EKG Practice Test

This quiz contains several brief medical histories and their matching ECGs. For each
question, you should check between 0 to 4 diagnoses. If the blood pressure is not specified, it
means that it is in the normal range.
Remember: Do not use your browsers back button. The result is shown only when you
have answered every question.
Enjoy!
1. Question
Intense chest pain, clammy skin.

Anterior STEMI
Inferoposterior STEMI
Left bundle branch block
Accelerated idioventricular rhythm
2. Question
Woke up with central oppressive chest pain which are increase with deep
inspiration and when lying on the back.

AVNRT
Sinus tachycardia
Typical atrial flutter
Atrial fibrillation
3. Question
Oppressive left lateral chest pain for 5 hours and impression sleeping left arm. BP
177/95 mmHg. Nitroglycerin spray has some effect on the pain.
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Left bundle branch block

Right bundle branch block
Pacemaker rhythm
Atrial fibrillation
4. Question
This patient has diabetes, has an history of previous myocardial infarction and
complains of dyspnea and chills. Temperature 39C

Left bundle branch block

Right bundle branch block
1st degree AV block
2nd degree AV block Mobitz I
5. Question
Dement patient with chest pain for 6 hours. The pain disapeared after
nitroglycerin spray.

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Inferior STEMI
Posterior STEMI
Atypical atrial flutter
Typical atrial flutter
The difference between atrial fibrillation (A-fib) and atrial flutter (A-flutter), is
clinically relevant because typical flutter can easily be treated by radiofrequency
ablation. A-fib and atypical A-flutter requires more expertise and radiofrequency
ablation has lower success rate.
Atrial flutter:
Atrial rate ca. 300 bpm (200-400 bpm) with a heart rate typically ca. 150 bpm.
1. Typical (type I) atrial flutter: saw-tooth-like waves
o Counterclockwise: negative flutter waves in II, III, aVF and positive in V1
o Clockwise: positive flutter waves in II, III, aVF and negative in V1
2. Atypical (type II) atrial flutter: doesn
6. Question
Former smoker with hypertension. He woke up this morning with a tingling
sensation in both arms. No chest pain. BP 210/93 mmHg. Symptoms disappear
completely after nitro spray.

Anterior STEMI
Left bundle branch block
Right bundle branch block
Pacerytme
7. Question
Smoker with hypertension and high cholesterol. Shortness of breath over the last
few weeks, recurrent stabbing retrosternal chest pain.
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Anterior STEMI
Infero-posterior STEMI
Sick sinus syndrom
Atrial fibrillation
8. Question
3 month with mild shortness of breath and intermittent chest pain.

Sinus rytm
Atrial flutter
Sick sinus syndrom
Pacemaker rhythm
9. Question
CABG operated in 2000. Complains of shortness of breath and cough.

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Anterior STEMI
Atrial fibrillation
Atypical atrial flutter
Typisk atrial flutter
10. Question
Active smoker with a family history of heart disease. Onset of chest pain an hour
ago.

Anterior STEMI
Left bundle branch block
2nd degree AV block 2:1
2nd degree AV block Mobitz I
11. Question
Active smoker. After this patient woke up, suddent onset of severe chest pain on
the left lateral region of the chest and between the shoulder blades.

Anterior STEMI
sinus rhythme
Inferior Q waves
Left bundle branch block
Anterior STEMI! This patients LAD was occluded. Inferior Q waves are not
significant.
12. Question
Young patient with one hour of palpitation, mild chest oppression and discrete
shortness of breath and dizziness. Has had several similar episodes among the
last few years.

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AVNRT
AVRT
Left main coronary artery occlusion
Atrial flutter
13. Question
Smoker. Two episodes with typical chest pain. The patient goes to his GP and
receives nitroglycerin spray with some effect.

Pacemaker rhythm
Left bundle branch block
Ventricular tachycardia
Premature ventricular complexe
14. Question
Previously healthy woman with a presyncope. Had a unquiet heart over the last
50 years but has never been properly investigated.

