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Paed BPT Study > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What are 4 signs of Right Ventricular Hypertrophy in ECG?

A
  1. R in V1 (<20mm), >25mm in neonates
  2. (and/or) S in V6 (>7mm)
  3. Upright T wave in V1 after 72yrs-5yrs
  4. RAD (-ve I, +ve aVF)
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2
Q

What is an ECG sign of Severe RVH?

A

T wave goes down in V1 due to strain

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3
Q

What is a sign of Left Ventricular Hypertrophy on ECG?

A

R wave > 25mm in V6

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4
Q

What is a sign if severe LVH on ECG?

A

ST depression and T wave inversion in V6

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5
Q

Where do you measure QT on an ECG?

A

Lead II and V5, QT/sq root of preceding RR interval.

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6
Q

At what age is an upright T wave in V1 considered normal and why?

A

birth - day 4. Due to high pulmonary pressures in foetal circulation (lungs full of fluid and bypassed mostly by FO and PDA)

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7
Q

What ECG finding indicates Right Atrial dilatation?

A

Tall P waves >3mm in V1,II

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8
Q

What causes Right Atrial dilatation?

A

Large ASD, TR (Ebsteins, Rheumatic), Pulmonary atresia, TS (rare), TAPVR, severe PS.

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9
Q

What ECG finding indicates Left Atrial dilatation?

A

Bifid + long P waves (>0.1/2.5 small squares OR 0.8 in neonate.

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10
Q

What causes Left Atrial Dilatation?

A

Mitral regurgitation, mitral stenosis, Large VSD

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11
Q

How are normal Q waves differentiated from pathological Q waves?

A 
Normal = thin/narrow and in inferior and lateral leads (II,III, aVF, V5,V6). 
Pathological = broad + deep in V1. Exception = some newborns have Q wave in V1
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12
Q

What do pathological Q waves indicate?

A

L-TGA, single ventricle, severe RVH, anterior myocardial infarction

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13
Q

What causes Left Axis Deviation?

A

LVH, LBBB (rare in paeds), Left anterior hemiblock (superior axis, narrow QRS –> Tricuspid atresia, AV canal defect, congenitally corrected TGA), WPW, PS (Noonan - esp if HCM), single ventricle

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14
Q

What causes RAD?

A

RVH (e.g. ToF), RBBB, Secundum ASD

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15
Q

What causes superior axis deviation (-ve I + aVF)?

A

AVSD, Tricuspid atresia, primum ASD, PS (Nooonan’s)

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16
Q

What causes prolonged PR?

A

(First degree heart block)

  1. Normal varient
  2. Myocarditis
  3. Digitalis Toxicity
  4. CHD (AVSD, ASD, Ebsteins)
17
Q

What would cause a shortened PR?

A
  1. Pre-excitation (WPW, Lown-Ganong-Levine Syndrome)
  2. Glycogen storage disease
  3. Low right atrial pacemaker
18
Q

What causes a prolonged QRS

A
  1. RBBB
  2. LBBB
  3. WPW
  4. Interventricular block
  5. Pre-mature ventricular beats
  6. VT
19
Q

What is the 5,4,3,2,1 rule for RVH?

A 
R wave in V1: 
>5sq <1month
>4sq<1yr
>3sq >3yr
S wave  in V6:
>3sq <1month
>2sq <1yr
>1sq >1yr
20
Q

What is the 5,4,3,2,1 rule for LVH?

A 
R wave in V6:
>3sq <1m
>4sq <1yr
>5sq >1yr
S wave in V1:
>1sq <1m
>2sq <1yr
>3sq >1yr
21
Q

What causes flat T waves?

A

Hypothyroidism, Hypokalemia, myocarditis

22
Q

What is sinus node dysfunction and name 3 causes

A

SA node unable to be dominant pacemaker. Unable to elevate HR in response to stress. Causes:

  1. CHD (ASD, AVSD, TGA)
  2. Post surgery - TGA atrial switch
  3. Meds (Digoxin, propranolol, verapamil,
  4. Myocardial disease (cardiomyopathy, myocarditis, pericarditis, Kawsaki’s, MI)
  5. Neonate: lupus, apnoeas + brady’s of prematurity
23
Q

What is 1st Degree Heart Block and what are 3 causes?

A

Constant prolonged PR interval, all beats conducted.
Causes:
Increased vagal tone, Rheumatic fever, Rubella, mumps, metabolic (K,Ca2+,BSL, Mg2+), cardiomyopathy

24
Q

What is second degree heart block, Mobitz 1?

A

Progressively longer PR until a beat isn’t conducted. Block at the AV level. Don;t get CHB.
Most caused by raised parasympathetic tone, myocarditis, post cardiac disease surgery

25
Q

What is second degree heart block, Mobitz 2?

A

Constant prolonged PR, dropping beats at a regular ratio, 3:1, 2:1. Block at bundle of His or bundle branches –> less predictable and can progress to CHB. Most often caused by CHD + post surgery.

26
Q

What is third degree heart block?

A

Complete dissociation of atrial and ventricular rate. atrial rate > ventricular rate.
Congenital = neonatal lupus, L-TGA, AVSD
Acquired = myocarditis, acute rheumatic fever, MI, post cardiac surgery

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