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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
Steps in evaluations: Step 2
Determine if impulses are sinus or not
26
Sinus | A,B,C
Normal conduction occurred = heart contracted normally
27
A. Evaluate P waves:
normal = small and positive deflection
28
Inverted P waves:
Impulse originates at the AV junction
29
Absent P waves:
Impulse originated somewhere at ventricles.
30
B. Look at relationship between P waves and QRS:
- Every P wave must have a QRS | - PR interval should be consistent
31
C. Evaluate T waves:
+ or - deflection-- uniform. Should be 25% of the amp. of the R wave.
32
Steps in evaluations: Step 3
Look for anything unusual
33
How to obtain a heart rate:
- Ausculate - Pulse -- listen & palpate at the same time - Palpate apex (apical apex) - From an ECG
34
Normal Sinus Rhythm
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
Sinus Bradycardia
Regular sinus rhythm with a heart rate below normal. | <120bpm -- cat
36
Sinus Bradycardia: | Physiologic
Increased vegal tone (cranial nerve 10) | Lean, trim animals
37
Sinus Bradycardia: | Pathologic
Renal failure, increased levels of K+ (hyperkalemia) cardiac arrest
38
Sinus Bradycardia: | Drug induced
Phenoyl (Ace), Narcotics
39
Sinus Bradycardia: | Tx
Anti-colonergic drug -- Glycopyrelate and Atropine
40
Sinus Tachycardia
Regular sinus rhythm with a increased rate Dog- <240 Most common arrhythmia in practice
41
Sinus Tachycardia: | Physiologic
Pain, exercise, stress
42
SinusTachycardia: | Pathologic
Fever, shock, anemia, hyperthyroidism, CHF, hypoxia
43
Sinus Tachycardia: | Drugs
Anti-colonergics, epinephrine
44
Sinus Tachycardia: | Tx
Identify and control
45
Sinus Arrhythmia
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
Ventricular premature contractions (VPC)
Cardiac impulse originated in the ventricles rather than SA node
47
VPC Guidelines
Poor tissue perfusion d/t pulse deficits Absent P waves Wide & bizarre QRS complexes +/- compensatory pause after VPC
48
VPC Causes
``` Cardiomyopathy Valve dz Feline hyperthyroidism Aorticstinosis Hypoxia (GDV) ```
49
VPC Signs
``` Exercise intolerance Weakness Syncopi (fainting) Pulse deficit, decreased perfusion Sudden death ```
50
VPC Tx
Anti-arrhythmic drugs (Litacane- K9, Procainamide- cat)
51
Bigeminy
One or two VPCs in a row | Consistent pattern of normal impulse and VPC
52
Ventricular Tachycardia
Three or more VPCs in a row
53
Ventricular Tachycardia Guidelines
Intermittent or sustained Absent or buried in QRS complex- P wave Fast heart rate <160 bpm
54
Ventricular Tachycardia Causes
``` Cardiomyopathy Valve dz Feline hyperthyroidism Aorticstinosis Hypoxia (GDV) ```
55
Ventricular Tachycardia Signs
Life threatening -> can convert to vfib
56
Ventricular Tachycardia Tx
Litacain - K9 Procainamide - feline CRI -> constant rate infusion
57
Ventricular Fibrillation (vfib)
Ventricular depolarization without coordinated activity
58
Vfib Guidelines
No pulse = 0 cardiac output Rapid, chaotic, irregular rhythm in ventricles NO P, QRS
59
Vfib Causes
``` Severe systemic illness Shock Trauma Anesthetic reaction Severe hypothermia Untreated Vtach ```
60
Vfib Tx
Electrical cardio version 1st (dfib) | Anti-arrhythmic 2nd
61
Ventricular Asystole
Absence of pacemaker activity -> no depolarization= cardiac output = no pulse +/- escape beat - may see several
62
Ventricular Asystole Tx
CPR ET-> 1. Intracardiac 2. Atropine
63
Atrial Fibrillation
Numerous disorganized atrial impulses that bombard the AV node
64
Atrial Fibrillation Guidelines
1. Inconsistent R-R intervals 2. Normal appearing QRS complex 3. +/- Flutter P waves
65
Atrial Fibrillation Causes
Atrial enlargement | Dialated cardiomyopathy
66
Atrial Fibrillation Tx
Digoxin | Quinidine
67
Atrial Standstill
Absence of P waves with a regular escape rhythm, escape beat is slow (40-60 eb/min) escape beat=no normal beats around
68
Atrial Standstill Guidelines
Slow rhythm >60 bpm No P waves Normal or wide appearing QRS
69
Atrial Standstill Causes
Atria distention Cardiomyopathy Hyperkalemia
70
Atrial Standstill Tx
Pacemaker (heart problem)
71
1st degree AV block
Delay in conduction through the AV node
72
1st degree AV block Guidelines
Prolonged P-R Intervals
73
1st degree AV block Causes
Geriatric pts
74
1st degree AV block Tx
Not needed
75
2nd degree AV block
Occasional P waves without corresponding QRS complexes
76
2nd degree AV block Guidelines
Regular occurring P waves Occasional dropped QRS complexes Common in horses d/t increased vegal tones Not common in cats & dogs
77
2nd degree AV block Tx
Anti-colonergic | May be unnecessary
78
3rd degree AV block | "Atriaventrical dissociation"
Complete block | Cardiac impulse is completely blocked at AV node
79
3rd degree AV block Guidelines
Consistent P-P at normal rate | Consistent but slow escape rhythm (40-60)
80
3rd degree AV block Causes
VSD | Cardiomyopathy
81
3rd degree AV block Tx
Pacemaker

Vet Sci 4 (12 decks)

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