ECG Flashcards
what is ventricular trigenemy
premature contraction every 3rd beat
how to recognise hypercalcalcaemia on an ecg
short QT interval
how to recognise hypocalcaemia
prolonged QT interval
what are symptoms of hypocalcaemia
facial twitching, pins and needles and fatigue
what are symptoms of hypercalcaemia
fatigue, thirst, increase urine output, muscle weakness
what is hypocalcaemia
low calcium
what is hyperecalcaemia
high calcium
how to spot hyperkalemia
t waves to become tall and peaked
how to spot hypokalaemia
low and flat t waves and u waves
what are the symptoms of abnormal potassium
muscle weakness
cramps
chest pain
palpatations
what is low potassium
hypoklemia
what is high potassium
hyperkalemia
how to get a posterior view
move v4, v5, v6 to the back
they become v7, v8, v9
what is the anterior leads
front of the heart
what are the posterior view
view of the back
what are the lateral leads
leads 1 , All, v5, v6
what are the anterior leads
v1, v2, v3, v4
what are the inferior leads
leads 2, 3 and AVF
when should you worry about st depression or elevation
when it happens in 2 or more leads
what are the causes of a semi
t wave inversion
st depression
st elevation
what is a semi
blocked artery in heart stops oxygen blood passing causing tissue death
how many mm is a small square
1mm
what is st depression
st segment falling low of the isometric line
what is the St segment
end of the S wave and start of the t wave
what is premature atrial contraction
abnormaly shaped p waves occurs
what is no substance ventricular trachycardia
3 or more in a row of premature contractions
what is ventricular couplets
premature contraction 2 in a row
what is ventricular bigeminey
premature contraction every other beat
what is ventricular trigenemy
premature contraction every 3rd beat
what is ventricular quadrigeminy
premature contractions every 4th beat
what are the symptoms of premature contraction
palpitation
chest pain
dizzness
shortness of breath
what is a premature contraction
occasional out of place complex on an ecg
what is the common symptoms of super ventricular tachycardia
palpatations shortness of breath dizziness chest pain (comes on suddenly)
what is supper ventricular tachycardia
narrow complex
regular rhythm
no visible P waves
above 100bpm (usually 150-250bpm)
what is the usual rate of sinus tachycardia
100-150bpm
what are the causes of sinus tachycardia
sepsis
pain
anxiety
what is browed complex tachycardia
QRS wider than 0.12 (3 small squares)
what is narrow complex tachycardia
QRS complex less than 0.125 (3 squares)
what Is atrial flutter
flutter waves happen in-between QRS complex
what is atrial fibrillation
irregularly, irregual rhythm
what is a lower junctional rhythm
p waves after ORS complex
impulses in AV node down to ventricles (creating QRS complex) up to atria creating P waves
How to identify mid junctional rhythm
impulses created in AV node into atria and ventricles at the same time
making no p waves
how to identify junctional rhythm
p waves negative in lead 1 and 2 and positive AVR
what is junctional rhythm
abnormal p waves on ECG
how to identify extreme axis deviation
negative in all lead 1,2 AVF
how to identify right axis deterioration
positive lead 2, AVF
negative in lead 1
(right is for reaching)
how to identify left axis deviation
postive p wave in lead one
and
negative p waves in lead 2 and AVF
(left is for leaving)
how to identify normal cardiac axis
all qrs are positive in lead 1, 2 and avf
how to identify right atrial enlargement
p waves over 2.5 small squares
how to identify left atrial enlargement
p waves longer than 3 small squares
what does a normal p wave look like
no longer than 3 small squares and no taller than 2.5 small squares
how tall is 2 large squares
1mv
how tall is one big square
0.5mv
how tall is one small square
0.1 mv
how to identify left ventricular hypertrophy
calculate ballers s wave in v1 and v2
caculate tallest r in v5 and v6
add together if over 3.5
what leads do we look in for left ventricular hypertrophy
v1 and v2
v5 and v6
what leads do you look in for right ventricular hypertrophy
v1 and v5
how can you identify right ventricular hypertrophy
r waves taller than 1 large box in v1
and
taller than 5 waves deep
and in v5 S waves is deeper than 1 box
how can you identify a third degree heart block on an ecg
regular p waves and regular QRS but no regular pattern
beats are often around 40bpm (due to only ventricles pumping blood around the body)
explain the pathophysiology of a third degree heart block (complete block)
their is a complete block at or bellow the AV node which prevents an impulse passing though the ventricles this leads to the ventricles being forced to create their own impulse to pump blood around the body
atria and ventricles beating independently
