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Stage 3: FOCP > Cardio week: ECG > Flashcards

Cardio week: ECG Flashcards

1
Q

Where are the chest leads V1-V6 placed in an ECG

A 
V1: 4th intercostal space RSE
V2: 4th intercostal space LSE
V3: between V2 & V4
V4: apex
V5: L anterior axillary (same level as V4)
V6: L mid-axillary (same level as V4)
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2
Q

Limb + chest leads:

Which look at chest in coronal/ axial plane?

A

Limb leads: coronal plane

Chest leads: axial plane

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3
Q

Where are the most common sites of infarction of the heart

A

Anterior and inferior aspects

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4
Q

Which part of the heart is supplied by the RCA?

What leads suggest a problem with the RCA?

A

Inferior

Leads: II, III, avF

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5
Q

Which part of the heart is supplied by the LAD?

What leads suggest a problem with the LAD?

A

Anteroseptal

Leads: V1-V4

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6
Q

Which part of the heart is supplied by the Cx?

What leads suggest a problem with the Cx?

A

Lateral

Leads: 1, aVL, V5, V6

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7
Q

What does the electrical axis indicate

A

Average direction of spread of ventricular depolarisation

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8
Q

Lead I/II positive/negative

Which indicates LAD/RAD?

A

LAD: Lead I positive, Lead II negative

RAD: Lead I negative, Lead II positive

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9
Q

How long & high should a normal P wave be?

A

length <0.11s
(2.5 small boxes)

height <2.5mm
(2.5 small boxes)

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10
Q

What is the significance of an absent P wave?

A

SA node has not fired eg in Atrial fibrillation

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11
Q

What might a taller P wave indicate?

A

Atrial hypertrophy eg in chronic pulmonary disease

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12
Q

How long should a normal PR interval be?

A

0.12-0.2s

3-5 small boxes

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13
Q

What happens to ECG during WPW syndrome?

Briefly explain why.

A

Shortened PR interval.

WPW: accessory pathway communicates between atria and ventricles, conducts electricity at much higher rate than AV node.

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14
Q

How long should normal QRS complex be

A

<0.12s

less than 3 small boxes

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15
Q

What stage in the cardiac cycle do the following signify

P wave
QRS complex
T wave
U wave
ST segment
A

P wave: atrial depolarisation

QRS complex: ventricle depolarisation

T wave: ventricle repolarisation

U wave: Purkinje fibre repolarisation

ST segment: ventricle contracting but no electricity flowing (periods between ventricular depolarisation and repolarisation)

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16
Q

What might tall QRS indicate?

A

Ventricular hypertrophy

or slim patient

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17
Q

What might tall T waves indicate?

A
  • Hyperkalemia

- Very early MI

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18
Q

What might prominent U waves indicate?

A
  • Hypercalcaemia
  • Hypokalemia
  • Digoxin toxicity
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19
Q

What might ST elevation indicate?

A
  • Acute MI
  • Pericarditis
  • Brugada syndrome
20
Q

What might ST depression indicate?

A
  • MI at back of heart
  • previous MI
  • previous ischaemia
21
Q

How does A Fib present on ECG

A

Absence of P waves

22
Q

How does A flutter present on ECG

A

Saw tooth appearance

23
Q

How does MI present on ECG

A

ST elevation or depression

24
Q

How does V fib present on ECG

A

Bag of worms (chaotic activity)

25
Q

How does V tachycardia present on ECG

A

Tidy looking QRS complexes

26
Q

How does SVT present on ECG

A

Very fast palpitations (very fast QRS complexes)

27
Q

How does first degree heart block present on ECG

A

Constant long PR interval

28
Q

How does Mobitz type I (second degree heart block) present on ECG

A

PR interval progressively lengthens until QRS complex completely blocked

29
Q

How does Mobitz type II (second degree heart block) present on ECG

A

Abnormally wide QRS complex

Some missing QRS complex (if serious)

30
Q

How does complete heart block present on ECG

A

No link between P waves and QRS complexes.

Individual rates of P waves & QRS complexes tend to be constant.

31
Q

How does a BBB present on ECG

A

Widened QRS complex

32
Q

Which lead is always negative in a normal ECG

A

avR

33
Q

Which are the only shockable arrhythmias

A

VT and VF

34
Q

ST inversion and elevation and depression

Which means ischaemia/infarction

A

ST elevation: infarction

ST depression/inversion: ischaemia

35
Q

What might a prolonged QT interval indicate

A

Acute MI, myocarditis, bradycardia

36
Q

4 Types of SVT

A
  1. A fib
  2. Paroxysmal SVT
  3. A flutter
  4. WPW syndrome
37
Q

Some examples of narrow complex tachycardias

A
  • sinus tachycardia

- a flutter

38
Q

Some examples of broad complex tachycardias

A
  • ventricular tachycardia

- junctional tachycardia in acute MI

39
Q

What is considered significant ST elevation (in terms of small square)

A

1 small square in limb lead

2 small squares in precordial lead

40
Q

What types of ST depression are more likely to be pathological

A
  • horizontal

- downwards

41
Q

In which leads is it normal for T wave to be inverted

A

aVR
III
V1

42
Q

4Hs and 4Ts that can cause a cardiac arrest

A

4H

  • hypokalemia/hyperkalemia
  • hypovolemia
  • hypoxia
  • hypothermia

4T

  • toxin
  • thromboembolism
  • tamponade
  • tension pneumothorax
43
Q

4 life threatening arrhythmias

A
  1. VF
  2. Pulseless VT
  3. Asystole
  4. Pulseless electrical activity
44
Q

Which 2 life threatening arrythmias are NOT shockable

A
  • Asystole

- Pulseless electrical activity

45
Q

ECG changes during hypothermia

A
  • bradycardia
  • ā€˜Jā€™ wave - small hump at the end of the QRS complex
  • first degree heart block
  • long QT interval
  • atrial and ventricular arrhythmias

Stage 3: FOCP (47 decks)

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