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ECG's > Conditions > Flashcards

Conditions Flashcards

1
Q

Why do you get a BBB?

A

Impaired electrical activity in the heart

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2
Q

What lead do you look at to identify heart block?

A

The last lead

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3
Q

What type of heart block has no association between the P wave and QRS?

A

Third degree heart block

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4
Q

How would you work out if you have a Mobits 1 or Mobits 2 Heart block? (Type 2 heart block)

A

In Mobits 1 there is a progressive delay in the P wave and QRS complex and a constant delay in type 2

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5
Q

What is a normal PR interval?

A

3-5 small boxes (60-100bpm)

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6
Q

What is meant by drop beats?

A

Some of the QRS’s are missing after the p wave

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7
Q

What is lead aVR assessing?

A

Right arm to left arm

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8
Q

A normal ECG’s QRS complex is ?

A

Narrow

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9
Q

How can you assess an irregular rhythm strip?

A

Count the amount of QRS intervals in the bottom lead and multiply by 6

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10
Q

Narrow QRS tachycardia’s either have a regulaar or irregular rhythm. What are the three types of regular rhythms?

A
  1. Sinus tachycardia
  2. Atrial flutter
  3. Supraventricular tachycardia
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11
Q

How would you treat ventriuclar tachycardia?

A

Cardioversion

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12
Q

How would you treat ventricular fibrillation?

A

Defibrillator

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13
Q

What are the three types of wide QRS tachycardia’s?

A
  1. Ventricular tachycardia
  2. Torsade de points
  3. Ventricular fibrillation
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14
Q

What is ventricular tachycardia ? What would you expect to see on ECG? (3 things)

A

An arrhythmia where the electrical activity in the ventricles undergoes rapid depolarisation. Commonly due to scarring of the ventricles.

On ECG:

  • Rapid, monomorphic regular broad QRS complex(>120ms)
  • Absent P wave
  • T waves difficult to identify
  • There will be a return to sinus rhythm
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15
Q

What is Ventricular fibrillation and what would you expect to see on ECG?

A

An irregular broad complex tachycardia.

On ECG:
- Chaotic heart rhythm

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16
Q

What is Torsades de pointe and what causes it? (7 things)

A

A Polymorphic ventricular tachycardia caused by a prolonged QT interval

Causes:

  • Congenital long QT syndrome
  • Medication
  • Hypothyroidism
  • AV block
  • MI
  • Renal/liver failure
  • Toxins
17
Q

What would you expect to see on ECG LBBB ? (5 things)

A
  • V1 a dominant S wave
  • QRS >120ms
  • Broad notched “M” shaped R wave

+

  • LAD
  • Poor R wave progression
18
Q

What would you expect to see on ECG in RBBB? (3 things)

A
  • QRS >120ms
  • RSR pattern (M shaped QRS) IN v1-v3
  • Slurred S wave in lateral leads (1,AvL, V5+V6)
19
Q

What would you expect to see on ECG in a first degree heart Block?

A
  • Slow signal from atria - ventricles (prolonged QR interval) >0.200
20
Q

What is a paroxysmal supraventricular tachycardia and what would you expect to see on ECG?

A

An abnormal erratic heart rhythm that affects the atria. It has an abrupt onset and offset

21
Q

How are ventricular tachycardias treated? (2 things if stable and 2 things if unstable ptx.)

A

If stable-
1. vagal manœuvres:

  • Valsalva: they blow into a syringe whilst laying down face up, for 15 seconds
  • Carotid sinus massage

If unstable-

  1. CPR +shock patient (Defibrillator)
  2. IV adrenaline + amiodarone after 3rd shock
    - Adrenaline should be administered every 3-5 mins after (every alternate shock)
22
Q

What broad complex tachycardia is always a pulseless rhythm?

A

Ventricular fibrillation

23
Q

What is meant by polymorphic and monomorphic?

A

Polymorphic:
The QRS varies in size

Monomorphic:
The QRS is. consistent

24
Q

What causes LBBB? (5 things)

A
  1. MI
  2. Ischaemic heart disease
  3. Hyperkalaemia
  4. Digoxin toxicity
  5. Aortic stenosis
25
Q

What causes RBBB? (5 things)

A
  1. RVH
  2. PE
  3. Ischaemic heart disease
  4. Congenital heart disease
  5. Normal variant (atypical finding)
26
Q

What would you expect to see on ECG in a second degree heart Block? (Type 1 3 points, Type 2, 4 points)

A

Mobitz 1:

  • Progressive elongation of the PR interval.
  • Dropped beats
  • Narrow QRS

Mobitz 2:

  • Irregular PR interval NO proceeding pr prolongation
  • Occasional dropped beat
  • Usually occurs following pre-existing LBBB
  • Broad QRS
27
Q

What would you expect to see on ECG in a third degree heart Block?

A

Complete heart block.
- No relationship between P waves and QRS complexes
-

28
Q

How would a type 3 heart block be treated?

What is a common cause of this?

A
  • Pacemaker

- Lyme disease

29
Q

What is this a stereotypical history of?

A 50-year-old woman with a history of rheumatic fever presents with dyspnoea. On examination she is found to be in atrial fibrillation, with a loud S1, split S2 and a diastolic murmur

A

Mitrial stenosis

  • Loud S1 and split s2, diastolic murmur
30
Q

What medication typically causes angioedema ?

A

ACEi

31
Q

What is the most common mechanism resulting in heart failure in patients with arrhythmias?

A

Systolic dysfunction.

32
Q

What is High output HF ? What causes it? (6 things)

A

Where a normal heart is unable to pump enough blood to meet the bodies demands.

Causes:

  • Pregnancy
  • Paget’s disease
  • Thyrotoxicosis
  • Anaemia
  • Arteriovenous malformation
  • Thiamine deficiency (wet ber beri)
33
Q

What would you expect to see on ECG in a patient with hypokalaemia?

A
  1. ST depression
  2. T wave inversion
  3. U waves
  4. Long QT interval
34
Q

What leads do posterior MI’s effect?

A

Leads 1,2 and 3

35
Q

What is the most reliable way to test for arterial insufficiency?

A

ABPI test (0.8 -1.3 are normal values) – outside of this and pressure stockings should be avoided

Note:
It is important to exclude arterial insufficiency before prescribing compression stockings.

36
Q

What. does contraction band necrosis indicate?

A

Recent myocardial infarction

37
Q

What is the most common cause of dilated cardiomyopathy?

A

Alcohol consumption

ECG's (4 decks)

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