explain the pathophysiology of a 2nd degree AV block type two
Av node working fine till a sudden block stops the ventricles to contract
explain the pathophysiology of a 2nd degree Av block type one
the av node takes longer and longer to transmit signals till a complex block occurs
explain the pathophysiology of a first degree AV block
the signals are able to pass through the AV node on a regular basis but slightly delayed on conduction which leads to a longer PR interval
how can you recognise a first degree AV block
longer than 5 squares and always the same distant from the QRS complex
what part of the hearts blocked in a first degree Av block
partial block on the area of the AV node
what is affected in a heart block
its affects the PR interval
what is the PR interval
the distance between the start of the p wave and the start of the QRS complex
how many MM and seconds is a large box
5mm
0.20 seconds
how many MM and seconds is a small box
1mm
o.o4 seconds
how long should a QT interval be
0.35- 0.46
9-12 small boxes
what is the QT inteval
distance from start q wave to the end of the T waves
what is the normal length of the QRS interval
- 06- 0.12 seconds
1. 5- 3 small boxes
what is the qrs interval
distance between start of the Q wave to the end of the S wave
how long should a PR interval be
0.12- 0.20 seconds
3-5 small boxes
what is it called when the QRS complex consists of one large downwards deflection its known as a QR wave
what is the secondary r wave called
R primary
what is the second downwards deflection after the R wave known as
S wave
what is the first upwards deflection called
R wave
what is the first downwards deflection known as
Q waves
how to identify sinus rhythm
P waves before every QRS complex
are the P waves in lead 2 up right and P waves in AVR facing downwards
are the QRS complex equal distance (count the large boxes)
is their a QRS after every P wave
where should the t waves be inverted
AVR and V 1
what is the T wave
represents ventricle reset period
what is the QRS complex
impulses traveling down into the ventricles and through purkunji fibres
what is the P wave
atrium filling with blood and the SA node firing contractions
where does the electrical impulse travel after the Ev node
through the bundle of his and both bundle branches then return to the SV node by the purkunji fibres
what is the role of the SA node
initiating an electrical impulse that travels down the Av node
what does the p- wave represent
(atrial depolarisation) atria contracting
what does the QRS complex represent
formed when the impulses passes through the ventricles ( ventricles contracting)
what does the PR interval represent
the time it takes for the impulses to travel from the atria to the ventricles
where is the Pr interval
distance from the start of the p wave to the start of the Qrs complex
what is the QT interval
the time between the start of the Q wave to the end of the T wave
what is the T wave
represents repolarisation of the ventricles ( when it relaxes)
what happens when the t wave returns back to the isoelectric line
cardiac impulses have caused the heart to contract and relax again
what is the best lead to get the best view of the heart
lead 2
what can you identify through measuring the R waves
if the rhythm is regular by comparing the distance between the R waves
how do you work out if the heart rate is regular
count the number of large squares between the R wave the dived it by 300
for example 300/4 is 75 bpm
how to measure the heart rate if the rhythm is irregular
count the number of large squares over a 10 second strip ( 1 second- 5 big squares)
now multiply this by 6
what is the first step to reading an ECG
assessing the rhythm
what is the second step to reading an ECG
assessing the rate
what is step three of reading an ECG
are all the waves poinint up in lead 1 and 2 and negative in AVR
what is the fourth step of reading an ECG
making sure the PR interval is between 3-5 small squares
what is the five step of reading a ECG
make sure their are no pathological Q waves
what do Q waves indicate
current or previous heart attacks
when are the Q waves considered pathological
wider than 1mm
deeper than 2mm
25% of the QRS complex
what is the six step of reading a ECG
seeing if the QRS complex is less than 3 small squares
if the QRS complex is wider than 3 small squares , what does it indicate
bundle branch block
what is the seventh step of reading a ECG
asses the R and S waves in the chest leads
what is the eighth step of reading a ECG
is the ST segment start on the isoelectric line
what is the 9th step of reading a ECG
are their any t wave abnormalities
what leads should the T waves be upright
lead 1, 2 and V2-V6
what is the last step to reading a ECG
is the QT interval normal
what is a normal QT interval
0.350- 0.436
