7 ECG Abnormalities Flashcards

1
Q

List sites a abnormal supra-ventricular rhythms may arise

A
  • Sinus node
  • Atrium
  • AV node
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2
Q

How are supra-ventricular rhythms conducted into the ventricles?

A

His-Purkinje system

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3
Q

What are QRS complexes like in supra-ventricular rhythms?

A

Narrow

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4
Q

In ventricular rhythms what are the QRS complexes like?

A

Larger than 3 small boxes

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5
Q

What is sinus bradycardia and tachycardia?

A
B = below 60
T = Above 100
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6
Q

What is the most common cardiac arrhythmia?

A

Atrial fibrillation

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7
Q

In AF where are electrical impulses initiated from?

A

Different sites in the atrium called ectopic sites

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8
Q

How does AF present on an ECG?

A
  • Absent P waves
  • Wavy baseline
  • Narrow QRS complex
  • Irregularly irregular
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9
Q

What are the most common complications of atrial fibrillation?

A

Blood clots arising in the atria

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10
Q

What is heart block?

A

Block in the electrical conducting system between the atria and the ventricles

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11
Q

What are common causes of heart block?

A

Acute myocardial infacrtion

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12
Q

What is 1st degree AV heart block?

A

Prolonged PR interval, but every P wave is still followed by a QRS complex
PR interval is bigger than 1 PR square

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13
Q

What is 2nd degree AV heart block?

A

Atria are contracting normally but not every impulse from the atria is making it through to the ventricles

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14
Q

What is Mobitz type 1?

A

progressive PR lengthening until one P wave is not conducted

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15
Q

What is Mobitz type 2?

A

The PR interval is normal, but then get a sudden non conduction of a beat

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16
Q

What is 3rd degree heart block?

A

Atria are doing there thing but impulse is not getting through, no relationship between the p wave and the QRS complexes

17
Q

What is a ventricular ectopic beat?

A

Causes ventricular contraction before the underlying rhythm would normally depolarise the ventricles
Get a wider and different shaped QRS complex compared to the usual

18
Q

What is ventricular tachycardia?

A

Get a consecutive run of more than 3 ectopic beats

19
Q

In terms of cardiac output describe atrial fibrillation and ventricular fibrillation?

A

Cardiac output present in AF, no cardiac output or heart beat is present in VF

20
Q

Which part of the heart is most vulnerable to ischemia?

A

Sub endocardial muscle

21
Q

How is ischaemia identified on a ECG?

A

ST segment depression or T wave inversion

22
Q

How is myocardial infarction identified on an ECG?

A

ST elevation

23
Q

What is a pathological q wave a sign of?

A

A previous myocardial infraction

24
Q

Describe a pathological Q wave?

A

More than 1 small square wide or 2 small square deep, the depth is more than 1/4 of the height of subsequent R wave and is greater than 1/3 the amplitude of the QRS complex

25
How can identify hyperkalameia on a ECG?
Tall T wave
26
How can identify hypokalaemia?
Low T wave
27
What is the cardiac axis?
``` The average (overall) direction of spread of the ventricular depolarisation ```
28
What is left axis deviation?
When overall direction ventricular depolarisation is upwards and to the left
29
What is right axis deviation?
When overall direction ventricular depolarisation is downwards and to the right
30
What is often the earliest ECG change seen during myocardial infarction?
Tall peaked T waves
31
How do you tell if the cardiac axis is normal?
In normal cardiac axis Lead II has the most positive deflection compared to Leads I and III
32
What does a prolonged PR interval suggest?
An atriventricular delay