Cardiology (ECGs) Flashcards
Interpret the following ECG
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HR = 84bpm
Normal sinus rhythm
Regular heart rhythm
Normal cardiac axis
P waves - present and normal morphology, followed by a QRS complex
ST segment eleveated in leads II, III and aVF
T waves ~ reciprocal T wave inversion in V2, with attened T waves in V3
Diagnosis: ST-elevation myocardial infarction (inferior)
Treatment: Dual anti-platelet therapy eg aspirin and clopidogrel, ACE-inhibitor, BB, statin
Interpret the following ECG
Con firms the patient’s name and date of birth
Checks the date and time the ECG was performed
Regular HR
Normal cardiac axis
P waves - present, normal morphology, each followed by a QRS complex
PR interval - normal - some PR depression
QRS complex - normal
ST segment - widespread ST elevation ~ reciprocal ST depression in aVR
T waves - normal
Diagnosis: Pericarditis
Treatment: Activity restriction and NSAIDs
Interpret the following ECG
Con firms the patient’s name and date of birth
Checks the date and time the ECG was performed
HR - 60bpm
Sinus rhythm
Left axis deviation
P wave present, normal morphology, followed by a QRS complex
PR interval - increased duration of 240ms
QRS complex - normal
ST segment - none signi cant, some benign early repolarisation (high take o ) in V2,V3,V4
T waves - normal
Diagnosis - First-degree AV block
Treatment - Avoid AV blocking drugs (e.g. beta-blockers, calcium channel blockers, digoxin)
Interpret the following ECG
Confi rms the patient’s name and date of birth
Checks the date and time the ECG was performed
HR - 60bpm
Irregularly irregular rhythm
Left axis deviation
Regular P waves throughout with intermittent non-conducted P waves
Normal PR interval (~160ms) with intermittent non-conducted P waves
AV conduction ratio (P:QRS) initially 3:2, then 2:1.
Broad QRS (>0.12 seconds) with right bundle branch block
ST segment normal
T waves normal
Diagnosis: Second-degree AV block (type 2) + right bundle branch block
Treatment: Permanent pacemaker
Interpret the following ECG
Con firms the patient’s name and date of birth Checks the date and time of ECG
HR - 42bpm
Regular heart rhythm
Normal cardiac axis
P waves - present, normal morphology, followed by a QRS complex
PR interval - normal
QRS complex - pathological Q waves in the inferior leads (Lead II, III and aVF)
ST segment - normal
T waves - inverted in the inferior leads (Lead II, III and aVF) and V4-V6
Diagnosis: Sinus bradycardia
Treatment: Manage underlying cause, (e.g. ceasing drug treatment, correct electrolytes/ thyroid dysfunction), permanent pacemaker
Interpret the following ECG
Con firms the patient’s name and date of birth Checks the date and time of ECG
HR 174bpm
Regular heart rhythm
Unable to assess cardiac axis
P waves - not visible
PR interval - unable to determine
QRS complex - broad
ST segment - not visible
T waves - not visible
Diagnosis: Ventricular tachycardia
Treatment: Amiodarone, implantable cardioverter de brillator (ICD)
Interpret the following ECG
Confi rms the patient’s name and date of birth Checks the date and time of ECG
HR - 90bpm
Irregularly irregular rhythm
Unremarkable cardiac axis
No visible P waves
Unable to assess PR interval due to lack of P waves QRS complex
ST segment unremarkable
T waves unremarkable
Diagnosis: A-fib
Treatment:
Direct-acting oral anticoagulants (DOACs) or warfarin based on CHA DS -VASc score
Rhythm control: synchronised DC cardioversion, or pharmacological cardioversion (e.g. ecainide or amiodarone)
Rate control: beta-blocker (e.g bisoprolol), CCB (e.g. verapamil, diltiazem), digoxin
Interpret the following ECG
Con rms the patient’s name and date of birth
Checks the date and time of ECG
HR - 45-54bpm
HR - regular
Normal cardiac axis
P waves - reduced p wave amplitude, absent in some strips
normal PR interval
Normal/slightly widened
Some ST depression in chest leads
Diagnosis: Hyperkalaemia
Treatment: IV calcium gluconate, combined insulin-glucose infusion or nebulised
salbutamol, calcium resonium (if chronic)
Interpret the following ECG
Con firms name and date of birth
Checks the date and time the ECG was performed
HR: 58 (300/5.2 large squares), 54 (9 beats in a 10 sec strip = 9 x 6)
Regular rhythm
Slight left axis deviation
P waves present, each one followed by QRS
PR interval normal
QRS complex normal
ST segment normal
T waves inverted in V1-V5 anterior leads suggesting LAD involvement
Diagnosis: NSTEMI
Treatment: MONA
Interpret the following ECG
Con firms the patient’s name and date of birth
Checks the date and time the ECG was performed
HR - 78 bpm (13 beats in a 10 sec strip = 13 x 6) Irregular rhythm, alternating 2:1 and 3:1 with occasional 4:1
Normal cardiac axis
P waves - sawtooth appearance, distinct waves not visible
Unable to assess the PR interval
QRS complex - large wave amplitude in V2 and V3
ST segment normal (students may suggest slight ST-elevation in anterior leads)
T waves normal
Diagnosis: Atrial flutter
Treatment: Anticoagulation and rate control/cardioversion
Interpret the following ECG
Confi rm the patient’s name and date of birth
Checks the date and time the ECG was performed
HR 75 bpm (300/4 large squares)
Regular rhythm
Normal cardiac axis
P waves - present, every p wave is followed by a QRS complex
PR interval mostly borderline short (120ms or 3 small squares) or short
QRS complex normal length but delta waves especially noticeable in the rhythm strip
ST segment normal; a more dominant R wave in V1 suggests type a WPW
T waves normal
Diagnosis: Wol f-Parkinson White Syndrome
Treatment: Vagal manoeuvres (e.g. valsalva) IV amiodarone
Electrical cardioversion
