Mixed Deck — All ECG Topics Flashcards

What is the normal heart rate range for adults at rest?

Answer: 60-100 beats per minute

Normal resting heart rate for adults is 60-100 bpm. Below 60 is bradycardia and above 100 is tachycardia.

What ECG pattern is associated with acute pulmonary embolism?

Answer: S1Q3T3 pattern (S wave in I, Q wave and T-wave inversion in III)

The S1Q3T3 pattern reflects right heart strain from acute PE, though sinus tachycardia is the most common PE ECG finding.

What is a common study method for preparing for the ECG certification exam?

Answer: Reviewing cardiac anatomy and rhythm identification

ECG certification exams heavily test knowledge of the heart's structure and function, as well as the ability to recognize and differentiate various cardiac rhythms from ECG tracings. Therefore, a common and effective study method involves thoroughly reviewing cardiac anatomy, understanding the electrical conduction system, and practicing the identification of normal and abnormal ECG waveforms and rhythms. This ensures comprehensive preparation for the exam.

A Holter monitor is most appropriate for evaluating a patient who experiences palpitations:

Answer: Intermittently throughout daily activities over 24–48 hours

A Holter monitor records continuous ECG over 24–48 hours, capturing arrhythmias that occur unpredictably during normal daily activities.

What is the refractory period of cardiac cells?

Answer: The time during which cells cannot be re-stimulated to contract

The refractory period is when cardiac cells are unresponsive to new electrical stimuli, preventing tetanic contraction and ensuring the heart has time to fill between beats.

What is the difference between depolarization and repolarization?

Answer: Depolarization is electrical activation; repolarization is electrical recovery

Depolarization is the process where cardiac cells become electrically activated (less negative), triggering contraction. Repolarization is the recovery process returning cells to their resting state.

Which of the following ECG findings suggests pericarditis rather than acute MI?

Answer: Diffuse ST elevation with PR segment depression in multiple leads

Pericarditis classically causes diffuse (saddle-shaped) ST elevation across many leads with PR depression, unlike the localized changes of MI.

How can you distinguish artifact from true ventricular fibrillation?

Answer: Check the patient's pulse and consciousness level

Always assess the patient clinically. If the patient is awake and responsive with a chaotic-looking ECG, it's likely artifact. True V-fib causes immediate loss of consciousness and pulse.

A patient with a permanent pacemaker has an ECG showing pacemaker spikes without subsequent QRS complexes. What is the most likely diagnosis?

Answer: Pacemaker failure to capture

Failure to capture occurs when the pacemaker spike fires but fails to depolarize the myocardium, producing spikes not followed by QRS complexes.

What ECG finding in a monitored patient should prompt the nurse to call a rapid response immediately?

Answer: Sustained ventricular tachycardia with a heart rate of 180 bpm

Sustained ventricular tachycardia is a life-threatening arrhythmia requiring immediate clinical assessment and intervention.

How should an ECG technician respond if a patient reports chest pain during the ECG recording?

Answer: Complete the recording immediately, document the symptom, and notify the supervising clinician

Completing the ECG during active symptoms captures potentially diagnostic changes; notifying a clinician ensures timely evaluation.

During ECG acquisition, the technician notices the calibration pulse measures 5 mm instead of the standard 10 mm. What does this indicate?

Answer: The gain is set to half standard (5 mm/mV)

Standard ECG calibration is 10 mm/mV; a 5 mm calibration pulse means the gain is halved (5 mm/mV), which will make all waveforms appear half their true amplitude.

Which precordial lead is positioned at the fourth intercostal space, right sternal border?

Answer: V1

V1 is placed at the fourth intercostal space along the right sternal border, directly over the right ventricle.

For a patient with a heart rate of 150 bpm on a rhythm strip at 25 mm/sec, the R-R interval measures approximately how many large boxes?

Answer: 2 large boxes

At 25 mm/sec, 300 ÷ 150 bpm = 2 large boxes per R-R interval (the '300 method').

What is one reason prior healthcare experience might be required for ECG certification?

Answer: It ensures familiarity with patient care and medical protocols.

Prior healthcare experience is valuable for ECG certification because it provides candidates with a foundational understanding of patient care principles, medical terminology, and clinical environments. This familiarity helps technicians interact professionally with patients, maintain sterile techniques, and adhere to essential medical protocols. Such experience contributes to safer and more effective patient interactions during ECG procedures.

A 45-year-old presents with syncope. The ECG shows a right bundle branch block with ST elevation in V1-V3 resembling a 'coved' pattern. What syndrome should be suspected?

Answer: Brugada syndrome

The coved-type ST elevation in V1-V3 with RBBB morphology is the classic Type 1 Brugada pattern, associated with risk of sudden cardiac death from ventricular fibrillation.

Why is skin preparation important before applying ECG electrodes?

Answer: To reduce impedance and improve signal quality

Cleaning the skin with alcohol and lightly abrading removes oils, dead skin cells, and debris that increase electrical impedance, resulting in cleaner ECG signals.

Which scenario might disqualify someone from pursuing ECG certification?

Answer: Lacking a high school diploma or equivalent

A high school diploma or its equivalent is a fundamental prerequisite for most professional certification programs, including ECG certification. This ensures that candidates possess the basic academic skills necessary to comprehend course material, follow instructions, and perform job duties. Without this foundational education, individuals typically cannot enroll in or complete accredited certification programs.

How can ECG certification contribute to career advancement?

Answer: By enabling professionals to take on specialized roles, such as stress testing

ECG certification provides foundational skills, and with additional experience or advanced training, professionals can specialize in more complex cardiac diagnostic procedures. These specialized roles, such as performing stress testing, Holter monitoring, or assisting in cardiac catheterization labs, expand their skill set and open doors to more advanced and often higher-paying positions within cardiology, contributing significantly to career advancement.

What is the recommended minimum number of leads monitored continuously in a telemetry unit?

Answer: 2

Continuous telemetry monitoring typically requires at least 2 leads to improve arrhythmia detection.