EKG Case Studies: Enhance Your EKG Interpretation Skills

Question 1

Analyze an EKG tracing showing ST-segment elevation in multiple leads. Identify the most likely underlying condition and the appropriate management strategy.

Accepted Answer

Acute myocardial infarction, thrombolytic therapy

Answer

Pericarditis, anti-inflammatory medications

Answer

Ventricular tachycardia, antiarrhythmic medications

Answer

Pulmonary embolism, anticoagulants

Question 2

Examine an EKG tracing showing ventricular tachycardia. Describe its defining characteristics, including the diagnostic criteria and potential treatment approaches.

Accepted Answer

Diagnostic criteria include a heart rate above 100 bpm, broad QRS complexes, and uneven RR intervals.

Accepted Answer

Treatment options may include vagal maneuvers, antiarrhythmic drugs, or cardioversion.

Answer

It is a generally benign arrhythmia that typically resolves spontaneously.

Answer

ECG findings include narrow QRS complexes, no P waves, and a consistent RR interval.

Question 3

Examine the provided EKG tracing of a patient experiencing chest pain. Based on the EKG findings, which type of myocardial infarction (MI) is most probable?

Accepted Answer

ST-elevation myocardial infarction (STEMI)

Answer

Non-ST-elevation myocardial infarction (NSTEMI)

Answer

Myocardial ischemia

Answer

Pericarditis

Question 4

Long QT Syndrome (LQTS) is a genetic condition that increases the risk of which life-threatening complication?

Accepted Answer

Irregular heartbeats and sudden cardiac arrest

Answer

Bradycardia and low blood pressure

Answer

Rapid heartbeats in the upper chambers of the heart and atrial fibrillation

Question 5

Bundle branch blocks are conduction delays in the heart's electrical pathways. Which of the following best describes their EKG findings and clinical significance?

Accepted Answer

They cause characteristic EKG changes and can affect heart function and prognosis.

Answer

They always lead to a complete heart block, stopping the heart.

Answer

They are usually harmless and have no clinical implications.

Question 6

A 52-year-old male experiences chest pain and shortness of breath. His EKG shows ST-segment elevation in leads II, III, and aVF. Which condition is most likely causing his symptoms and EKG findings?

Accepted Answer

Myocardial Infarction

Answer

Pericarditis

Answer

Ventricular Tachycardia

Answer

Pulmonary Embolism

Question 7

A 65-year-old male presents with chest pain. His EKG shows an irregular rhythm with no discernible P waves. What is the most likely diagnosis?

Accepted Answer

Atrial fibrillation

Answer

Ventricular tachycardia

Answer

Supraventricular tachycardia

Answer

Bradycardia

Question 8

In EKG interpretation, which finding is characteristic of hypertrophic cardiomyopathy (HCM)?

Accepted Answer

Left ventricular hypertrophy (LVH) with ST-segment and T-wave abnormalities and possible arrhythmias

Answer

Normal sinus rhythm without significant ST-segment or T-wave changes

Answer

Right ventricular hypertrophy (RVH) with ST-segment depression and T-wave inversions

Answer

Atrial fibrillation with rapid ventricular response and frequent premature ventricular contractions

Question 9

What is a well-known risk factor for developing Long QT Syndrome (LQTS)?

Accepted Answer

Family history of sudden unexplained death in young relatives

Answer

Regular aerobic exercise

Answer

Current smoking

Answer

Elevated serum cholesterol levels

Question 10

For an atrial fibrillation patient with elevated stroke risk, which pharmacological treatment is most appropriate?

Accepted Answer

Digoxin and warfarin

Answer

Amiodarone and aspirin

Answer

Metoprolol and clopidogrel

Question 11

A 65-year-old male presents with palpitations. His EKG shows atrial fibrillation. What's the best initial treatment to control his heart rate?

Accepted Answer

Start a beta-blocker

Answer

Give adenosine

Answer

Cardiovert to sinus rhythm

Answer

Prescribe an antiarrhythmic medication

Question 12

A 65-year-old male presents with dizziness and fatigue. His EKG shows complete heart block. Which management is most appropriate?

Accepted Answer

Implant a permanent pacemaker.

Answer

Monitor the patient, as most cases are benign.

Answer

Give atropine to increase the heart rate.

Answer

Prescribe beta-blockers to slow the heart rate.

Question 13

Which EKG finding is most characteristic of pericarditis?

Accepted Answer

Diffuse ST-segment elevation

Answer

ST-segment depression in multiple leads

Answer

PR interval prolongation

Answer

T-wave inversion in leads V1-V4

Question 14

A patient presents with a wide, bizarre QRS complex that is greater than 120 milliseconds in duration. Which of the following is the most probable diagnosis?

