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MOD > Approach to the ECG > Flashcards

Approach to the ECG Flashcards

1
Q

What is the definition of ECG?

A

The ECG is a recording of changes in electrical potential difference occurring during the depolarisation and repolarisation of the myocardium plotted against time.
i.e. It is is a Voltage - Time Graph

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2
Q

Where do you connect each colour lead to (Red, Yellow, Green, Black)?

A

Red - Right forelimb
Yellow - Left forelimb
Green - Left hindlimb
Black - Right hindlimb (Earth)

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3
Q

What is lead I?

A

Lead I = Right fore to Left fore

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4
Q

What is lead II?

A

Lead II = Right fore to left hind

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5
Q

What is lead III?

A

Lead III = left fore to left hind

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6
Q

Which lead normally has the largest QRS?

A

Lead II

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7
Q

What is a Sinus Arrhythmia?

A

Regular irregular pattern
-occurs at normal HR

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8
Q

What does sinus arrhythmia indicate?

A

High vagal tone - which is normal in healthy dogs

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9
Q

What is a wandering pacemaker?

A

Variable P wave morphology

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10
Q

Is sinus arrhythmias normal in cats?

A

No!
Look for causes of enhanced vagal tone
-feline asthma
- Compromised respiration

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11
Q

What is Sinus arrest?

A
  • Sinus arrest definition: pause of >2 preceding R-R intervals
  • May be seen as part of accentuated sinus arrhythmia (e.g.
    brachycephalic breed).
  • Periods of sinus arrest (up to 5 seconds) are normal in sleeping dogs (shown by Holter monitoring)
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12
Q

What is a ventricular premature complex?

A

*Wide QRS with oppositely directed T wave
*looks like zig-zag lines
*contraction initiated by purkinje fibers not SA node

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13
Q

How would you treat ventricular tachycardia?

A

*Lidocaine IV
-prevent ventricular fibrillation + death

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14
Q

What are the systemic causes of ventricular premature complex?

A

*Gastric dilation volvulus
*Splenic lesions / splenectomy
*Sepsis
*Pancreatitis
*Pyometra
*Thoracic trauma
*CNS lesions

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15
Q

What is a first degree AV block?

A

*P : QRS ratio = 1:1
*P-R interval = prolonged

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16
Q

What is a morbitz type I second degree AV blocks?

A

– Also called the “Wenckebach phenomenon”
– Shows high vagal tone
– Normal in resting horse
– Variable P-R interval before “dropped” P wave
– Not normal in dog, associated with high vagal tone

17
Q

What is a morbitz type II second degree AV block?

A

*Constant P-R interval
*But some times the P waves aren’t conducted so no QRS.

18
Q

What is a third degree AV block?

A

No association between P waves and QRS complexes

19
Q

What can happen if a supraventricular tachycardia is sustained?

A
  • v fast HR - 300bpm
    *Can lead to congestive heart failure
  • use drugs to slow conduction through AV node
20
Q

With atrial fibrillation what needs to be controlled?
What drugs would you use?

A

*Control ventricular response to atrial fibrillation
*use drugs to slow conduction across AVN - diltiazem / digoxin

21
Q

Whilst looking at lead II if an R wave height is over 3.0mV what does this tell us?

A

Left ventricle enlargement

22
Q

If QRS complex is longer than 0.06seconds what does this tell us?

A

Ventricular hypertrophy

23
Q

If P wave is more than 0.04seconds what does this tell us?

A

Left atrium enlargement

24
Q

What does a tall P wave tell us?

A

Right atrial enlargement

25
Q

What does a damped QRS complex tell us?

A

*there’s something between the heart and recording electrodes

26
Q

What could cause a damped QRS complex?

A

– Conformation (massive breed)
– Fat
– Pleural effusion
– Pericardial effusion
– Thoracic mass

27
Q

In a large animal what lead would you use?

A

Base-Apex lead
RA = R. jugular furrow
LA = Left apex
RH (earth) = thoracic inlet

28
Q

What on an ECG notes a right ventricular enlargement?

A

Deep S waves in leads I, II and aVF

29
Q

What does a left bundle branch block look like?

A
  • Normal P:QRS ratio
  • Tall, wide QRS complexes, T waves on opposite direction
  • QRS duration > 0.08
    seconds
30
Q

What does right bundle branch block look like?

A
  • Normal P:QRS ratio
  • Tall, wide S waves, so –ve QRS complex, T waves on opposite direction
  • QRS duration > 0.08 seconds
31
Q

What does left anterior fascicular block look like?

A
  • +ve QRS in lead I (& aVL)
  • S waves (-ve QRS) in II, III & aVF
  • Normal QRS duration
32
Q

What does QT interval tell us?

A
  • Total time for ventricular depolarisation and repolarisation.
33
Q

What does a slow HR indicate regarding QT interval?

A

Increased QT interval

34
Q

What does a dog with an high QT interval likely have?

A

Hypocalcaemia

35
Q

What does a cat with high QT interval likely have?

A
  • V&D after dietary indiscretion.
  • Hypothermia
  • Dehydrated
  • No electrolyte disturbances
36
Q

Should a T wave be symmetrical?

A

No - should be asymmetrical

37
Q

What does tall spikey T wave indicate?

A

Hyperkalaemia

38
Q

What does ST depression + elevation indicate?

A

Depression = myocardial injury
Elevation = epicardial irritation

MOD (103 decks)

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