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FFP chest pain and palpitations > ECG > Flashcards

ECG Flashcards

1
Q

What does P wave represent

A

Atrial depolarisation (contraction)

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2
Q

Normal parameters of P wave

A

3 small squares duration
2.5 small squares high
Upright in leads I, AvF, V3-V6

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3
Q

What does PR segment represent and how high should it be

A

Delay at AV node

Should be 0. Should be on baseline

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4
Q

PR interval represent?

what Duration normal?

A

Atrial depolarisation and delay at AV node

3-5 small squares

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5
Q

What does qrs complex represent

A

Ventricular depolarisation

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6
Q

What is the R wave

A

always the first positive deflection

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7
Q

what is the q wave

A

Any negative wave before the R wave

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8
Q

What is the S wave

A

Any negative wave that follows the R wave

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9
Q

What is the R’ wave

A

Any subsequent positive wave that follows the R wave

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10
Q

What does the QT interval represent

A

Whole ventricular action potential

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11
Q

Normal duration of QT interval

A

males 2 big squares

Females 11 small or 2 big 1 small

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12
Q

ST segment represent?

What elevation is normal

A

plateau phase of ventricular action potential

up to 2mm normal on chest leads

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13
Q

T wave represent?

A

Ventricular repolatisation

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14
Q

How to assess rate

A

Count the number of large squares between two peaks of R waves.

Divide 300 by this number

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15
Q

How to assess rate when there are irregular rhythms

A

Count the number of QRS complexes on the entire rhythm strip and multiply this number by 6

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16
Q

How to assess rhythm

A

Mark the R waves with a piece of paper and move this along the ECG to see if all the waves match up

17
Q

What would cause a regular irregular rhythm

A

2nd degree heart block

18
Q

What would cause an irregularly irregular rhythm

A

AF

19
Q

What is cardiac axis

A

The overall direction of electrical spread in the heart when the ventricles contract

20
Q

What is the normal direction of the cardiac axis

When can this axis be deviated

A

-30° ￫ 90°

Axis is deviated if electrical activity is stronger on one side - e.g. in Left Ventricular Hypertrophy

21
Q

what condition could P waves be absent

A

AF

22
Q

IN a normal axis, what will the QRS complexes look like in lead 1 and aVF

A

Both point up

23
Q

In a left axis deviation, what will the QRS complexes look like in lead 1 and aVF

A

LEad 1 the QRS will point up

aVF QRS will point down

24
Q

In a r axis deviation, what will the QRS complexes look like in lead 1 and aVF

A

Lead 1 the QRS will point down

aVF the QrS will point up

25
Q

In extreme axis, what will the QRS look like

A

Both point down

26
Q

What to assess in P waves

A

is each P wave followed by a QrS complex

Is each QRS complex preceded by a P wave

Do P wave look normal

27
Q

What conditions cause prolongation of PR interval

A

certain heart blocks (1st degree, 2nd degree Mobitz type 1)

28
Q

What does a shorted PR interval indicate

A

Pre-excitation syndromes

29
Q

What can cause a broad QRS

A

(i) Abnormal depolarisation (e.g. bundle branch blocks, ventricular ectopic beats)
(ii) Pre-excitation (accessory pathways)

30
Q

Where is the ST segment supposed to be

A

On isoelectric line

31
Q

How elevated must ST segment be to be considered abnormal

A

by at ;east 1mm in limb leads
2mm in chest leads

AND

they must occur in 2+ adjacent leads e.g. leads v1,v2,v3
or leads 2, aVF and III

32
Q

What does elevated ST segment indicate

A

ST Elevation of >1mm (limb leads)/>2mm (chest leads) in adjacent leads indicates ST Elevation Myocardial Infarction (STEMI)

33
Q

What does depressed ST segment indicate

A

Ischaemia

34
Q

What does abrnoma T wave look like

What would this indicate

A

Tall and tented

Tall:
At least ½ the amplitude of the preceding QRS complex)
Tented:
Look as if they’ve been pinched from above - i.e. a pointed peak, narrow base

Hyperkalaemia

35
Q

When is T wave inversion normal

A

Lead aVR

normal variant in leads V1 and III

36
Q

What could t wave inversion indicate

A

non-specific sign for Ischaemia, Bundle Branch Blocks, Pulmonary Embolism (PE), Hypertrophic Cardiomyopathy (HCM) etc.

37
Q

What does a flattened T wave indicate

A

Non specific sign of ischaemia or electrolyte imbalance e.g. hypokalaemia

38
Q

What is there a risk of if the QT interval is prolonged

A

Life threatening arrhythmias

FFP chest pain and palpitations (6 decks)

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