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Electrocardiography Flashcards

7 cards from real ACSM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. During exercise stress testing, which ECG change is considered the most significant indicator of myocardial ischemia?

    Answer: Horizontal or downsloping ST-segment depression ≥1 mm

    Horizontal or downsloping ST-segment depression ≥1 mm at 80 ms past the J-point is the classic ECG criterion for exercise-induced myocardial ischemia.

  2. What does the QT interval on an ECG represent?

    Answer: Total ventricular electrical activity from depolarization through repolarization

    The QT interval encompasses both ventricular depolarization (QRS) and repolarization (T wave), representing total ventricular electrical activity.

  3. A patient's ECG shows a ventricular rate of 150 bpm with narrow QRS complexes and no visible P waves. Which arrhythmia is most likely?

    Answer: Atrial flutter with 2:1 block

    Atrial flutter typically presents at 150 bpm ventricular rate due to 2:1 AV conduction of the 300 bpm atrial flutter rate, often with sawtooth flutter waves hidden in QRS complexes.

  4. On a standard ECG at normal paper speed, how many small squares represent 1 second?

    Answer: 25

    At the standard paper speed of 25 mm/sec, each small square (1 mm) = 0.04 seconds, so 25 small squares = 1 second.

  5. Which lead configuration is best for monitoring ST-segment changes in the inferior wall of the left ventricle?

    Answer: II, III, and aVF

    Leads II, III, and aVF are inferior leads that face the inferior wall of the left ventricle, making them optimal for detecting inferior wall ischemia.

  6. What is the normal duration of the QRS complex on an ECG?

    Answer: 0.06–0.10 seconds

    A normal QRS complex duration is 0.06–0.10 seconds (1.5–2.5 small squares); values ≥0.12 seconds suggest a bundle branch block or ventricular origin.

  7. During a graded exercise test, ST-segment elevation in a non-Q-wave lead is most concerning for which condition?

    Answer: Vasospastic (Prinzmetal) angina or severe transmural ischemia

    Exercise-induced ST elevation in a non-infarct lead strongly suggests transmural ischemia or vasospastic angina due to severe coronary artery narrowing or spasm.