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Cloned from: Abnormal EKGs



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Spatial factors that influence ST segment changes
1. Size of ischemic or infarcted area
2. Location of ischemia or infarcted area (subepi or subendo)
3. Location of recording electrode
4. Wall thickness
Non spatial factors that influence ST segment changes during ischemia
Differences in transmembrane voltage between ischemic and normal tissue during diastole (TQ segment) and systole (ST segment)
Disappearance of S-T segment changes due to an increase in internal resistance between damaged and normal cells
Healing over
Direction of vector that generate a Q wave
Left to right- Q waves seen in Lead I
Can result in a pseudo Q wave infarct pattern
Septal hypertrophy as seen in familial HCM
Has a large right to left activation pattern that obscures Q wave diagnosis associated with left ventricular ischemia or infarct
LBBB
Sensitive to a raise in intracellular calcium and will shut down- slows conduction velocity
Nexal connections
Peaked (tall) T waves can result from
1. Hyperkalemia
2. Ischemia- elevated extracellular K
3. Elevated extracellular K- leads to decreased membrane resistance to K
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