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ANKI Cardiovascular > [19] ECG Analaysis > Flashcards

[19] ECG Analaysis Flashcards

1
Q

What are the steps in ECG analysis?

A
  1. Rate
  2. Rhythm
  3. Axis
  4. P waves
  5. QRS
  6. PR interval
  7. QTc
  8. ST segments
  9. T-waves
  10. Extras
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2
Q

How is rate calculated on ECG?

A

300/no of large squares between R waves

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3
Q

How should rhythm be assessed on ECG?

A

Look for P waves followed by QRS complexes

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4
Q

How does AF look on ECG, in terms of rhythm?

A

No discernable P waves, and irregularly irregular QRS

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5
Q

How does atrial flutter look on ECG, in terms of rhythm?

A

Saw-toothed baseline

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6
Q

How does nodal rhythm look on ECG, in terms of rhythm?

A

Regular QRS, but no P waves

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7
Q

What is normal axis on ECG?

A

I and II +ve

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8
Q

What is left axis deviation on ECG?

A

I +ve

II -ve

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9
Q

What is right axis deviation on ECG?

A

I -ve

II +ve

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10
Q

What can cause RAD?

A 
Anterolateral MI 
Right ventricular hypertrophy
PE 
Left posterior hemiblock
Wolff Parkinson Wight
ASD secundum
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11
Q

What can cause LAD?

A 
Inferior MI 
LVH
L. anterior hemiblock
WPW
ASD primum
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12
Q

What can cause absent P waves?

A

AF
SAN block
Nodal rhythm

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13
Q

What can cause dissociated P waves?

A

Complete heart block

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14
Q

What is P mitrale?

A

Bifid P waves

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15
Q

What can cause P mitrale?

A

LA hypertrophy

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16
Q

Give 4 examples of causes of LA hypertrophy?

A

HTN
Aortic stenosis
Mitral regurg
Mitral stenosis

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17
Q

What is P pulmonale?

A

Peaked P waves

i think this means they’re a bit spikey?

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18
Q

What can cause P pulmonale?

A

RA hypertrophy

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19
Q

Give 2 examples of causes of RA hypertrophy

A

COPD

Pulmonary hypertension

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20
Q

What is considered to be a wide QRS complex?

A

> 120ms (>3 small squares)

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21
Q

What can cause a wide QRS complex?

A

Ventricular initiation
Conduction defect
WPW

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22
Q

What is considered to be a pathological Q wave?

A

> 1mm wide

>2mm deep

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23
Q

What causes a pathological Q wave?

A

Full thickness MI

24
Q

How does the QRS appear in RVH?

A

Dominant R wave in V1

Deep S wave in V6

25
Q

How does the QRS appear in LVH?

A

R wave in V6 >25mm

R wave in V5/6 + S wave in V1 >35mm

26
Q

What is the normal PR interval?

A

120-200ms (3-5 small squares)

27
Q

How is the PR interval measured?

A

From the start of the P wave to the start of QRS

28
Q

What can cause a long PR interval?

A

Heart block

29
Q

What can cause a short PR interval?

A

Accessory conduction, eg WPW
Nodal rhythm
Hypertrophic cardiomyopathy

30
Q

What can cause a depressed PR interval?

A

Pericarditis

31
Q

What is the normal QTc?

A

380-420ms (9.5-10.5 small squares)

32
Q

How is the QT measured?

A

Start of QRS to end of T wave

33
Q

What is the formula for calculating QTc?

A

Actual QT / square root of R-R interval

34
Q

What are the causes of long QTc?

A 
Toxins
Inherited
Ischaemic
Myocarditis
Mitral valve prolapse 
Electrolytes
35
Q

What toxins can cause long QTc?

A

Macrolides
Class Ia/III anti-arrhythmics, e.g. quinidine, amiodarone
TCAs
Histamine antagonists

36
Q

Give two examples of inherited conditions which give long QTc

A

Romano-Ward

Jervell

37
Q

What electrolyte disturbance can cause long QTc?

A

Decreased Mg, K, or Ca

38
Q

What can cause short QTc?

A

Digoxin
Beta-blockers
Phenytoin

39
Q

What is considered to be elevated ST segment?

A

> 1mm in limbs, >2mm in chest

40
Q

What can cause elevated ST segments?

A

Acute MI
Prinzmetal’s angina
Pericarditis
Ventricular aneurysm

41
Q

What effect does pericarditis have on ST segment?

A

Causes it to be saddle shaped

42
Q

What is considered to be a depressed ST segment?

A

> 0.5mm

43
Q

What can cause ST depression?

A

Ishaemia

Digoxin

44
Q

What effect does ischaemia have on ST segment?

A

Causes it to be flat

45
Q

What effect does digoxin have on ST segment?

A

Causes it to be down-sloping

46
Q

Where are T-waves normally inverted?

A

aVR and V1

V2-3 in black people

47
Q

When is T wave inversion abnormal?

A

I, II, V4-6

48
Q

What can cause T wave inversion?

A 
Strain
Ischaemia
Ventricular hypertrophy
BBB
Digoxin
49
Q

When is the T wave peaked?

A

Increased potassium

50
Q

When is the T wave flattened?

A

Decreased potassium

51
Q

Where in the ECG to U waves occur?

A

After T waves

52
Q

What can cause U waves?

A

Low potassium

53
Q

Where in the ECG can J waves (Osborne waves) occur?

A

Between QRS and ST segment

54
Q

What are the causes of J waves?

A

Hypothermia
Hypercalcaemia
Subarachnoid haemorrhage

55
Q

How many ms is 1 small square?

A

40ms

ANKI Cardiovascular (24 decks)

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