Accepted Answer

Bundle branch block

Answer

Ventricular tachycardia

Answer

Atrioventricular block

Answer

Ventricular fibrillation

Question 15

When interpreting an EKG, which of the following is the most reliable indicator of the heart rate?

Accepted Answer

QRS complex

Answer

QT interval

Answer

PR interval

Answer

P wave interval

Question 16

For a patient with atrial fibrillation and an elevated stroke risk, which medication is most suitable for risk management?

Accepted Answer

Warfarin

Answer

Aspirin

Answer

Metoprolol

Answer

Amiodarone

Question 17

A 65-year-old male presents with palpitations. His EKG shows atrial fibrillation with a rapid ventricular rate. What's the best initial management?

Accepted Answer

Rate control medications

Answer

Vagal maneuvers

Answer

Antiarrhythmic medications

Answer

Electrical cardioversion

Question 18

What is a major risk factor for developing Long QT Syndrome (LQTS)?

Accepted Answer

Family history of LQTS

Answer

Underlying heart disease

Answer

Excessive caffeine intake

Answer

Advanced age

Question 19

For a patient with third-degree (complete) atrioventricular block, which medication is the most suitable for immediate treatment to increase heart rate and prevent severe bradycardia?

Accepted Answer

Atropine

Answer

Digoxin

Answer

Amiodarone

Answer

Adenosine

Question 20

In an EKG tracing of a patient with a left bundle branch block (LBBB), which three of the following characteristics are most prominent?

Accepted Answer

Wide QRS complex, left axis deviation, RSR' pattern in V1

Answer

Narrow QRS complex, right axis deviation, inverted T waves in V1-V3

Answer

Shortened PR interval, prolonged QT interval, peaked T waves

Answer

Atrial fibrillation, ventricular tachycardia, heart block

Question 21

Which EKG finding is typical of the Brugada pattern?

Accepted Answer

ST-segment elevation in leads V1-V3

Answer

T-wave inversion in leads I and aVL

Answer

QRS prolongation in the inferior leads

Answer

PR interval shortening

Question 22

A 72-year-old male presents with dizziness and fatigue. His EKG shows a regular heart rate of 45 beats per minute. What is the most likely diagnosis?

Accepted Answer

Sinus bradycardia

Answer

Sinus tachycardia

Answer

Sick sinus syndrome

Answer

Atrial fibrillation

Question 23

In atrial flutter, which antiarrhythmic drug class is commonly used as the first-line treatment?

Accepted Answer

Class III

Answer

Class I

Answer

Class II

Answer

Class IV

Question 24

For a patient with persistent atrial fibrillation and a history of stroke, which combination of antithrombotic and antiarrhythmic drugs is the first-line pharmacological treatment option?

Accepted Answer

Amiodarone and warfarin

Answer

Metoprolol and aspirin

Answer

Digoxin and clopidogrel

Answer

No pharmacological management

Question 25

Which EKG changes are typically seen in atrial flutter?

Accepted Answer

Sawtooth pattern in the flutter waves and varying cycle lengths between the flutter waves

Answer

Regular P waves and QRS complexes

Answer

Wide QRS complexes and ST-segment elevation

Answer

Prolonged PR interval and absent P waves

Question 26

In an EKG of a patient with an atrial septal defect (ASD), which finding is most likely present?

Accepted Answer

Left atrial enlargement

Answer

Right bundle branch block

Answer

QRS complex prolongation

Answer

ST-segment elevation

Question 27

In an EKG, which finding is typical of Wolff-Parkinson-White (WPW) syndrome?

Accepted Answer

Shortened PR interval and a delta wave

Answer

Prolonged PR interval and absent P wave

Answer

Wide QRS complex and ST-segment elevation

Question 28

Which EKG finding is NOT associated with right bundle branch block (RBBB)?

Accepted Answer

Narrow QRS complex

Answer

Right axis deviation

Answer

Delayed intrinsicoid deflection in lead V6

Question 29

What is the hallmark EKG finding in Long QT Syndrome (LQTS)?

Accepted Answer

Prolonged QTc interval

Answer

Shortened PR interval

Answer

Inverted T waves in leads V1-V3

Answer

Wide QRS complex

Question 30

In EKG interpretation, you observe a pacemaker rhythm. Which statement about pacemakers is true?

Accepted Answer

Dual-chamber pacemakers sense and pace both atria and ventricles.

Answer

Single-chamber pacemakers pace both atria and ventricles.

Answer

Pacemakers always create a normal sinus rhythm on an EKG.

Answer

Pacemakers never require monitoring or management.

Question 31

Which clinical presentation is most strongly associated with the Brugada pattern on an EKG?

