Approach to ECGs - Tachy/Bradyarrhythmias
Tachyarrhythmias - HR > 100
Wide
(1) VT - DANGER
(2) Sinus Tachy w/ BBB
(3) SVT w/ abberancy - N B Afib + WPW - DANGER
(4) Vfib/flutter - DANGER
Narrow - Regular
(1) Sinus tachycardia
(2) Atrial flutter
(3) SVTs - atrial/junctional tachy not from SA node
Narrow - Irregular
(1) A fib -absent P
(2) A flutter - w/ variable block
(3) Multifocal atrial tachycardia (MAT)
- 3 different P waves in lead II
- treat with beta-agonist despite tachy
Bradyarrhythmias - HR < 60
(1) Sinus bradycardia
(2) Sick Sinus Syndrome (runs of tachy/brady)
(3) SA node block - escaped beats
(4) SA node arrest - escape rhythms
(5) AV block
1º - long PR intervals >120-200ms from longer pause
2º - Mobitz I / Wenkebach - successively longer PR intervals (2:1 , 3:2, 4:3, etc.)
2º - Mobitz II / Mobitz - , 3:1, 4:1, etc. - DANGER
3º - P running through QRS - DANGER
Narrow QRS - Proximal AV block (lower AV cells can function)
Wide QRS - Distal AV block - ventricular pacemaker
- Dr. Michael Wong @mchlwng
#Tachycardia #Bradycardia #tachyarrhythmia #bradyarrhythmia #ECG #EKG #diagnosis #electrocardiogram #cardiology #differential
