ECG Arrhythmia Quiz

The given information describes a sawtooth pattern and a flutter wave, which are characteristic features of atrial flutter. Atrial flutter is caused by an abnormal circuit in the right atrium, leading to a rapid heart rate of 300 bpm. The conduction pattern described in the question also matches the different ratios of atrial to ventricular contractions seen in atrial flutter. Therefore, the correct answer is atrial flutter.

The given information describes a prolonged but constant P-R interval, regular poppin Ps, P then QRS, and a normal QRS complex. This pattern indicates a delay in the conduction of electrical impulses from the atria to the ventricles, specifically through the AV node. This is characteristic of a 1st degree heart block, where there is a delay in the conduction but all atrial impulses are eventually conducted to the ventricles.

The given answer, atrial fibrillation, is the correct explanation for the description provided. Atrial fibrillation is characterized by an irregular heart rhythm with no clear P waves on the ECG. The baseline appears fibrillating, and the heart rate can be slow, normal, or fast. In atrial fibrillation, the atria are fibrillating and not contracting properly, which can lead to the formation of blood clots and an increased risk of strokes. If the patient has a chronic condition, they may be prescribed medications such as Digoxin and Warfarin to manage their symptoms and reduce the risk of complications.

The given ECG findings are suggestive of supraventricular tachycardia (SVT). SVT is characterized by a fast heart rate originating above the ventricles. In this case, the absence or difficulty in identifying P waves suggests that the atrial activity is not clearly visible, which is common in SVT. The narrow QRS complex also indicates that the electrical conduction through the ventricles is normal. Considering the valsalva maneuver is a common approach to terminate SVT episodes, further supporting the diagnosis.

In a 3rd degree (complete) heart block, there is a complete blockage of the electrical signals between the atria and the ventricles. This means that the P waves, which represent atrial depolarization, have no relationship with the QRS complexes, which represent ventricular depolarization. The QRS complexes may be regular or wide, and not every P wave is followed by a QRS complex. In this type of heart block, the AV node fails to conduct the electrical impulses from the atria to the ventricles, so the ventricles generate their own impulses. This can be dangerous as it disrupts the normal coordination of the heart's electrical system.

Ventricular fibrillation is a type of cardiac arrhythmia characterized by the rapid and chaotic electrical activity in the ventricles of the heart. This abnormal rhythm prevents the heart from effectively pumping blood, leading to a lack of oxygen supply to the body's organs and tissues. Ventricular fibrillation can present in two forms: coarse and fine. Coarse ventricular fibrillation refers to a more visible and disorganized pattern on an electrocardiogram (ECG), while fine ventricular fibrillation appears as a finer and more irregular pattern. Both forms of ventricular fibrillation are life-threatening emergencies that require immediate medical intervention to restore a normal heart rhythm.

The given ECG findings are consistent with a left bundle branch block (LBBB). LBBB is characterized by a widened QRS complex (>0.12 seconds) and specific changes in the V1 and V6 leads. In V6, there is a broad monomorphic R wave with no Q wave, which is a typical finding in LBBB. In V1, there is a broad monomorphic S wave, which is also seen in LBBB. Additionally, the absence of Q waves in V6 and the fact that the rhythm is normal sinus rhythm (NSR) further support the diagnosis of LBBB.

The given answer is RBBB (Right Bundle Branch Block). This is because RBBB is characterized by a wide QRS complex (>0.12 secs) and a slurred S wave in leads V1 and V6. Additionally, RBBB can also present with an R-S-R wave in leads V1 and V2, which is mentioned in the question. Therefore, based on the provided information, RBBB is the most appropriate diagnosis.

The given answer is correct because the description matches the characteristics of 2nd degree heart block, type 1. In this condition, there is a progressively prolonged P-R interval, meaning that the time between the P wave and the QRS complex becomes longer with each beat. Eventually, a QRS complex is dropped, resulting in an irregular pattern where not every P wave is followed by a QRS complex. The QRS complex itself is normal, indicating that the impulse from the SA node is able to reach the ventricles, but it is delayed at the AV node for a longer time with each beat.

Sinus tachycardia is the correct answer because the given information suggests that there are P waves present, which indicates that the electrical impulses are originating from the SA node. Additionally, the presence of a cause such as pain, temperature, exercise, anxiety, or congestive heart failure suggests that the increased heart rate is a physiological response. The mention of a heart rate over 140 also aligns with sinus tachycardia, as it is defined as a heart rate greater than 100 beats per minute.

Torsades de pointes is the correct answer because it matches the given description. Torsades de pointes is a type of ventricular tachycardia characterized by a twisting of the QRS complex on an electrocardiogram (ECG). It usually occurs in short bursts and can cause dizziness and a brief loss of consciousness. The waveforms on the ECG typically point mainly upwards and then twist and point downwards.

The description provided matches the characteristics of a type 2 2nd degree heart block, also known as Mobitz type 2.

In this type of heart block, there is a constant PR interval (indicating the impulse from the atria to the ventricles is consistently delayed), sudden drop of QRS (indicating some impulses are blocked from reaching the ventricles), and not every P wave is followed by a QRS complex. This is considered dangerous because it can lead to further complications, such as complete heart block.

The correct answer is agonal rhythm. Agonal rhythm refers to a slow, irregular, and wide QRS complex rhythm that occurs during cardiac arrest or near-death situations. It is characterized by a lack of organized electrical activity and is often seen as the last electrical activity before complete cessation of the heart. In contrast to other options such as ventricular fibrillation or torsades de pointes, agonal rhythm does not show the characteristic chaotic or twisting patterns. While ventricular standstill also lacks electrical activity, agonal rhythm is typically seen as a precursor to this state.

Ventricular standstill refers to the complete absence of any electrical activity in the ventricles of the heart. This means that there is no contraction or pumping of blood, resulting in no cardiac output. Ventricular standstill can occur due to various reasons, such as acute myocardial infarction (AMI) or conduction system disease. In this case, the correct answer is ventricular standstill because it aligns with the given explanation that the total absence of ventricular activity leads to no cardiac output.