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Heart and ECG > ECG > Flashcards

ECG Flashcards

1
Q

What ECG leads will show changes if RCA is occluded?

A

II, III, aVF

Inferior

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2
Q

What ECG leads will show changes if distal LAD is occluded?

A

V3 and V4

Anteroapical

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3
Q

What ECG leads will show changes if circumflex artery is occluded?

A

I, aVL, V5 and V6

Anterolateral

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4
Q

What ECG leads will show changes if proximal LCA is occluded?

A

I, aVL, V2-V6

Extensive anterior

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5
Q

What ECG leads will show changes if RCA (true posterior) is occluded?

A

Tall R in V1

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6
Q

How to measure heart rate from an ECG?

A

REMEMBER one BIG box = 300bpm

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7
Q

What is an atrial flutter look like? What is it?

A

It is the ectopic focus in atria

P waves right next to each other - one BIG box

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8
Q

How to diagnosis atrial fibrillation? what is it?

A

No p waves but you see small waves of atrial depolarisation

It is multiple ectopic foci - atrial rate 350-450 bpm and ventricular rate is greater than 120bpm AND high Irregular

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9
Q

How to see a bundle branch block on ECG? AND what is it?

A

It is when a signal is blocked down one or both bundle branches

See wide QRS

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10
Q

What to see in a 3rd degree heart block?

A

P waves that are not followed up straight by QRS and ventricular rate is low (around 40bpm)

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11
Q

What is the ECG axis of the chest leads normally? (look at QRS)

A

V1 and V2 - negative

V3 and V4 - Isoelectric

V5 and V6 - positive

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12
Q

What happens if there was a right ventricular hypertrophy on an ECG? what causes it?

A

Dominant R wave in V1
V5 and V6 has dominant S wave.
width of QRS is normal (unlike RBBB which is wide)

Causes: Pulmonary hypertension

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13
Q

What happens if there was a left ventricular hypertrophy on an ECG? (between -90 and -30)

A

V1 has deep S wave and st elevation

V5 and V6 has tall R wave, and st depression

[v1 (s) and v5(r) = above 35mm]

Causes: System hypertension

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14
Q

What is a normal PR interval? What does changes mean?

A

3-5 small boxes

Atrial ectopic focus (father = longer and closer = shorter)

OR long = first degree heart block

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15
Q

What causes changes in QRS complex?

A

widens if there is a ventricular ectopic focus.

intermediate
prolonged - more than 3 small boxes

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16
Q

Changes in QT interval?

A

changes depending on the rate - as rate increases QT interval decreases.

17
Q

What can cause prolonged QT interval?

A

medications: Amiodarone

Inherited - mutation of LQT1/T2/T3

Torsades de pointes

18
Q

Other than cardiac hypertrophy what else can cause QRS transition? (the positive)

A

Myocardial infarction

19
Q

what can be seen in an ECG for right atrial enlargement? what causes this?

A
  • large p wave at V1, v2, II, III and aVF

- caused by stenotic tricuspid valve

20
Q

What happens if there was a left ventricular hypertrophy on an ECG?

A
  • see two peaks in lead II. (gap of 40ms)
  • biphasic p wave in lead V1 (hill with valley next to it)

causes by stenosis of mitral valve

21
Q

When does subendocardial ischemia occur?

A

incomplete blockage in coronary artery - angina

22
Q

When is seen on an ECG for subendocardial ischemia?

A
  • ST depression (J point goes down)

affects I, II, V4 to V6

23
Q

When does sub-endocardial infarction happen?

A

complete blockage of coronary artery for more than 20 minutes resulting in necrosis.

NSTEMI

see ST depression and T inversion (deep and seen in chest leads and in two contiguous leads (right next to each other), Dominant R wave)

increased cardiac enzyme

NOTE: T wave inversion can be normal in III, aVR and V1.

BUT abnormal in V2 to V6

24
Q

What causes transmural ischemia?

A

occurs second to vasospastic angina - triggered by alcohol, cocaine or tobacco

25
Q

What ECG changes is seen with transmural infarction?

A

T wave inversion
hyper-acute - T wave (in two continguous leads)

ST elevation (STEMI) - above 1 mm or at V2/V3 above 2mm

big negtaive pathologic Q waves (1 small wide and 2 small boxes deep)

26
Q

How to see a hyperkalaemia on ecg?

A

Tall tended T waves

Heart and ECG (3 decks)

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