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Vet Sci 4 > Cardiology ECG's > Flashcards

Cardiology ECG's Flashcards

1
Q

What is an ECG?

A

Recording of electrical activity of the heart

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2
Q

How is an ECG recorded?

A

Attach electrode or leads to pt. Add conducting agents then hook to ECG machine.

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3
Q

Conducting agents

A

Alcohol

Ultrasound gel

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4
Q

Limb leads

A

Lead 1
Lead 2: most common
Lead 3
All make up “Einthoven’s triangle”

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5
Q

Augmented limb leads

A
  • aVR
  • aVL
  • aVF
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6
Q

Patient placement for ECG:

A

Pt in R lateral recumbency (if possible) on Table on blanket or padded table
Pt breathing normal: avoid interference/artifact

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7
Q

Interference/artifact causes:

A

Pt movement: panting,trembling, etc

60-cycle: electrical interference

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8
Q

Lead placement on patient:

A 
Right Axillary: White Lead
Right Inguinal: Green Lead
Left Axillary: Black Lead
Left Inguinal: Red Lead
\+/- Chest: Tan/brown Lead
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9
Q

P wave

A

Small, + deflection in lead 2.
SA node has fired and atria has depolarized.
Diastolic phase

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10
Q

PR Interval

A

Period of time where AV node is causing a delay in conduction.

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11
Q

QRS Complex

A

Q = -, R = +, S = - deflections.
Largest part.
Ventricular depolarization a.k.a contraction.
Systolic phase

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12
Q

T wave

A

+ or - deflection – uniform.
Should be 25% of the amp of the R wave.
Ventricular depolarization or relaxation.

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13
Q

ST segment

A

Period of time between ventricular contraction and relaxation.

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14
Q

RR Interval

A

Period of time between cardiac contractions.

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15
Q

What is an arrhythmia?

A

A disruption of normal electricity in the heart.

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16
Q

Causes of arrhythmia:

A
  1. Abnormal rate of rhythm

2. Abnormal site of origin

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17
Q

Intrinsic pacemaker rates:

A
  • Dependent on size of animal/species
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18
Q

SA Node

A

70-120 bpm

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19
Q

Atrial muscle

A

0 bpm

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20
Q

AV Node

A

40-60 bpm

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21
Q

Bundle of HIS

A

40-60 bpm

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22
Q

Bundle branches

A

20-40 bpm

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23
Q

Purkinje fibers

A

20-40 bpm

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24
Q

Steps in evaluations: Step 1

A

Evaluate R-R Intervals – must be within a 10% variation.

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25
Q

Steps in evaluations: Step 2

A

Determine if impulses are sinus or not

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26
Q

Sinus

A,B,C

A

Normal conduction occurred = heart contracted normally

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27
Q

A. Evaluate P waves:

A

normal = small and positive deflection

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28
Q

Inverted P waves:

A

Impulse originates at the AV junction

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29
Q

Absent P waves:

A

Impulse originated somewhere at ventricles.

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30
Q

B. Look at relationship between P waves and QRS:

A
  • Every P wave must have a QRS

- PR interval should be consistent

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31
Q

C. Evaluate T waves:

A

+ or - deflection– uniform. Should be 25% of the amp. of the R wave.

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32
Q

Steps in evaluations: Step 3

A

Look for anything unusual

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33
Q

How to obtain a heart rate:

A
  • Ausculate
  • Pulse – listen & palpate at the same time
  • Palpate apex (apical apex)
  • From an ECG
34
Q

Normal Sinus Rhythm

A

Normal P, Q, R, S, T
Rate is normal for size of pt:
Cat=120-240 Dog=70-160
P waves are small and + R waves are tall and spiky. R to R are consistent

35
Q

Sinus Bradycardia

A

Regular sinus rhythm with a heart rate below normal.

<120bpm – cat

36
Q

Sinus Bradycardia:

Physiologic

A

Increased vegal tone (cranial nerve 10)

Lean, trim animals

37
Q

Sinus Bradycardia:

Pathologic

A

Renal failure, increased levels of K+ (hyperkalemia) cardiac arrest

38
Q

Sinus Bradycardia:

Drug induced

A

Phenoyl (Ace), Narcotics

39
Q

Sinus Bradycardia:

Tx

A

Anti-colonergic drug – Glycopyrelate and Atropine

40
Q

Sinus Tachycardia

A

Regular sinus rhythm with a increased rate
Dog- <240
Most common arrhythmia in practice

41
Q

Sinus Tachycardia:

Physiologic

A

Pain, exercise, stress

42
Q

SinusTachycardia:

Pathologic

A

Fever, shock, anemia, hyperthyroidism, CHF, hypoxia

43
Q

Sinus Tachycardia:

