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Pathophysiology ECG > Characteristics ECG > Flashcards

Characteristics ECG Flashcards

1
Q

Sinus bradycardia

A

<60 bpm

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2
Q

Sinus tachycardia

A

> 100 bpm

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3
Q

Sinus arrthythmia

A

variations in heartrate during insp. (increases HR) and exp. (decreases HR).

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4
Q

Atrial premature beat

A
  • Early P
  • P- wave may “sit” on T- wave
  • Narrow QRS
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5
Q

Ventricular premature beat

A
  • No P- wave (or retrograde)
  • Wide QRS
  • Uni-/ multifocal
  • Compensatory beat before next “normal” beat
  • Bigeminy/ Trigeminy
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6
Q

Atrial tachycardia

A
  • Continuous/ nonparoxysmal: 100- 150 bpm.

- Sudden/ paroxysomal: 150- 250 bpm.

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7
Q

Junctional (AV) premature beat

A
  • no P (or retrograde) preciding QRS
  • Shorter PR- interval
  • QRS followed by compensatory pause

Supranodal: inverse P before QRS (II lead) except aVR where opposite
Mesonodal: no P- wave
Infranodal: QRS before inverse P

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8
Q

Ventricular tachycardia

A
  • Sustained >30s, unsustained <30s.
  • Nonparoxysmal/ paroxysmal
  • Monomorphic/ polymorphic (i.e. Torsades de pointes: QRS amplitude fluctuates)
  • Wide QRS
  • AV dissociation (P i QRS, fusion beat)
  • Ventricular escape < Accelerated ventricular rhythm < Tachycardia
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9
Q

Junctional tachycardia

A
  • Nonparoxysmal = continuous, paroxysmal = sudden

- Escape rhythm < Accerlerated junctional rhythm < Tachycardia

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10
Q

Atrial Flutter

A
  • 250- 300 bpm
  • NO P- wave (f instead)
  • Sawtoothed pattern (lead II, III)
  • Common: 2:1 AV- block

2:1, 3:1, 4:1 block

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11
Q

Ventricular Flutter

A

> 200 bpm

  • High amplitude sine wave- like pattern
  • No P, QRS or T- waves
  • F for f- waves
  • No effecive ventricular activity
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12
Q

Atrial Fibrillation

A
  • 350- 600 bpm.
  • baseline appears flat
  • NO TRUE P- waves
  • irregular appearance of QRS in abs. of P- waves
  • “wavelike” fronts
  • irregular
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13
Q

Ventricular Fibrillation

A
  • 120- 200 bpm.
  • Fusion beats
  • irregular
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14
Q

Wolf- Pakinson- White (WPW)

A
  • Delta wave
  • Short PR
  • Widening of QRS due to delta wave
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15
Q

Lown- Ganong- Levine Syndrome (LGL)

A
  • PR < 0,12s
  • T- wave inversion
  • no delta wave
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16
Q

RBBB

A
  • wide QRS > 0,12s.
  • V1,2: M cmpl. or notched R (RSR’)
  • I, aVL, V6: wide, deep S
    (ST depression and T- wave inversion might be seen)
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17
Q

LBBB

A
  • wide QRS > 0,12s.
  • I, aVL, V5, V6: slurred or notched R
  • V1: wide, deep S
  • lack of Q in V5 or V6
  • rS or QS in V1-V4
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18
Q

Hyperacute MI

A
  • NO Q
  • ST- elevation –> “T- en dome” =ST- elevation merged with tall peaked T
  • Increased T by amplitude and width (tall peaked T- waves)
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19
Q

Acute MI

A
  • ST- elevation accompanied by T- inversion (symmetrical)
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20
Q

Subacute MI

A
  • no ST
  • path. Q
  • Inverted deep T (coronary T).
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21
Q

Chronic/ Definitive/ Old MI

A
  • Inverted/ upright T or nearly isoelectric

- deep path. Q

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22
Q

LAH

A
  • Left deviation > -30*
  • Normal QRS
  • No ST or T changes
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23
Q

LPH

A
  • Right deviation
  • Normal QRS
  • No ST or T changes
  • Tall R in inferior leads
  • Deep S in lateral leads
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24
Q

Bifasicular block

A

RBBB + LAH: QRS > 0,12s.
or
RBBB + LPH: QRS > 0,12s.

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25
Q

1st degree AV- BLOCK

A

PR > 0,12S.
All beats are conducted
RHYTHMIC

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26
Q

2nd degree AV- BLOCK

Mobitz type I

A
  • Progressive prolongation of PR until one QRS is missed (usually 3rd or 4th)
  • RR gets shorter
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27
Q

2nd degree AV- BLOCK

Mobitz type II

A
  • PR constant
  • QRS is dropped without PR prolongation
    (after one P, no QRS)
  • RR constant
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28
Q

2nd degree AV- BLOCK

2:1

A

Every other P gets conducted (QRS dropped).

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29
Q

3rd degree AV- BLOCK

A

Complete block.
- No P get conducted
(P- waves marching across rhythm strip, no relation to QRS).

30
Q

HIGH DEGREE AV- BLOCK

A

Consecutive P get blocked. Conduction sometimes. (Escape rhythm may start).

31
Q

P- mitrale

A

Wide P- wave

32
Q

P- pulmonale

A

Tall P- wave

33
Q

Salve

A

Accerelation, but doesn’t last longer than 3 beats.

