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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. Which ECG finding during exercise testing is considered a reason for immediate test termination?

    Answer: New onset of sustained ventricular tachycardia

    Sustained ventricular tachycardia is an absolute indication to stop an exercise test immediately due to the risk of deterioration into ventricular fibrillation.

  2. On an ECG, what does a pathological Q wave indicate?

    Answer: Previous myocardial infarction with myocardial necrosis

    Pathological Q waves (>0.04 seconds wide or >25% of R-wave amplitude) reflect electrically silent myocardial scar tissue from a prior transmural infarction.

  3. Which condition is associated with a prolonged QTc interval that could increase risk during vigorous exercise?

    Answer: Long QT syndrome (LQTS)

    Long QT syndrome prolongs ventricular repolarization, creating susceptibility to torsades de pointes (polymorphic VT), which exercise or sympathetic activation can trigger.

  4. The P-wave on a standard ECG represents which cardiac event?

    Answer: Atrial depolarization

    The P-wave represents the spread of electrical impulse (depolarization) through both atria, triggering atrial contraction; atrial repolarization is hidden within the QRS.

  5. During ECG monitoring, a rhythm strip shows regularly irregular R-R intervals that increase during inspiration and decrease during expiration. This most likely indicates:

    Answer: Sinus arrhythmia

    Sinus arrhythmia is a normal variation where R-R intervals cyclically lengthen with inspiration and shorten with expiration due to changes in vagal tone.

  6. Which precordial lead transition zone finding suggests right axis shift or right ventricular dominance?

    Answer: R/S ratio >1 occurring as early as V1 or V2

    Dominant R waves in V1–V2 (early transition or reversed R-wave progression) suggests right ventricular hypertrophy or posterior MI rather than normal left-to-right R-wave growth.

  7. An exercise physiologist notes that a client's heart rate fails to increase appropriately during a progressive exercise test. This phenomenon is called:

    Answer: Chronotropic incompetence

    Chronotropic incompetence is defined as the inability to achieve ≥80% of age-predicted maximum heart rate without beta-blocker use and is associated with increased cardiovascular risk.