Axis: NA Intervals: No PR, QRS> 120ms Morphology: Sinusoidal wave forms c/w extreme hyperkalemia ST segment: c/w extreme hyperkalemia T-waves: c/w extreme hyperkalemia
  • 93. Answer: EKG 46 Rate: 83 bpm Rhythm: NSR with sinusoidal PVC (post treatment of EKG 45) Axis: +90 Intervals: PR= 200 ms, QRS< 120ms Morphology: Narrow QRS, flattened P’s, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 95. Answer: EKG 47 Rate: 71 bpm Rhythm: Sinus with first degree AV block Axis: + 48 Intervals: PR= 300 ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 97. Answer: EKG 48 Rate: 117 bpm Rhythm: A-fib Axis: +45 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, no LVH, no BBB ST segment: c/w a-fib T-waves: c/w a-fib
  • 99. Answer: EKG 49 Rate: 115 bpm Rhythm: Junctional tachycardia Axis: + 63 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB, inverted P following QRS c/w junctional rhythm ST segment: No ischemic changes T-waves: No ischemic changes
  • 100. EKG 50
  • 101. Answer: EKG 50 Rate: 63 bpm Rhythm: NSR with PACs Axis: - 6 Intervals: PR= 120 ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: Biphasic Ts in V2-3 suggest possible left main stenosis (Wellen’s)
  • 102. EKG 51
  • 103. Answer: EKG 51 Rate: 75 bpm Rhythm: Atrial flutter Axis: + 53 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: T wave inversion in V4-6 c/w possible lateral wall ischemia
  • 104. EKG 52
  • 105. Answer: EKG 52 Rate: 38 bpm Rhythm: Sinus bradycardia Axis: + 17 Intervals: PR= 200 ms, QRS< 120 ms Morphology: Narrow QRS, LVH, right atrial enlargement, no BBB ST segment: No ischemic changes T-waves: T wave inversion in I, II, III, aVF, V5-V6 c/w possible inferior lateral wall ischemia
  • 106. EKG 53
  • 107. Answer: EKG 53 Rate: 107 bpm Rhythm: Sinus tachycardia Axis: - 27 Intervals: PR= 180ms, QRS= 120 ms Morphology: Wide QRS, LVH, IVCD ST segment: No ischemic changes T-waves: Non specific changes asso w/ LVH
  • 108. EKG 54
  • 109. Answer: EKG 54 Rate: 140 bpm Rhythm: Multifocal atrial tachycardia Axis: -40 Intervals: PR= 120-160 ms, QRS <120ms Morphology: Narrow QRS, no LVH, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 110. EKG 55
  • 111. Answer: EKG 55 Rate: 214 bpm Rhythm: Ventricular tachycardia Axis: +150 Intervals: No PR, QRS> 120ms Morphology: Wide QRS c/w v-tach ST segment: c/w v-tach T-waves: c/w v-tach
  • 112. EKG 56
  • 113. Answer: EKG 56 Rate: 45 bpm Rhythm: Third degree heart block Axis: - 5 Intervals: No PR, QRS < 120ms Morphology: Narrow QRS, LVH, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 114. EKG 57
  • 115. Answer: EKG 57 Rate: 47 bpm Rhythm: Sinus bradycardia w/ ectopic atrial pacemaker Axis: -135 Intervals: PR= 200ms, QRS> 120ms Morphology: Wide QRS, flattened P waves c/w hyperkalemia ST segment: c/w hyperkalemia T-waves: c/w hyperkalemia
  • 116. EKG 58
  • 117. Answer: EKG 58 Rate: 34-70 bpm Rhythm: Atrial pacer with failure to capture; PVCs Axis: + 19 Intervals: PR= 200ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 118. EKG 59
  • 119. Answer: EKG 59 Rate: 72 bpm Rhythm: Sinoatrial block Axis: + 34 Intervals: PR= 200ms, QRS< 120ms Morphology: Narrow QRS, LVH, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 120. EKG 60
  • 121. Answer: EKG 60 Rate: 88 bpm Rhythm: Ectopic atrial pacemaker Axis: + 72 Intervals: PR= 180ms, QRS> 120ms Morphology: Wide QRS, no chamber enlargement, RBBB ST segment: c/w RBBB T-waves: c/w RBBB