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Lateral STEMI
AVRNT
Typical atrial flutter
Atrial fibrillation
15. Question
30 minutes with typical chest pain.

Inferior STEMI
Posterior STEMI
Non-specific ST changes
Atrial fibrillation
16. Question
Known with diabetes, ischemic heart disease and COPD. Increasing shortness of
breath. Known with daily intermittent chest pain.

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Inferior STEMI
Antero-lateral STEMI
Right bundle branch block
3rd degree AV block
17. Question
CABG 15 years ago. Transcatheter aortic valve implantation 1 month ago. Severe
chest pain and shortness of breath for one hour, palor and cold sweats. BP
160/90 mmHg.

Anterior STEMI
VVI Pacemaker rhythm
DDD Pacemaker rhythm
Left bundle branch block
18. Question
Previously healthy. 1 hours with strong, oppressive retorsternal chest pain and
dyspnea. Good effect of nitroglycerin given prehospitaly. Pale and clammy skin.
Has usually a normal ECG.

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Anterior STEMI
Left bundle branch block
Inferior STEMI
Atypical atrial flutter
19. Question
Patients with diarrhea, who suddenly became dizzy and got shortness of breath.
BP 108/54 mmHg

3rd degree AV block

Right bundle branch block
Ventricular escape rhythm
Pacemaker rhythm
20. Question
Previously healthy patient with shortness of breath over a few days.

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2nd degree AV block 2:1

Left bundle branch block
Right bundle branch block
Ventricular tachycardia
21. Question
History of prior CABG. Known with left bundle branch block. 3 days with
shortness of breath, cough and fever. Normal BP.

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Left bundle branch block

Anterior STEMI
Accelerated idioventricular rhythm
Ventricular tachycardia
22. Question
Previously healthy patient. Chest pain for several days radiating to the neck and
left arm. Distinct worsening for 30 minutes.

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Anterior STEMI
Posterior STEMI
2:1 AV block
Sinus rhythm
23. Question
Former smoker with hypertension and atrial fibrillation. Cardiac arrest with VF.
CPR 3 minutes. Defibrillated to this ECG.

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Inferoposterior STEMI
Right bundle branch block
Left bundle branch block
Pacenaker rhythm
24. Question
Former smoker patient with a family history of cardiovascular disease. Over the
last few days, he had intermittent pricking sensation in the chest. Marked
deterioration one hour ago with the pain radiating now to the neck.

Left bundle branch block

Nodal rythm
Anterior STEMI
Lateral STEMI
25. Question
This patient had nausea when he woke up this morning but he has now severe
chest pain which started an hour ago.

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Sinus bradycardia
2:1 AV block
Anterior STEMI
Lateral STEMI
26. Question
On the way to work: nausea and severe chest pain.

Anterior STEMI
Accelerated idioventricular rhythm
RBBB
Nodal rytme
27. Question
CABG in 2003. Chest pain since yesterday. The pain is aggravating after he had
been working with a showel in the snow.

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Sinus rhythm
Left bundle branch block
1st degree AV block
Inferior STEMI
28. Question
Previously healthy patient. Intermittent chest pain worsening with deep
inspiration.

Anterior STEMI
Left bundle branch block
2:1 AV block
AVRT
There is diffuse concave non-significant ST elevation which could indicate
pericarditis.
29. Question
Known with ischemic heart disease, atrial fibrillation and pacemaker. This
afternoon onset of malaise, coughing, chest pain localized in the left side and
neck pain. A bit of dyspnea as well.

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Atrial fibrillation
Pacemaker rhythm
Right bundle branch block
Left bundle branch block
30. Question
Known to have hypertension and being a former smoker. Acute onset of
oppressive chest pain that radiates to his jaw.

Inferior STEMI
Posterior STEMI
Anterior STEMI
Lateral STEMI

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