Accepted Answer

Increased risk of ventricular arrhythmias and sudden cardiac death

Answer

Increased risk of atrial fibrillation

Answer

Benign variant with no clinical implications

Answer

Indicator of a recent myocardial infarction

Question 32

A 65-year-old woman experiences heart palpitations and dizziness. Her EKG reveals a heart rate of 150 beats per minute, regular P waves, and a narrow QRS complex. Which diagnosis is most likely?

Accepted Answer

Sinus tachycardia

Answer

Supraventricular tachycardia

Answer

Atrial fibrillation

Answer

Ventricular tachycardia

Question 33

Which advanced EKG technique is specifically designed to detect low-amplitude, late potentials linked to a higher risk of ventricular arrhythmias?

Accepted Answer

Signal-averaged ECG (SAECG)

Answer

Holter monitoring

Answer

Echocardiography

Answer

Cardiac MRI

Question 34

In a patient with a heart rate of 120 beats per minute, which EKG interval is typically the shortest?

Accepted Answer

RR interval

Answer

PR interval

Answer

QT interval

Answer

ST segment

Question 35

A prolonged PR interval on an EKG may indicate:

Accepted Answer

First-degree atrioventricular block

Answer

Ventricular tachycardia

Answer

Wolff-Parkinson-White syndrome

Answer

Complete heart block

Question 36

Elevated ST segments on an EKG are characteristic of:

Accepted Answer

Myocardial ischemia

Answer

Inverted T waves

Answer

Shortened QT interval

Answer

Prolonged PR interval

Question 37

In inferolateral myocardial infarction, ST elevation is typically seen in which EKG leads?

Accepted Answer

II, III, aVF

Answer

I, aVL, V1-V4

Answer

V5-V6, aVR

Answer

Lead aVR only

Question 38

A wide QRS complex on an EKG is commonly caused by:

Accepted Answer

Bundle branch block

Answer

Ventricular hypertrophy

Answer

Premature ventricular contractions

Answer

Atrial fibrillation

Question 39

The antiarrhythmic medication most commonly used to terminate ventricular tachycardia in a patient with myocardial infarction is:

Accepted Answer

Lidocaine

Answer

Amiodarone

Answer

Digoxin

Answer

Verapamil

Question 40

Hyperkalemia on an EKG typically causes:

Accepted Answer

Tall, peaked T waves

Answer

Flattened T waves

Answer

Shortened QT interval

Answer

Widened QRS complex

Question 41

In the diagnosis of an anteroseptal myocardial infarction, which EKG lead provides the most valuable information?

Accepted Answer

Lead V1

Answer

Lead I

Answer

Lead II

Answer

Lead V6

Question 42

A patient's EKG exhibits a regular rhythm with a heart rate of 120 beats per minute and a QRS complex duration of 0.12 seconds. Which arrhythmia is most likely present?

Accepted Answer

Sinus tachycardia

Answer

Ventricular tachycardia

Answer

Atrial fibrillation

Answer

Heart block

Question 43

Which of the following is not a prevalent cause of bundle branch block?

Accepted Answer

Atrial fibrillation

Answer

Myocardial infarction

Answer

Hyperkalemia

Answer

Congenital heart defect

Question 44

An EKG exhibits a prolonged PQ interval and a wide QRS complex without any visible P waves. Which diagnosis is most probable?

Accepted Answer

Complete heart block

Answer

Incomplete heart block

Answer

Ventricular tachycardia

Answer

Supraventricular tachycardia

Question 45

In a young, healthy person, what does a T wave inversion in lead V1 typically indicate?

Accepted Answer

Normal variant

Answer

Myocardial infarction

Answer

Pericarditis

Answer

Ventricular hypertrophy

Question 46

A patient presents with an EKG showing ST elevation in leads II, III, and aVF. Which diagnosis is most likely?

Accepted Answer

Inferior wall myocardial infarction

Answer

Lateral wall myocardial infarction

Answer

Anterior wall myocardial infarction

Answer

Posterior wall myocardial infarction

Question 47

What is the correct order of electrical events in the heart, as seen on an EKG?

Accepted Answer

P wave, QRS complex, T wave

Answer

P wave, T wave, QRS complex

Answer

QRS complex, P wave, T wave

Answer

T wave, P wave, QRS complex

Question 48

A patient with heart failure presents with an EKG showing a widened QRS complex. What is the likely cause?

Accepted Answer

Bundle branch block

Answer

Electrolyte imbalance

Answer

Arrhythmia

Answer

Myocardial infarction

Question 49

Which EKG finding is associated with hyperkalemia?

Accepted Answer

Peaked T waves

Answer

Prolonged PR interval

Answer

Depressed ST segment

Question 50

A patient presents with an EKG showing a slow ventricular rate and a regular atrial rate. What is the most likely diagnosis?