  • 122. EKG 61
  • 123. Answer: EKG 61 Rate: 115 bpm Rhythm: Sinus tachycardia Axis: + 61 Intervals: PR= 160ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 124. EKG 62
  • 125. Answer: EKG 62 Rate: 89 bpm Rhythm: Wandering atrial pacemaker Axis: + 45 Intervals: PR= 200ms, QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST elevation in II, III, aVF, V3-6 with ST depression in aVL, V1-2 c/w acute inferior, anterior, lateral wall infarction and possible septal ischemia T-waves: c/w acute inferior, anterior, lateral wall infarction
  • 126. EKG 63
  • 127. Answer: EKG 63 Rate: 167 bpm Rhythm: Supraventricular tachycardia Axis: + 40 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB, Q waves in V1-2 c/w possible septal infarction ST segment: ST depression in I, II, aVF, V3-6 c/w possible inferior-lateral ischemia T-waves: c/w possible inferior-lateral ischemia
  • 128. EKG 64
  • 129. Answer: EKG 64 Rate: 214 bpm Rhythm: Ventricular tachycardia Axis: N/A Intervals: No PR, QRS> 120ms Morphology: Wide QRS c/w v-tach ST segment: c/w v-tach T-waves: c/w v-tach
  • 130. EKG 65
  • 131. Answer: EKG 65 Rate: 77 bpm Rhythm: Dual chamber pacing Axis: - 47 Intervals: PR= 160 ms, QRS> 120ms Morphology: Wide QRS, LVH, LBBB c/w right ventricular pacer ST segment: c/w LVH T-waves: T inversion in I, aVL, V6 c/w possible lateral wall ischemia
  • 132. EKG 66
  • 133. Answer: EKG 66 Rate: 94 bpm Rhythm: NSR Axis: + 90 Intervals: PR= 200ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB, R in V2, R/S in V2, V3 approaches 1, c/w posterior wall infarct ST segment: ST elevation in II, III, aVF with reciprocal ST depression in I, aVL, V2-6 c/w acute inferior wall infarction T-waves: c/w acute posterior and inferior wall infarction
  • 134. EKG 67
  • 135. Answer: EKG 67 Rate: 86 bpm Rhythm: NSR Axis: - 6 Intervals: PR= 160 ms, QRS< 120ms Morphology: Narrow QRS, LVH, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 136. EKG 68
  • 137. Answer: EKG 68 Rate: 59 bpm Rhythm: Junctional bradhycardia Axis: + 90 Intervals: No PR, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST elevation in V2-3 c/w possible anterior septal ischemia T-waves: possible anterior septal ischemia
  • 138. EKG 69
  • 139. Answer: EKG 69 Rate: 63 bpm Rhythm: Wandering pacemaker Axis: + 45 Intervals: PR= 140-160, QRS< 120ms Morphology: Narrow QRS ST segment: ST elevation in II, aVF, V4-6 with ST depression in V1-2 c/w acute inferior lateral wall infarction T-waves: c/w acute inferior lateral wall infarction
  • 140. EKG 70
  • 141. Answer: EKG 70 Rate: 100-167 bpm Rhythm: SVT with intervention Axis: N/A Intervals: PR=180, QRS< 120 ms Morphology: Narrow QRS ST segment: ST depression in aVF T-waves: c/w SVT
  • 142. EKG 71
  • 143. Answer: EKG 71 Rate: 107 bpm Rhythm: Sinus tachycardia Axis: +30 Intervals: PR=160 ms, QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB, poor R wave progression ST segment: No ischemic changes T Wave: Hyperacute T waves c/w hyperkalemia
  • 144. EKG 72
  • 145. Answer: EKG 72 Rate: 50 bpm Rhythm: Sinus bradycardia Axis: - 45 Intervals: PR= 160 ms, QRS=120 ms Morphology: Wide QRS, no chamber enlargement, RBBB, LAHB ST segment: ST elevation in I, aVL, V2,5,6 c/w acute anterior lateral wall MI T Wave: biphasic T in V3, nonspecific T inversion in III
