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
Q

How can identify hyperkalameia on a ECG?

A

Tall T wave

26
Q

How can identify hypokalaemia?

A

Low T wave

27
Q

What is the cardiac axis?

A
The average (overall) direction of spread of the ventricular
depolarisation
28
Q

What is left axis deviation?

A

When overall direction ventricular depolarisation is upwards and to the left

29
Q

What is right axis deviation?

A

When overall direction ventricular depolarisation is downwards and to the right

30
Q

What is often the earliest ECG change seen during myocardial infarction?

A

Tall peaked T waves

31
Q

How do you tell if the cardiac axis is normal?

A

In normal cardiac axis Lead II has the most positive deflection compared to Leads I and III

32
Q

What does a prolonged PR interval suggest?

A

An atriventricular delay