Pediatric ECG Considerations Flashcards
7 cards from real CET practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pediatric ECG Considerations flashcards as text
Lead V4R is frequently added to pediatric ECGs. Its PRIMARY purpose is to:
Answer: Evaluate right ventricular activity, especially in congenital heart disease
V4R (right-sided precordial lead) is placed at the mirror image of V4 on the right chest wall to evaluate right ventricular forces, which is particularly important in congenital heart disease assessment.
Which arrhythmia is the MOST common sustained tachyarrhythmia in infants and young children?
Answer: Supraventricular tachycardia (SVT)
SVT is the most common sustained arrhythmia in pediatric patients, often presenting with rates of 220–300 bpm in infants, narrow QRS complexes, and abrupt onset/termination.
An infant presents with a ventricular rate of 250 bpm, narrow QRS complexes, and no discernible P waves. The MOST likely rhythm is:
Answer: Supraventricular tachycardia (SVT)
SVT in infants typically presents with rates of 220–300 bpm, narrow QRS, and absent or retrograde P waves buried in the T wave, distinguishing it from sinus tachycardia.
When recording a pediatric ECG, the standard paper speed and gain settings are:
Answer: 25 mm/s and 10 mm/mV
Standard ECG settings are 25 mm/s paper speed and 10 mm/mV gain (1 mV = 10 mm) for both pediatric and adult recordings; these settings are used unless otherwise specified.
In a child with complete (third-degree) AV block, the ECG shows:
Answer: P waves and QRS complexes with no consistent relationship
In complete AV block, atria and ventricles beat independently with no relationship between P waves and QRS complexes; the atrial rate is faster than the ventricular escape rate.
A newborn's ECG 48 hours after birth shows a QRS axis of +180 degrees (extreme right axis). This is MOST consistent with:
Answer: Significant right ventricular hypertrophy or congenital heart defect
While moderate right axis deviation is normal in neonates, extreme right axis deviation (+180°) is abnormal and warrants evaluation for right ventricular hypertrophy or structural heart disease.
Which ECG finding in a child with chest pain and a history of Kawasaki disease should raise concern for myocardial ischemia?
Answer: ST-segment elevation and Q waves in the inferolateral leads
Kawasaki disease can cause coronary artery aneurysms leading to thrombosis and myocardial infarction; ST elevation and pathological Q waves indicate ischemic injury in this clinical context.