22.8.2013 Flashcards

0
Q

Electrical alternans

A

Beat to beat variation of QRS complexes by 1mm

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1
Q

Tall waves,DD

A

Chamber enlargement
Young individuals
Thin,Emaciated individuals
Mastectomy pts

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2
Q

Calculation of heart rate,boxes

A

100 use small boxes

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3
Q

Causes of low voltage QRS complexes

A
Obesity
COPD
Pleural or pericardial effusion
Generalised Edema 
Hypothyroidism
Amyloidosis
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4
Q

Causes of electrical alternans

A

Cardiac tamponade
Poor conduction in ventricles alternating with normal conduction
SVT
Severe myocardial ischemia

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5
Q

Normal intrinsicoid deflection in V1 and V2

A

<0.03S

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6
Q

Normal intrinsicoid deflection in V5 and V6

A

<0.05S

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7
Q

Components of QRS

A

Ventricular activation time

Intrinsicoid deflection

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8
Q

Sequence of ventricular activation

A
  1. septum
  2. free wall of both ventricles
  3. posterobasal wall of septum and left ventricle
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9
Q

Total duration of septal q wave should not exceed

A

0.03S

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10
Q

Normal sinus rhythm is indicated by

A

Upright p wave in lead 2

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11
Q

Measurements of inverted portion of p wave

A

Less than 1mm in depth and duration

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12
Q

ECG of rt atrial enlargement

A

Tall(>2.5mm) peaked p waves in leads 2,3,avF
Axis of p wave shifted to right of 60’
P3>P1

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13
Q

Normal p wave duration

A

<110ms

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14
Q

Causes of rt atrial enlargement

A

Tricuspid or pulmonary valvular disease
Pulmonary hypertension
Acute pulmonary embolism
Right ventricular failure or hypertrophy

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15
Q

Inverted p wave in V1

A

Lt atrial hypertrophy

Emphysema

16
Q

ECG changes of left atrial enlargement

A

P mitrale(duration>2.5boxes) in lead I,II,aVF,V5,V6
Axis of p wave is shifted to left,P1>P3
Inverted portion of P wave in lead V1 is more than 1mm vertically and horizontally

17
Q

LVH without increased voltage

A
Obesity
Anasarca
Peripheral Edema
Increased diameter of chest
Emphysema
Large breasts
Biventricular hypertrophy
Amyloidosis 
Pericardial effusion
Pleural effusion
Hypothyroidism
18
Q

Increased voltage not resulting from LVH

A

Lt Mastectomy
Adolescent boys
Anemia
Thin individuals

19
Q

Intrinsicoid deflection and ventricular hypertrophy

A

Delayed in V1 and V2 in RVH

Delayed in V5 and V6 in LVH

20
Q

ECG changes of LVH due to volume overload

A

Tall R waves
Prominent Q waves
Tall and upright T waves in V5 and V6

21
Q

Conduction defects associated with LVH

A

Incomplete BBB

LAFB

22
Q

Anti hypertensive medications not effective in reducing LVH

A

Hydralzine

Minoxidil

23
Q

ECG finding that is a must for RVH

A

Rt axis deviation

24
Q

Lead 1 sign

A
Seen in emphysema and chronic bronchitis where diaphragm is shifted downwards
Small complexes in lead 1 and V6
Poor R wave progression
Right axis deviation 
P pulmonale
25
Q

Most frequent ECG findings of pulmonary embolism

A

Sinus tachycardia

Incomplete RBBB

26
Q

ECG findings in RVH

A
Rt axis deviation
qR in V1
R wave in V1 more than 7mm
R wave taller than S wave in V1
Delayed onset of intrinsicoid deflection(V1>0.03)
rS complex in V1-V6 with rt axis
S1S2S3 pattern in adults
27
Q

ECG changes of acute pulmonary embolism

A

Sinus tachycardia,atrial flutter,atrial fibrillation
Rt axis
S1Q3T3
rSR’ pattern in V1 of acute onset
V1 shows QS,qR or R>S pattern
Clockwise rotation with persistent S in V6
P pulmonale
Ta wave exaggeration resulting in ST depression in inferior leads
ST elevation in V1
T wave inversion in V1-V3

28
Q

ECG findings of biventricular hypertrophy

A

Katz wachtel phenomenon
P pulmonale with LVH
Voltage discordance

29
Q

ECG findings of RVH are more prominent in

A

TOF

congenital pulmonary stenosis

30
Q

Type A RVH is seen in

A

Primary pulmonary hypertension
Severe pulmonic stenosis
Mitral stenosis with severe pulmonary hypertension

31
Q

Type A RVH

A

Rt axis deviation of more than 120’
Monophasic R waves in V1
Deep S waves in V5,V6

32
Q

Type B RVH causes

A

ASD

MS with mild to moderate pulmonary hypertension

33
Q

Type B RVH

A

R wave in V1 is slightly taller than S wave
rsr’ pattern in V1
Normal QRS in V5 and V6
Axis is at 90’

34
Q

Type C RVH causes

A

Pulmonary disease

Acute pulmonary embolism

35
Q

Type C RVH

A

Deep S wave in V1-V6

Axis less than 90’

36
Q

QRS prolongation in RVH

A

Doesnot occur unless there is RBBB