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Phase 2a revision > Cardio > Flashcards

Cardio Flashcards

1
Q

Which ECG leads monitor the inferior aspect of the heart?

A

II, III, aVF

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2
Q

Which ECG leads monitor the lateral aspect of the heart?

A

I, aVL, V5, V6

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3
Q

Which ECG leads monitor the anterior aspect of the heart?

A

V3, V4

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4
Q

Which ECG leads monitor the septal aspect of the heart?

A

V1, V2

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5
Q

What is the normal QRS axis?

A

-30 to +90

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6
Q

What is the range for Left axis deviation?

A

-30 to - 90

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7
Q

What is the range for right axis deviation?

A

+90 to +180

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8
Q

What is the usual cause of right axis deviation?

A

Right ventricular hypertrophy

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9
Q

What is the usual cause of left axis deviation?

A

Conduction defects

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10
Q

How do you work out the heart rate for regular rhythms?

A

300 / number of big boxes

1500 / number of small boxes

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11
Q

How do you work out the heart rate for irregular rhythms?

A

Count beats on rhythm strip and x6

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12
Q

What does the P wave represent?

A

Atrial depolarisation - combination of left and right

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13
Q

What does right atrial enlargement look like on an ECG?

A

Taller P wave >2.5mm

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14
Q

What does a P wave taller than >2.5mm suggest?

A

Right atrial enlargement

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15
Q

What does left atrial enlargement look like on an ECG?

A

Wider P wave >120ms (3 small squares)

May be M shaped - P. mitrale

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16
Q

What does a wide P wave >120ms suggest?

A

Left atrial enlargement

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17
Q

What is the PR interval?

A

Start of P wave until end of QRS

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18
Q

What does the PR interval represent?

A

Conduction through the AV node

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19
Q

What is the normal duration of a PR interval?

A

120-200ms

3-5 small squares

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20
Q

What does a PR interval >200ms suggest?

A

First degree heart block - delayed conduction through AV node

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21
Q

What do progressively increasing PR intervals suggest?

A

2nd degree heart block (Mobitz I) - not all atrial impulses reach vetricles

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22
Q

What does a PR interval <120ms suggest?

A

Wolff-Parkinson-White syndrome - accessory pathway allows early activation of the ventricle

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23
Q

What is the PR segment?

A

End of P wave until start of QRS

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24
Q

What does a normal PR segment look like?

A

Flat, isoelectric

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25
Q

What is PR segment depression suggestive of?

A

Pericarditis

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26
Q

What does the QRS complex represent?

A

Contraction of the ventricles

27
Q

What does a normal QRS complex look like?

A

70-100ms wide

S wave <30mm deep

28
Q

What does a narrow QRS complex (<70ms) suggest?

A

Originating supraventricularly - SAN, AVN, atria

Third degree Hid bundle heart block

29
Q

What does a broad QRS (>100ms) suggest?

A

BBB, Hyperkalaemia, W-P-W syndrome, Hypothermia

30
Q

How do you determine Left ventricular hypertrophy on an ECG?

A

S wave in V1 > 35mm

R wave in V5/6 > 35mm

31
Q

What does a Q wave represent?

A

Left-to-right depolarisation of the interventricular septum

32
Q

When is a Q wave pathological?

A

> 40ms wide
2mm deep or >25% depthy of QRS complex
Seen in leads V1-3
Absent in V5-6

33
Q

What is the ST segment?

A

End of S wave until beginning of T wave

34
Q

What does the ST segment represent?

A

Time between ventricular depolarisation and repolarisation

35
Q

What is the J point?

A

Point between QRS and ST segment

36
Q

What does ST elevation suggest?

A

Myocardial infarction - STEMI
Prinzmetal’s angina
Pericarditis
LBBB

37
Q

What does ST depression suggest?

A

Right ventricular hypertrophy

RBBB

38
Q

What does the T wave represent?

A

Ventricular repolarisation

39
Q

What do abnormal T waves look like?

A 
Symmetrical
Tall
Peaked
Biphasic
Inverted
40
Q

What is the QT interval?

A

Start of Q wave until end of T wave

41
Q

What does the QT interval represent?

A

Time for ventricular depolarisation and repolarisation

42
Q

What is the relationship between QT interval and heart rate?

A

Inversely proportional

43
Q

What is an atrial septal defect?

A

Connection between 2 atria

44
Q

Explain the pathophysiology of an atrial septal defect

A

Slightly higher pressure in LA than RA
Blood shunts left –> right
Increased flow in right heart and lungs

45
Q

Does atrial septal defect cause cyanosis?

A

No

46
Q

What is a ventricular septal defect?

A

Connection between 2 ventricles

47
Q

Explain the pathophysiology of ventricular septal defect

A

High pressure LV, low pressure RV

Blood shunts left–> right

48
Q

Doest ventricular septal defect cause cyanosis?

A

No

49
Q

What is a coarctation of the aorta?

A

Narrowing of the aorta at the sight of insertion of the ductus arteriosus

50
Q

Does it cause cyanosis?

A

No

51
Q

What is a congenital abnormality of the aortic valve?

A

Bicuspid aortic valve

52
Q

What are the abnormalities in Tetralogy of Fallot?

A
  1. Pulmonary infundibular stenosis
  2. Overriding aorta
  3. Ventricular septal defect
  4. Right ventricular hypertrophy
53
Q

Explain the pathophysiology of Fallot’s tetralogy

A

Stenosis of the RV outflow tract leads to the RV being at higher pressure than LV
Blood shunts Right –> left
(via VSD)

54
Q

Does Fallot’s tetralogy cause cyanosis?

A

Yes

55
Q

What is a patent ductus arteriosus?

A

Connection between aorta and pulmonary arteries

56
Q

What is a patent foramen ovale?

A

Connection between left and right atria

57
Q

What are the clinical signs of ASD?

A

Pulmonary flow murmur

Big pulmonary arteries and heart

58
Q

What are the clinical signs of VSD?

A

Large - breathless, poor feeding, big heart, tachycardia

Small - v. loud systolic murmur

59
Q

What are the clinical signs of Coarctation of the aorta?

A

Severe - collapse with heart failure

Mild - hypertension (particuarly right arm)

60
Q

What are the clincial signs of patent ductus arteriosus?

A

Large - breathless, poor feeding

Small - asymptomatic

61
Q

What are the clincial signs of patent foramen ovale?

A

No symptoms - normal health if no other abnormalities

62
Q

What are th clincial signs of Fallot’s tetralogy?

A

BLUE - cyanosis

63
Q

Which structural defects cause cyanosis?

A

Fallot’s tetralogy

Phase 2a revision (1 decks)

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