  • 146. EKG 73
  • 147. Answer: EKG 73 Rate: 100 bpm Rhythm: bigemini Axis: 0 Intervals: PR= 120ms, QRS=80, 120 ms Morphology: First QRS narrow followed by wide PVC, no chamber enlargement, no BBB ST segment: No ischemic changes T Wave: No ischemic changes
  • 148. EKG 74
  • 149. Answer: EKG 74 Rate: 150 bpm Rhythm: A-flutter Axis: 0 Intervals: No PR, QRS=120 ms, QTc=379 ms Morphology: Wide QRS, no chamber enlargement, LBBB ST segment: No ischemic changes T Wave: Non-specific T wave changes associated with LBBB
  • 150. EKG 75
  • 151. Answer: EKG 75 Rate: 45 bpm Rhythm: Sinus bradycardia Axis: -23 Intervals: PR=220 ms, QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T Wave: No ischemic changes
  • 152. EKG 76
  • 153. Answer: EKG 76 Rate: 167 bpm Rhythm: supraventricular tachycardia Axis: +45 Intervals: No PR, QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB, Q waves in V1-2 ST segment: ST depression in I,II, aVF, V3-6 c/s with inferior lateral wall ischemia T Wave: c/w inferior lateral wall ischemia
  • 154. EKG 77
  • 155. Answer: EKG 77 Rate: 69 bpm Rhythm: Bigemini Axis: 0 Intervals: PR=160 ms, QRS=80, 120 ms Morphology: First QRS narrow followed by wide PVC, no chamber enlargement, no BBB ST segment: No ischemic changes T Wave: No ischemic changes
  • 156. EKG 78
  • 157. Answer: EKG 78 Rate: 58-68 bpm Rhythm: Sinus Axis: Intervals: PR=160 ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST elevation in II, III, aVF, V4-6 with reciprocal ST depression V1, V2, aVL c/w acute inferior lateral MI T Wave: c/w acute inferior lateral MI
  • 158. EKG 79
  • 159. Answer: EKG 79 Rate: 100 bpm Rhythm: NSR Axis: +104 Intervals: PR=140 ms, QRS= 80 ms Morphology: Narrow QRS, right atrial enlargement, LAHB ST segment: No ischemic changes T Wave: No ischemic changes
  • 160. EKG 80
  • 161. Answer: EKG 80 Rate: 136 bpm Rhythm: Junctional tachycardia Axis: -4/12 Intervals: No PR, QRS<120 ms Morphology: Narrow QRS, LVH, no BBB ST segment: No ST elevation or depression T Wave: T wave inversion in I, aVL, V6 c/w possible lateral wall ischemia
  • 162. EKG 81
  • 163. Answer: EKG 81 Rate: 150 bpm Rhythm: A-flutter Axis: 0 Intervals: No PR, QRS= 160ms Morphology: Wide QRS, No chamber enlargement, IVCD, poor R wave progression ST segment: No ischemic changes T-waves: No ischemic changes
  • 164. EKG 82
  • 165. Answer: EKG 82 Rate: 68 bpm Rhythm: NSR Axis: + 63 Intervals: PR= 200 ms, QRS= 200 ms Morphology: Wide QRS, no chamber enlargement, RBBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 166. EKG 83
  • 167. Answer: EKG 83 Rate: 88 bpm Rhythm: NSR with PVCs Axis: + 18 Intervals: PR= 240 ms, QRS< 120ms Morphology: Narrow QRS with wide QRS c/w PVCs ST segment: No ischemic changes T-waves: No ischemic changes
  • 168. EKG 84
  • 169. Answer: EKG 84 Rate: 100 bpm Rhythm: NSR Axis: - 10 Intervals: PR= 160ms, QRS= 120 ms Morphology: Wide QRS, LVH, LBBB ST segment: Non specific J point elevation and ST depression in I, aVL, V5-6 c/w possible lateral wall ischemia T-waves: T inversion in I, aVL, V5-6 c/w possible lateral wall ischemia
  • 170. EKG 85
  • 171. Answer: EKG 85 Rate: 96 bpm Rhythm: A-fib Axis: + 36 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 172. EKG 86