Drugs

A

Anti-colonergics, epinephrine

44
Q

Sinus Tachycardia:

Tx

A

Identify and control

45
Q

Sinus Arrhythmia

A

Irregular sinus rhythm that originates in the SA node
Inconsistent R-R interval, alternating periods of a slow & fast heart rate associated with reap. Normal in dogs & horses, never normal in cats – pathology

46
Q

Ventricular premature contractions (VPC)

A

Cardiac impulse originated in the ventricles rather than SA node

47
Q

VPC Guidelines

A

Poor tissue perfusion d/t pulse deficits
Absent P waves
Wide & bizarre QRS complexes
+/- compensatory pause after VPC

48
Q

VPC Causes

A 
Cardiomyopathy 
Valve dz
Feline hyperthyroidism 
Aorticstinosis
Hypoxia (GDV)
49
Q

VPC Signs

A 
Exercise intolerance 
Weakness 
Syncopi (fainting)
Pulse deficit, decreased perfusion
Sudden death
50
Q

VPC Tx

A

Anti-arrhythmic drugs (Litacane- K9, Procainamide- cat)

51
Q

Bigeminy

A

One or two VPCs in a row

Consistent pattern of normal impulse and VPC

52
Q

Ventricular Tachycardia

A

Three or more VPCs in a row

53
Q

Ventricular Tachycardia Guidelines

A

Intermittent or sustained
Absent or buried in QRS complex- P wave
Fast heart rate <160 bpm

54
Q

Ventricular Tachycardia Causes

A 
Cardiomyopathy 
Valve dz
Feline hyperthyroidism 
Aorticstinosis
Hypoxia (GDV)
55
Q

Ventricular Tachycardia Signs

A

Life threatening -> can convert to vfib

56
Q

Ventricular Tachycardia Tx

A

Litacain - K9
Procainamide - feline
CRI -> constant rate infusion

57
Q

Ventricular Fibrillation (vfib)

A

Ventricular depolarization without coordinated activity

58
Q

Vfib Guidelines

A

No pulse = 0 cardiac output
Rapid, chaotic, irregular rhythm in ventricles
NO P, QRS

59
Q

Vfib Causes

A 
Severe systemic illness
Shock 
Trauma
Anesthetic reaction
Severe hypothermia
Untreated Vtach
60
Q

Vfib Tx

A

Electrical cardio version 1st (dfib)

Anti-arrhythmic 2nd

61
Q

Ventricular Asystole

A

Absence of pacemaker activity -> no depolarization= cardiac output = no pulse +/- escape beat - may see several

62
Q

Ventricular Asystole Tx

A

CPR
ET-> 1. Intracardiac
2. Atropine

63
Q

Atrial Fibrillation

A

Numerous disorganized atrial impulses that bombard the AV node

64
Q

Atrial Fibrillation Guidelines

A
  1. Inconsistent R-R intervals
  2. Normal appearing QRS complex
  3. +/- Flutter P waves
65
Q

Atrial Fibrillation Causes

A

Atrial enlargement

Dialated cardiomyopathy

66
Q

Atrial Fibrillation Tx

A

Digoxin

Quinidine

67
Q

Atrial Standstill

A

Absence of P waves with a regular escape rhythm, escape beat is slow (40-60 eb/min)
escape beat=no normal beats around

68
Q

Atrial Standstill Guidelines

A

Slow rhythm >60 bpm
No P waves
Normal or wide appearing QRS

69
Q

Atrial Standstill Causes

A

Atria distention
Cardiomyopathy
Hyperkalemia

70
Q

Atrial Standstill Tx

A

Pacemaker (heart problem)

71
Q

1st degree AV block

A

Delay in conduction through the AV node

72
Q

1st degree AV block Guidelines

A

Prolonged P-R Intervals

73
Q

1st degree AV block Causes

A

Geriatric pts

74
Q

1st degree AV block Tx

A

Not needed

75
Q

2nd degree AV block

A

Occasional P waves without corresponding QRS complexes

76
Q

2nd degree AV block Guidelines

A

Regular occurring P waves
Occasional dropped QRS complexes
Common in horses d/t increased vegal tones
Not common in cats & dogs

77
Q

2nd degree AV block Tx

A

Anti-colonergic

May be unnecessary

78
Q

3rd degree AV block

“Atriaventrical dissociation”

A

Complete block

Cardiac impulse is completely blocked at AV node

79
Q

3rd degree AV block Guidelines

A

Consistent P-P at normal rate

Consistent but slow escape rhythm (40-60)

80
Q

3rd degree AV block Causes

A

VSD

Cardiomyopathy

81
Q

3rd degree AV block Tx

Vet Sci 4 (12 decks)

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