I serioulsy keep on missing these. I was wondering if anyone has any tips on how to approach key differentiating factors on these heart block questions...like what do you look at first? I don't see the 3:2 pattern with the 2nd degree in some of the questions I've been getting.
COMLEX 3rd degree heart block vs. 2nd degree mobitz type 2?
- Thread starter serimeri
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Biggest thing is looking at the relationship between the P wave and the qrs. If there is no relationship at all then its 3rd degree.
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word
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Word to yo motha
Thanks, i feel like I see no relationship between QRS and P wave in some examples of 2nd degree Mobitz 2. sometimes. I think my problem might stem from the fact that I always focus on lead 2.
Thank heavens I'm going into Psychiatry where all I'll ever have to worry about is QTC interval.
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If you're having trouble seeing the p-wave you can look at V1 (if you think anatomically, its the closest to the atria/SA node so the p-wave amplitude is often greater). Its also helpful in flutter because often you won't see the classic sawtooth except in V1. Once you find the p-waves then check a few sequential QRS complexes to check the relationship between the P and the QRS. Below is a patient with intermittent mobitz II (top strip was at presentation and bottom was after some observation, originally presented after syncopal episode). Take a look at the PR in particular.
