Cardiology - ECG interpretation Flashcards
How do you calculate rate on an ECG?
rate = 300 / (number of large squares in R-R interval)
How would LAD appear on ECG? Causes?
Positive in lead I
Negative in lead II, aVF
Causes - inferior MI, VT, WPW, L ant hemiblock
How would RAD appear on ECG? Causes?
Negative in lead I
Positive in aVF
Causes - PE, cor pulmonale, lateral MI, L posterior hemiblock
What ECG change is seen in TCA overdose?
QRS prolongation
Causes of QTc prolongation?
acute MI
hypothermia
hypocalcaemia
drugs (TCAs, quinidine)
Causes of chest pain?
CVS - ACS, aortic dissection
Resp - pneumothorax, pneumonia, PE
MSK - costochondritis
GI - oesophagitis, cholecystitis, pancreatitis
Secondary symptoms to ask about in chest pain history?
N&V, sweating, SOB, cough, haemoptysis, LOC, palpitations, dizziness
acute mx of STEMI/NSTEMI
12 lead ECG + MONA + GRACE
Aspirin 300mg + clopidogrel
Cannula - bloods (FBC, U&Es, TnT, VBG, cholesterol) + IV morphine
Nitrates
O2 if sats <90
CXR
Calculate GRACE risk score, start enoxaparin unless CI
If STEMI early referral for PCI in cathlab (or thrombolysis)
Changes in ECG leads V1-3 indicate an MI in which location?
Anteroseptal
Changes in ECG leads V5-6, all indicate an MI in which location?
anterolateral
Changes in ECG leads V2-4 indicate an MI in which location?
anterior
Changes in ECG leads V1-6 indicate an MI in which location?
extensive anterior
Changes in ECG leads I, II, aVL, V6 indicate an MI in which location?
lateral
Changes in ECG leads II, III, aVF indicate an MI in which location?
inferior
Changes in ECG leads V1, V4R indicate an MI in which location?
RV
Causes of AF?
IHD, heart failure, htn, valvular disease, sepsis, PE, thyrotoxicosis, drug abuse, lung/pleural disease, low K/volume/temp
What is torsades de pointes and what causes it?
Polymorphic VT assoc with low Mg/K, and long QTc.
How is SVT treated?
Unstable - electrical cardioversion
Stable - valsalva, carotid sinus massage, adenosine or verapamil
Sudden severe chest/back pain and a history of htn - must rule out what diagnosis?
aortic dissection - can resemble MI, may also see aortic regurg, asymmetrical pulses, htn, tamponade, neurological signs
