ECG Flashcards

1
Q

ECG Paper

A

1 x large box, 5mm x 5mm = 0.2 seconds

1 x small box, 1mm = 0.04 seconds

Speed = 25mm/sec

5 x large boxes = 1 second

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2
Q

Cath lab criteria

A

Chest pain/tightness lasting more than 20 mins & within last 9 hours

AND

ECG showing 2mm (male) or 1.5mm (female) in anterior leads (V2&3)

OR

1mm in any 2 contiguous leads showing same view of heart

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3
Q

Not cath lab

A

Seizures that cannot be managed

Compromised airway that cannot be managed

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4
Q

STEMI with ROSC post arrest

A
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5
Q

Posterior STEMI

A

Back of the heart

MI symptoms & ST depression in V1-V3

V4, V5, V6 moved to patient’s back beneath scapula

STE in leads V4, 5, 6 (7, 8, 9)

0.5mm of STE = significant

Reciprocal ST depression in V1-3

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6
Q

Right ventricular MI

A

Acute inferior MI

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7
Q

ECG/MI - when not to give GTN

A

Inferior MI

RV involvement

Preload

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8
Q

ECG - V4R

A

V4 to same spot on right side

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9
Q

ECG - hyper/hypokalemia

A

Hypokalaemia - scooped shape in ST depression
Hyperkalaemia - tall and peaked T waves; wide and bizarre QRS

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10
Q

ECG - PR interval

A

3 - 5 small boxes

0.12 - 0.20 seconds

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11
Q

ECG - QRS interval

A

1.5 - 3 small boxes

0.08 - 0.12 seconds

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12
Q

ECG - QT prolongation

A

Normal -

0.34 - 0.46 in women

0.34 - 0.44 in men

If T wave finished before midpoint between R-R interval QT is normal

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13
Q

Broad Complex Tachycardia

A

VT or SVT with a conduction delay
Rapid HR
Broad QRS (>3 small boxes)
Regular rhythm

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14
Q

Severe hyperkalaemia

A

Tall, peaked T waves
Wide and bizarre QRS complexes

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15
Q

PVCs

A

Occasional broad complex generated by ventricles
Quad/tri/bi = PVC every 4/3/2 beats consistently
Ventricular couplets - 2 in a row
Non sustained VT - 3 or more vent beats >100bpm, lasting less than 30 seconds

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16
Q

Paced Rhythm

A

Broad QRS complex with pacing spikes or arrows
Mimic diagnostic criteria of LBBB

17
Q

Wolff-Parkinson White

A

Tall R & inverted T in V1 - V3
Sinus with short PR
Slurred upstroke causing broad QRS
Additional electrical pathway between atria and ventricles causing additional impulses to trigger abnormal conduction

18
Q

Left Bundle

19
Q

Right Bundle

20
Q

First degree heart block

21
Q

Second degree heart block type 1

22
Q

Second degree heart block type 2

23
Q

Complete heart block

24
Q

Silent/atypical MI criteria

25
Anterior leads
26
Inferior leads
27
Septal leads
28
Paced rhythm/MI
29
ECG NINE POINTS
Rate? A = V? Reg? P wave appearance? Uniform? P before each QRS? QRS after each P? PR & QTc intervals normal & consistent? QRS narrow or broad? ST segment normal? Where’s the pacemaker?
30
ECG NINE POINT +
Review each lead systematically P waves upright in I II and V2-V6? No Q waves >0.4 wide in same leads QRS & T same general direction in LL ST segment start isoelectrically except in V1&V2 where it might be slightly elevated T wave normally upright in I II & V3-V6 R wave progression in chest leads
31
Modified Sgarbossa in LBBB