Common ECG Abnormalities

Question 1

what time is 5 small squares

Answer 1

0.2s

Question 2

what amplitude is 5 small squares

Answer 2

0.5mV

Question 3

what is normal QTc

Answer 3

350-450ms

Question 4

whatis Bazzett formula

Answer 4

QT/√RR

Question 5

what makes sinus rhythm (4)

Answer 5

regular P-P interval
1:1 P:QRS interval
QT<120ms
PR<160ms

Question 6

what are segments

Answer 6

lines between waves

Question 7

what are intervals

Answer 7

wave to wave
except PR interval which is start of P to start of Q

Question 8

dodgy sinus arrhythmia

Answer 8

older people, not cyclic with breath
heart disease
digoxin toxicity

Question 9

sinus tachycardia causes

Answer 9

drugs
stress
anaemia
HF
fever/pain/sepsis
hyperthyroid
hypovolemia
hypotension

Question 10

Why might you not see a p wave in sinus tachycarida

Answer 10

yes but can be hidden in next T wave

Question 11

causes of sinus bradycardia

Answer 11

opiates
digoxin
sinus sick syndrome =SAN damage
lithium/organophosphate poisonoing

Question 12

AF on ECG

Answer 12

no p waves
irregular rhythm and shape
normal QRS
absent T waves
tachycardia

Question 13

A flutter

Answer 13

sawtooth f waves
bpm around 100

Question 14

AVNRT?

Answer 14

AV node reentrant tachycardia

Question 15

2 Key feature of Wolff Parkinson White syndrome

Answer 15

delta wave. wide QRS

Question 16

what is WPW syndrome?

Answer 16

bundles of Kent bypass AVN so ventricles depolarise prematurely

Question 17

what can WFW cause

Answer 17

AF or AVNRT

Question 18

VT features

Answer 18

> 120bpm
3 wide QRS complexes in a row

Question 19

VF

Answer 19

> 180
No P, QRS or T

Question 20

what is the cause of heart block and what is it?

Answer 20

sclerosis or fibrosis
elec signal is delayed or doesn’t get to ventricles

Question 21

1st degree heart block

Answer 21

bradycardia
1:1 ratio P:QRS interval
Prolonged PR >200ms

Question 22

Wenkebach

Answer 22

PR interval gradually increases til a QRS is missed
increased vagal tone
but can be beta blockers
hyper K+
calcium blockers
digoxin
Lyme disease
Fingolimod

Question 23

what is wenkebach also

Answer 23

mobitz type one, 2nd degree heart block

Question 24

mobitz type 2

Answer 24

some absent qrs complexes
not gradual PR prologation
dangerous
consistent PP interval

Question 25

RBBB

Answer 25

Marrow M on V1 W on V6 QRS>120ms

Question 26

LBBB

Answer 26

William W on V1 M on V6 QRS >120ms

Question 27

what leads show what bit

Answer 27

Septal V1, V2 Anterior V3, V4 Inferior, II, III, AVF Lateral, V5, V6, I, AVL

Question 28

when ST eleveation or depression

Answer 28

full thickness STEMI - elevation partial thickness NSTEMI, depression

Question 29

ST elevation in comparison to what

Answer 29

TP segment

Question 30

posterior MI which leads depression ST segment

Answer 30

V1, V2

Question 31

why would T waves be inverted in adult if not MI (2)

Answer 31

subarachnoid haemorrhage (neurological T waves) PE -> right heart strain

Question 32

T wave inversion V2-V5

Answer 32

MI

Question 33

Big U waves?

Answer 33

always pathological

Question 34

In which leads are Q waves normally absent

Answer 34

V1-V3

Question 35

morphology of pathological Q waves

Answer 35

deep >40ms or >25% depth of QRS

Question 36

Q waves on V1-V3

Answer 36

could be acute MI if also ST elevation etc or could be previous or developing MI

Question 37

normal axis range

Answer 37

-30 to 90 degrees

Question 38

where is 0 degreees on ECG

Answer 38

pointing to the right as you look at it

Question 39

what is say -60 called

Answer 39

Left axis deviation

Question 40

what is say +110 called

Answer 40

right axis deviation

Question 41

where is extreme axis deviation

Answer 41

-90 - -180 degrees

Question 42

what is baseline

Answer 42

t-p segment

Question 43

what leads to calculate axis

Answer 43

lead 1 and AVF then lead 2

Question 44

signs of PE on ecg

Answer 44

SQT deep S wave in lead 1 deep Q wave in lead 3 inverted T wave in lead 3

Question 45

Hypokalemia sign no ECG

Answer 45

massive U wave

Question 46

Hyperkalemia on ECG

Answer 46

Big, sharp pointed T waves

Question 47

sign of junctional rhythm

Answer 47

inverted P waves on lead 2 bradycardia P waves can be hidden in QRS or after QRS