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Clinical Practice 1 > Basic ECG's > Flashcards

Basic ECG's Flashcards

1
Q

What does an ECG represent?

A

The electrical activity leading to heart contraction which results in blood being pumped around the body

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2
Q

What function do all heart cells possess?

A

Automaticity

- All cells can start an electrical signal if normal mechanisms fail

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3
Q

What is the ‘normal pacemaker’ called?

A

Sino Atrial Node (SA node)

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4
Q

Where should all electrical activity start?

A

SA node

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5
Q

List the electrical and mechanical pathway of heart contraction

A
  1. SA node
  2. Atrial contraction (signal passes over atria)
  3. AV node picks up and holds signal (allows ventricular filling)
  4. Signal passes via bundle branches and purkinje fibres
  5. Stimulates ventricular contraction
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6
Q

What does the isoelectric line represent?

A

‘Flat line’ where all electrical activity should start and finish

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7
Q

What is the P wave and what does it represent?

A
  • A small rounded +ve wave at the start of an ECG
  • Represents electrical signal moving over atria
  • Results in atrial contraction
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8
Q

What does the PR interval show?

A

A pause in activity as the signal is held at the AV node

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9
Q

What is the QRS complex and what does it represent?

A
  • Tallest waveform (ventricles largest area in heart)
  • Signal moving through ventricles
  • Ventricular contraction
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10
Q

What is the ST segment?

A

Flat line between QRS and T wave

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11
Q

What can the ST segment show?

A

An acute myocardial infarction

STEMI

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12
Q

What is the T wave and what does it show?

A
  • Larger rounded wave
  • Electrical activity returning to normal for next contraction
  • Ventricular REPOLARISATION
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13
Q

Do all MI’s present with ST elevation?

A

No
nSTEMI
Look at other signs and symptoms
ECG not definitive diagnosis

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14
Q

What does the QT interval show?

A

Time taken for ventricular contraction AND relaxation to occur

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15
Q

What 6 elements represent a ‘normal’ ECG?

A
  1. Begins with P wave
  2. PR interval of defined length
  3. QRS tall, thin and spikey
  4. Flat ST segment
  5. Rounded T wave
  6. QT interval of appropriate length
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16
Q

What is the most important thing to keep in mind when identifying abnormal ECG’s?

A

Know what normal looks like

bear in mind not everyone’s normal is textbook normal

17
Q

What 4 main issues lead to abnormal ECG’s?

A
  1. Coronary circulation issues
  2. Infection
  3. Nervous control issues
  4. Electrical signals not functioning correctly
18
Q

What conditions are caused by issues with coronary circulation?

A
  • Angina (narrow arteries)

- MI (blocked coronary arteries)

19
Q

What is an infection of the heart called?

A

Pericarditis

20
Q

What can cause nervous control issues of the heart?

A

HEAD INJURY
Damage to higher brain functions which control rate and rhythm
Change in Inter Cranial Pressure (ICP) –> Bradycardia

21
Q

What can ECG ‘leads’ tell you?

A

Which part of the heart is impacted

22
Q

What can ST elevation show?

A

MI

23
Q

What is important to bear in mind when diagnosing ST elevation?

A

It must be seen in at least 2 related ‘leads’ corresponding to the same area of the heart

24
Q

What does ST depression show?

A

Ischaemia

25
Q

What condition can ST depression alone indicate?

A

Angina

26
Q

What can reciprocal ST changes (elevation and depression) indicate (mirror image)?

A

MI

27
Q

What 6 signs are important to bear in mind when diagnosing cardiac problems ALONGSIDE an ECG?

A
  1. Chest pain
  2. Blood Pressure
  3. Pulse
  4. Respiratory Rate
  5. Capillary Refill
  6. Glasgow Coma Scale
28
Q

Name some symptoms associated with cardiac problems

A 
Sweating 
Dizziness 
Fainting 
Vomiting 
Nausea
Anxiety 
Pallor 
History 
Onset/Severity 
Breathless 
Pain on exertion? 
Social history 
Family history
29
Q

What are the 2 types of cardiac rhythms is cardiac arrest?

A
  • Shockable :)

- Non-Shockable :(

30
Q

Name the 2 ‘Shockable’ cardiac rhythms

A
  • Ventricular Fibrillation (VF)

- PULSELESS Ventricular Tachycardia (pVT)

31
Q

Name the 2 ‘Non-Shockable’ cardiac rhythms

A
  • Asystole

- Pulseless Electrical Activity (PEA)

32
Q

What are the characteristics of VF?

A
  • No organised activity
  • No proper ‘pumping’ of the heart
  • No pulse
  • Random presentation
33
Q

What are the characteristics of pVT?

A
  • Each wave looks the same
  • Can indicate organised activity (rate too fast for heart to pump)
  • No pulse
34
Q

What are the characteristics of Asystole?

A
  • No electrical activity = No cardiac output

- SA node has not corrected itself

35
Q

What are the characteristics of PEA?

A
  • No pulse
  • Activity NOT VT and pVT
  • Ventricles failing
  • Complexes wide, odd and irregular
36
Q

What does an ECG ‘lead’ show you?

A

A view of the heart

Clinical Practice 1 (5 decks)

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