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3: MED1 Y3 - Cardiovascular [2] > [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
How does the QRS appear in LVH?
R wave in V6 >25mm | R wave in V5/6 + S wave in V1 >35mm
26
What is the normal PR interval?
120-200ms (3-5 small squares)
27
How is the PR interval measured?
From the start of the P wave to the start of QRS
28
What can cause a long PR interval?
Heart block
29
What can cause a short PR interval?
Accessory conduction, eg WPW Nodal rhythm Hypertrophic cardiomyopathy
30
What can cause a depressed PR interval?
Pericarditis
31
What is the normal QTc?
380-420ms (9.5-10.5 small squares)
32
How is the QT measured?
Start of QRS to end of T wave
33
What is the formula for calculating QTc?
Actual QT / square root of R-R interval
34
What are the causes of long QTc?
``` Toxins Inherited Ischaemic Myocarditis Mitral valve prolapse Electrolytes ```
35
What toxins can cause long QTc?
Macrolides Class Ia/III anti-arrhythmics, e.g. quinidine, amiodarone TCAs Histamine antagonists
36
Give two examples of inherited conditions which give long QTc
Romano-Ward | Jervell
37
What electrolyte disturbance can cause long QTc?
Decreased Mg, K, or Ca
38
What can cause short QTc?
Digoxin Beta-blockers Phenytoin
39
What is considered to be elevated ST segment?
>1mm in limbs, >2mm in chest
40
What can cause elevated ST segments?
Acute MI Prinzmetal's angina Pericarditis Ventricular aneurysm
41
What effect does pericarditis have on ST segment?
Causes it to be saddle shaped
42
What is considered to be a depressed ST segment?
>0.5mm
43
What can cause ST depression?
Ishaemia | Digoxin
44
What effect does ischaemia have on ST segment?
Causes it to be flat
45
What effect does digoxin have on ST segment?
Causes it to be down-sloping
46
Where are T-waves normally inverted?
aVR and V1 | V2-3 in black people
47
When is T wave inversion abnormal?
I, II, V4-6
48
What can cause T wave inversion?
``` Strain Ischaemia Ventricular hypertrophy BBB Digoxin ```
49
When is the T wave peaked?
Increased potassium
50
When is the T wave flattened?
Decreased potassium
51
Where in the ECG to U waves occur?
After T waves
52
What can cause U waves?
Low potassium
53
Where in the ECG can J waves (Osborne waves) occur?
Between QRS and ST segment
54
What are the causes of J waves?
Hypothermia Hypercalcaemia Subarachnoid haemorrhage
55
How many ms is 1 small square?
40ms

3: MED1 Y3 - Cardiovascular [2] (19 decks)

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