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Cardio > Basic ECG > Flashcards

Basic ECG Flashcards

1
Q

Which are the septal leads?

A
  • facing: v1, v2

- no reciprocal

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2
Q

Which are the anterior leads?

A
  • facing: v3, v4

- no reciprocal

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3
Q

Which are the anteroseptal leads?

A
  • facing: v1, v2, v3, v4

- no reciprocal

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4
Q

Which are the lateral leads?

A
  • facing: I, aVL, V5, V6

- reciprocal: II, III, aVF

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5
Q

Which are the anterolateral leads?

A
  • facing: I, aVL, V3, V4, V5, V6

- reciprocal: II, III, aVF

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6
Q

Which are the inferior leads?

A
  • facing: II, III, aVF

- opposite: I, aVL

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7
Q

Which are the posterior leads?

A
  • facing: none

- opposite: v1, v2, v3, v4

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8
Q

What does a positive lead I and negative aVF suggest?

A

left axis deviation

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9
Q

What does a negative lead I and positive aVF suggest?

A

right axis deviation

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10
Q

What does a negative lead I and negative aVF suggest?

A

extreme axis deviation

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11
Q

How does a normal P wave look like?

A
  • P wave positive in leads II, III, AVF
  • P wave duration <0.12s
  • P wave height <2.5mm
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12
Q

What is normal q wave duration?

A

Duration <0.04s (1 small sq)

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13
Q

What does a normal qrs complex look like?

A
  • Duration <0.12s (3 small sq)

- Normal R wave progression from V1 to V4 (should get more positive)

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14
Q

What is the normal PR interval?

A

0.12-0.20s (3-5 small squares)

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15
Q

What is the normal QT Interval?

A

0.38-0.42s (9.5 - 10.5 small squares) or grossly

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16
Q

What does the P wave represent?

A

atrial depolarisation originating in the sinoatrial node (SA node)

17
Q

What does the PR interval represent?

A

depolarization originating in the SA node and traveling through the atria, the AV node, and the His-Purkinje system

18
Q

What does the QRS complex represent?

A

ventricular depolarisation

19
Q

What does the ST segment represent?

A

the segment between ventricular depolarization and repolarization

20
Q

What does T wave represent?

A

ventricular repolarization

21
Q

What does the QT interval represent?

A

total time of ventricular depolarisation and repolarisation

22
Q

What are the causes of right atrial enlargement?

A

Caused by pulmonary HTN

  • Chronic lung disease (Cor Pulmonale)
  • Pulmonary embolism
  • Tricuspid Stenosis
  • Tricuspid Regurgitation
23
Q

How does right atrial enlargement appear on ECG?

A
  • Axis deviation of P wave to right
  • Amplitude of 1st part of P wave increases (>2.5mm)
  • P wave width no change (because 2nd part of P wave is left atrial in origin, hides prolonged depolarization of right atrium)
24
Q

What are the causes of left atrial enlargement?

A

If in isolation, classically seen with MS

If in association with LVH

  • Systemic HTN
  • Aortic stenosis
  • Mitral regurgitation
  • Hypertrophic Cardiomyopathy
25
Q

How does left atrial enlargement appear on ECG?

A
  • No significant axis deviation (because left atrium is normally already electrically dominant)
  • 2nd part of P wave increase in amplitude (i.e. >1mm below isoelectric line in V1; not visible in lead II)
  • Increase in duration of P wave
26
Q

What are the causes of right ventricular enlargement?

A
  • Chronic lung disease (cor pulmonale)
  • Pulmonary embolism
  • Pulmonary stenosis
  • Pulmonary hypertension
  • Congenital heart disease (e.g. ToF)
27
Q

What are the ecg changes seen in right ventricular enlargement?

A

Right axis deviation (>100)
- Lead I more –ve than +ve

Poor R wave progression

  • V1: R wave larger than S wave
  • V6: S wave larger than R wave

+/- RV Strain Pattern (Downward sloping ST Depression + T wave inversion)

28
Q

What are the causes of left ventricular enlargement?

A
  • Hypertension (most common cause)
  • Aortic stenosis
  • Aortic regurgitation
  • Mitral regurgitation
  • Coarctation of the aorta
29
Q

What are the ecg changes seen in left ventricular enlargement?

A

kolov-Lyon criteria: R wave amplitude (V5 or 6) + S wave amplitude (V1 or 2) is >35mm (>7 large squares)

Left axis deviation (not as useful in Dx)

+/- LV Strain Pattern (Downward sloping ST Depression + T wave inversion)

30
Q

In which leads can T wave inversion be physiological?

A

May be inverted in III, aVR, V1 & V2 without being abnormal

Cardio (16 decks)

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