Accepted Answer

Complete heart block

Answer

Atrial flutter

Answer

Paroxysmal supraventricular tachycardia

Answer

Sinus node dysfunction

Question 51

Which of the following EKG findings is a definitive indicator of an acute myocardial infarction?

Accepted Answer

ST-segment elevation of ≥2 mm in at least two contiguous leads

Answer

PR interval prolongation

Answer

T-wave inversion

Answer

QT interval shortening

Question 52

A patient with chest pain and shortness of breath presents with an EKG showing ST-segment depression. Which of the following diagnoses is most likely?

Accepted Answer

Ischemia

Answer

Pericarditis

Answer

Myocarditis

Answer

Pulmonary embolism

Question 53

Which of the following EKG patterns is characteristic of atrial fibrillation?

Accepted Answer

Irregular P waves and absence of distinct QRS complexes

Answer

Regular P waves and narrow QRS complexes

Answer

Wide QRS complexes with alternating upright and inverted T waves

Question 54

A patient with a history of hypertension has an EKG showing left ventricular hypertrophy. Which of the following EKG findings would be expected?

Accepted Answer

Tall R waves in leads V5 and V6 and deep S waves in leads V1 and V2

Answer

Shortened PR interval

Answer

Wide QRS complexes

Answer

Inverted T waves in leads II, III, and aVF

Question 55

A patient is receiving digitalis therapy. Which of the following EKG findings may be observed?

Accepted Answer

Prolonged PR interval and shortened QT interval

Answer

Increased heart rate

Answer

Narrowed QRS complexes

Question 56

Which of the following EKG findings is indicative of left bundle branch block?

Accepted Answer

Wide and notched QRS complex with a duration ≥120 ms

Answer

Absence of Q waves in leads I, II, and III

Answer

Shortened PR interval

Answer

Inverted T waves in leads V1-V3

Question 57

A patient with a history of atrial fibrillation has an EKG showing rapid ventricular rates. Which of the following treatments is most appropriate?

Accepted Answer

Rate-controlling medication

Answer

Pacemaker implantation

Answer

Antiarrhythmic medication

Answer

Electrical cardioversion

Question 58

A patient presents with chest pain and an EKG showing ST-segment elevation in leads V1-V6. Which of the following is the most likely diagnosis?

Accepted Answer

Proximal left anterior descending (LAD) artery occlusion

Answer

Posterior wall MI

Answer

Inferior wall myocardial infarction (MI)

Answer

Lateral wall MI

Question 59

A patient with atrial fibrillation (AFib) is being evaluated for anticoagulation therapy using the CHA2DS2-VASc score. Which of the following EKG findings increases the risk of stroke?

Accepted Answer

CHA2DS2-VASc score of 5 or greater

Answer

PR interval less than 180 ms

Answer

Normal sinus rhythm

Answer

Ventricular rate less than 80 bpm

Question 60

A patient presents with symptoms of dizziness and syncope, and their EKG shows P waves independent of QRS complexes. Which of the following is the most likely diagnosis?

Accepted Answer

Third-degree atrioventricular (AV) block

Answer

Second-degree AV block, Mobitz II

Answer

First-degree AV block

Answer

Sinus bradycardia

Question 61

An EKG of a patient with a suspected pulmonary embolism (PE) shows an S1Q3T3 pattern. Which of the following statements about this finding is accurate?

Accepted Answer

This pattern is highly suggestive of a PE.

Answer

This pattern is not clinically significant.

Answer

This pattern is only seen in patients with chronic obstructive pulmonary disease (COPD).

Answer

This pattern is commonly seen in patients with left ventricular hypertrophy.

Question 62

A patient with chest pain is suspected of having pericarditis. Which of the following EKG findings is characteristic of pericarditis?

Accepted Answer

Diffuse ST-segment elevation in all leads except aVR

Answer

ST-segment depression in leads II, III, and aVF

Answer

T-wave inversion in leads V1-V3

Question 63

A patient with a suspected left bundle branch block (LBBB) has an EKG that shows a wide QRS complex (greater than 120 ms) with a notched R wave in leads I and aVL. Which of the following statements about this finding is accurate?

Accepted Answer

This finding is characteristic of an LBBB.

Answer

This finding is characteristic of a right bundle branch block (RBBB).

Answer

This finding is not clinically significant.

Answer

This finding is indicative of an atrioventricular (AV) block.

Question 64

An EKG of a patient with hypertension shows an increased amplitude of the S wave in leads V1 and V2. Which of the following is the most likely diagnosis?

Accepted Answer

Left ventricular hypertrophy (LVH)

Answer

Dilated cardiomyopathy

Answer

Right ventricular hypertrophy (RVH)

Answer

Myocardial infarction