>3 beats = Tachycardia

34
Q

Hyperkalemia

A
  • tented T
  • flat or missing P
  • shorter QT
  • atrial fibrillation
  • PR prolongation
  • QRS widening (may merge with T- wave)
35
Q

Hypokalemia

A
  • flat T
  • ST- depression
  • Long ST > 0,45s.
  • arrhythmia or bradycardia
36
Q

Hypercalcemia

A

Shortened QT

37
Q

Hypocalcemia

A

Prologned QT

38
Q

Subendocardial lesion

A
  • TP, PR elevated

- ST depressed

39
Q

Subepicardial/ Transmural lesion

A
  • TP, PR depressed
  • ST- elevated
  • Coronary T- wave
40
Q

Larger/ Transmural infarct

A
  • path. Q
41
Q

Smaller/ Subendocardial infarct

A
  • path. Q

- R- reduction (unusually short R).

42
Q

Anterior lead

A

V1-4

43
Q

Inferior lead

A

II, III, aVF

44
Q

Left lateral

A

I, aVL, V5-6

45
Q

Right leads

A

avR, V1

46
Q

Inferior infarction

A

II, III, aVF

47
Q

Lateral infarction

A

I, aVL, V5-6

48
Q

Anterior infarction

A

V1-6

  • tall R
  • ST- depression
  • R > S
49
Q

Posterior infarction

A

reciprocal changes in V1 (ST depression, tall R)

Mirror images of ant. infarc.

50
Q

Ant. lateral infarction

A

I, aVL + most of/ all V1-6

51
Q

Junctional escape beat

A
  • after sinus arrest. NO P (may be retrograde before, after or during QRS)
52
Q

Paroxysmal Supraventricular Tachycardia (PSVT)

A
  • sudden onset, usually initiated by premature beat. Sudden termination.
  • regular rhythm
  • retrograde P may be seen in II, III
  • V1: pseudo R’
  • 150- 250 bpm
53
Q

Multifocal Atrial Tachycardia (MAT)

A
  • irregular rhythm
  • there is a P- wave before each QRS
  • 3 p- wave morphologies
  • 100- 200 bpm.
54
Q

Accelerated Idioventricular rhythm

A

…sometimes seen during acute infarct

  • 50- 100 bpm.
  • ventricular escape
  • No P
  • QRS is wide
  • HR approx. 75 bpm.
55
Q

Torsade de Pointes

A
  • prologned QT
  • QRS spiral around the baseline, changing axis and amplitude

Onset of TdP VT typically preceded by RR intervals: short (caused by extrasystole) - long (compensatory pause) - short

56
Q

Atrial Pacemaker

A

Spike followed by a P and normal QRS.

57
Q

Ventricular Pacemaker

A

Spike followed by wide QRS.

Abs. of P or retrograde P may be seen.

58
Q

No- Q- wave infarction

A
  • No Q
  • T- wave inversion
  • ST- depression
59
Q

Apical Ballooning Syndrome

A
  • T- inversion

- ST- elevation

60
Q

Angina

A
  • ST- depression

- T- inversion

61
Q

AV- nodal reentrant tachycardia (AVNRT)

A
  • Paroxysmal
  • Regular tachycardia 140- 280 bpm
  • QRS usually narrow
  • ST depression may be seen
  • P -wave if visible exhibitd rretrograde inversion with P- wave inversion in II, III, aVF
  • P may be buried in the QRS, visible after QRS. Rarely visible before QRS.
62
Q

Sick Sinus Syndrome

A

Multiple ECG abn. may be seen:

  • sinus bradycardia
  • sinus arrhythmia
  • sinus arrest > 3s.
  • atrial fibrillation with slow ventricular response
  • bradycardia- tachycardia syndrome:
  • -> alt. bradycardia with paroxysmal tachycardia often supraventricular.
63
Q

Atrioventricular Reentry Tachycardia (AVRT): ORTHODROMIC CONDUCTION

A
  • 200- 300 bpm
  • P buried in QRS or retrograde
  • QRS < 0,12s.
  • T- wave inversion
  • ST- segment depression
64
Q

Atrioventricular Reentry Tachycardia (AVRT): ANTIDROMIC CONDUCTION

A
  • 200- 300 bpm

- wide QRS

65
Q

Right atrial hypertrophy

P- pulmonale

A
  • increased amplitude of first portion of P
  • no change in duration of P-wave (0,1 s.)
  • possible right deviation of P- wave

Tallest P seen in aVF and II

66
Q

Left atrial hypertrophy

P- mitrale

A
  • increased amplitude of terminal portion of P- wave
  • increased P- wave duration
  • no significant axis deviation
  • should drop > 1mm in V1

In lead II notched P

67
Q

Right ventricular hypertrophy

A
  • right axis deviation, greater than 100*

- ratio R- wave amplitude to S- wave is >1 in V1, and <1 in V6

68
Q

Left ventricular hypertrophy

A
  • R amplitude in V5 or V6 + amplitude of S in V1 or V2 >35mm
  • R in V5 >26mm
  • R in V6 >18mm
  • R wave in V6 exceeds R- wave in V5

In limb leads:

  • R wave in aVL >11mm
  • R in aVF >20mm
  • R in I >13mm
  • R in I + S in III >25mm
69
Q

Difference AV- BLOCK/ SA- BLOCK

A

AV- BLOCK: - no. P
- no QRS

SA- BLOCK: no P

70
Q

Long QT syndrome (LQTS) type II

A
  • prolonged QT (normal QT <0,44s)
    Longest QT usually found in II, V5 or V6
  • prominent U, might merge with T
71
Q

Long QT syndrome (LQTS) type I

A
  • prolongation of QT interval is caused by large T- waves with broad base
72
Q

Brugada sign

A

Coved > 2 mm, descending ST- elevation, followed by a negative T in at least two leads out of V1, V2 and V3.

Pathophysiology ECG (1 decks)

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