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Critical Care > Basic ECG Interpretation > Flashcards

Basic ECG Interpretation Flashcards

1
Q

What is cardiac conduction based on?

A

Automaticity

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2
Q

What is automaticity?

A

The ability of heart cells to spontaneously generate an action potential.

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3
Q

What is conductivity?

A

The ability for cardiac cells to transmit action potential from one cell to another.

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4
Q

What is rhythmicity?

A

The ability for cardiac cells to spontaneously generate an action potential at a regular rate.

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5
Q

What are the three inherent rates?

A

The SA node, the AV node, and purkinje fibers.

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6
Q

What is the inherent rate of the SA node?

A

60-100 beats/min

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7
Q

What is the inherent rate of the AV node?

A

40-60 beats/min

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8
Q

What is the inherent rate of the purkinje fibers?

A

15-40 beats/min

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9
Q

When does atrial depolarization happen?

A

The P wave.

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10
Q

When does ventricular depolarization happen?

A

The QRS complex.

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11
Q

When does ventricular repolarization happen?

A

The T wave.

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12
Q

When does atrial contraction happen?

A

The P wave.

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13
Q

What happens during the PR interval?

A

Time (in seconds) from onset of atrial depolarization to the onset of ventricular depolarization (impulse travels from the SA node to the AV node with a brief delay to allow the atria to empty).

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14
Q

What is the QRS interval?

A

The time it takes for the impulse to travel through the bundle branches and purkinje fibers.

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15
Q

What is the J point?

A

The point at which the QRS returns to the isoelectric line.

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16
Q

What is the ST segment?

A

From the end of QRS to the beginning of T wave, when normal it is flat and the same level as the isoelectric baseline.

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17
Q

What might the ST segment indicate?

A

Myocardial ischemia.

18
Q

What is the QT interval?

A

The time (in seconds) from the beginning of ventricular depolarization to the end of ventricular repolarization.

19
Q

What is the small block method?

A

Counting the number of small blocks between complexes and dividing 1500 by that number.

20
Q

How do you measure regularity?

A
  • Check the consistency of distance between R to R interval.
  • Check the consistency of distance between P to P interval.
  • Is it the same distance or does it vary?
21
Q

How can you calculate rhythm?

A
  • Is R-R interval regular or irregular?
  • Is P-P interval regular or irregular?
  • Is rate within normal range (60-100)?
  • Are the intervals normal, shortened, or prolonged?
  • Are the intervals consistent or do they vary?
22
Q

What is the normal interval of PR?

A

0.12-0.20 seconds (3-5 little boxes)

23
Q

What is the normal QRS interval?

A

<0.12 seconds (less than 3 little boxes)

24
Q

What is the normal interval for QT?

A

Most accurate: “normal” determined according to the heart rate. Should be less than half of the R-R interval.

25
Q

When is the PR interval considered prolonged?

A

Longer than 0.20. This means that it is taking too long for the electrical impulse to leave the AV node.

26
Q

What is a prolonged PR interval called?

A

A first-degree AV block.

27
Q

When is the QRS interval considered prolonged?

A

> or equal to 0.12. This means that it is taking too long for the electrical impulse to travel down the bundle branches.

28
Q

What is a prolonged QRS interval called?

A

Bundle Branch Block (BBB)

29
Q

What is normal sinus rhythm?

A

The normal rhythm of the heart. The impulse is initiated at the sinus node. A “P” wave appears before each QRS complex. PR interval is within 0.12-0.20 seconds, and QRS is narrow (<0.12 seconds).

30
Q

What is bradycardia?

A

Slow heartrate.

31
Q

How can we treat bradycardia?

A

Digitalis, beta-blockers, calcium channel blockers.

32
Q

What might bradycardia be associated with?

A

Sleep, severe pain, inferior wall myocardial ischemia, and spinal cord injuries.

33
Q

What specific medication can we use to treat bradycardia?

A

Atropine 1.0 mg IV - if symptomatic every 3-5 minutes (3mg MAX)

34
Q

What if atropine is ineffective for bradycardia?

A

Transcutaneous pacing, dopamine or epinephrine infusion may be used.

35
Q

What is sinus tachycardia?

A

Fast heart rate.

36
Q

What are causes for sinus tachycardia?

A

Stress, exercise, and stimulants (coffee and nicotine).

37
Q

What clinical problems is sinus tachycardia associated with?

A

Fever, anemia, hyperthyroidism, hypoxemia, heart failure, and shock.

38
Q

What medications can we use to treat sinus tachycardia?

A

Beta-blockers or calcium channel blockers can be used to decrease the heart rate.

39
Q

When is sinus dysrhythmia present?

A

If the RR intervals are irregular by more than 0.12 seconds on the ECG. The rate gradually increases with inspiration and gradually decreases with expiration.

40
Q

Does sinus dysrhythmia require treatment?

A

Generally no, unless there are long pauses.

Critical Care (3 decks)

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