  • 173. Answer: EKG 86 Rate: 102 bpm Rhythm: NSR with 2 PACs in between the sinus beats Axis: + 35 Intervals: PR = 220 ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: non-specific flattened T in I, V5-6; T inversion in aVL, V1-4
  • 174. EKG 87
  • 175. Answer: EKG 87 Rate: 167 bpm Rhythm: V-Tachycardia Axis: N/A Intervals: No PR, QRS>120 ms Morphology: Wide QRS ST segment: c/w V-Tach T-waves: c/w V-Tach
  • 176. EKG 88
  • 177. Answer: EKG 88 Rate: 75 bpm Rhythm: A-Flutter Axis: + 53 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: c/w a-flutter T-waves: c/w a-flutter
  • 178. EKG 89
  • 179. Answer: EKG 89 Rate: 67 bpm Rhythm: NSR Axis: + 41 Intervals: PR= 160 ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST depression in II, III, aVF c/w possible inf wall ischemia T-waves: No inversion or flattening
  • 180. EKG 90
  • 181. Answer: EKG 90 Rate: 45 bpm Rhythm: Junctional bradycardia Axis: + 62 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: Non-specific biphasic T in V2
  • 182. EKG 91
  • 183. Answer: EKG 91 Rate: 43 bpm Rhythm: Sinus bradycardia Axis: + 71 Intervals: PR= 200 ms , QRS<120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes U-wave c/w hypokalemia
  • 184. EKG 92
  • 185. Answer: EKG 92 Rate: 94 bpm Rhythm: Paced + intrinsic sinus rhythm Axis: - 12 Intervals: PR= 160ms, QRS= 100-120 Morphology: Wide paced QRS, LVH, no BBB ST segment: No ischemic changes T-waves: T inversion in I, aVL c/w possible high lateral ischemia
  • 186. EKG 93
  • 187. Answer: EKG 93 Rate: 39 bpm Rhythm: Third degree heart block Axis: + 40 Intervals: No PR, QRS>120 ms Morphology: Wide QRS, LVH, LBBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 188. EKG 94
  • 189. Answer: EKG 94 Rate: 136 bpm Rhythm: A-fib w/ rapid ventricular response Axis: + 31 Intervals: No PR, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 190. EKG 95
  • 191. Answer: EKG 95 Rate: 64 bpm Rhythm: NSR Axis: + 6 Intervals: PR=140 ms, QRS< 120 ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: ST depression in II, aVF, V3-6 c/w inferior lateral wall ischemia T-waves: c/w inferior lateral wall ischemia
  • 192. EKG 96
  • 193. Answer: EKG 96 Rate: 43 bpm Rhythm: Sinus bradycardia Axis: + 68 Intervals: PR=180 ms, QRS< 120ms Morphology: Narrow QRS, no chamber enlargement, no BBB ST segment: No ischemic changes T-waves: No ischemic changes
  • 194. EKG 97
  • 195. Answer: EKG 97 Rate: 114 bpm Rhythm: MFAT Axis: - 70 Intervals: PR= 160-200ms, QRS>120 ms Morphology: Wide QRS, LVH, RBBB, LAHB ST segment: c/w LVH, RBBB, LAHB T-waves: c/w LVH, RBBB, LAHB
  • 196. EKG 98
  • 197. Answer: EKG 98 Rate: 73 bpm Rhythm: NSR with non-conducted ectopic atrial beats Axis: - 39 Intervals: PR= 200 ms, QRS< 120 ms Morphology: Narrow QRS, LVH, no BBB ST segment: c/w LVH T-waves: c/w LVH
  • 198. EKG 99
  • 199. Answer: EKG 99 Rate: 115 bpm Rhythm: Sinus tachycardia Axis: + 79 Intervals: PR= 160ms, QRS<120 ms Morphology: Narrow QRS, LVH, no BBB ST segment: No ischemic changes T-waves: peaked T waves c/w hyperkalemia
  • 201. Answer: EKG 100 Rate: 94 bpm Rhythm: NSR Axis: - 20 Intervals: PR= 160ms, QRS= 120ms Morphology: Wide QRS, no chamber enlargement, LBBB ST segment: c/w LBBB T-waves: c/w LBBB
  • 203. Answer: EKG 101 Rate: 75 bpm Rhythm: sinus Axis: - 130 Intervals: PR= < 200 ms , QRS= 100 ms Morphology: Narrow QRS with delta wave c/w WPW ST segment: diffuse ST depressions T-waves: no T wave changes