ECG

Question 1

What does axis deviation mean?

Answer 1

Same direction = hypertrophy
Opposite direction = ischemia

Question 2

What does low voltage indicate?

Answer 2

Obstruction to ECG (pericarditis)

Question 3

What are the 4 stemi mimics?

Answer 3

1) left ventricular hypertrophy
2) pericarditis
3) left bundle branch block
4) benign early repolarization

Question 4

What vessel supplies the anterior heart and what leads view it?

Answer 4

LAD
AVR, V1, V2

Question 5

What vessel supplies the high lateral heart and which leads view it?

Answer 5

LCx

AVL, lead I

Question 6

Which vessel supplies the inferior heart and which leads view it?

Answer 6

RCA

Lead II, lead III, AVF

Question 7

Which vessel supplies the lateral heart and which leads view it?

Answer 7

LAD

V3 V4

Question 8

Which vessels supply the SA and AV nodes with blood?

Answer 8

RCA and LCx

Question 9

On a 12 lead RV dysfunction can be observed by:

Answer 9

STE in II, III and aVF (inferior)
Reciprocal changes in I and v6 (high lateral)
Reciprocal changes in v2 and v3 (anterior)

Question 10

What vessel supplies blood to the right ventricle?

Answer 10

The RCA but sometimes LCx in certain populations

Question 11

How to view right ventricle with ecg

Answer 11

V4R
Place electrode in 5th intercostal space and at the right mid clavicular line

Question 12

What is standard ecg calibration?

Answer 12

1 mV 10 mm (10 boxes) tall
0.20 sec (5 boxes) wide

Question 13

Where to view atrial enlargement?

Answer 13

Lead II and v1

Question 14

LAE

Answer 14

Left atrial enlargement
Camel hump p waves in lead II (p mitral) and scoop after p wave in v1

Question 15

RAE

Answer 15

Right atrial enlargement
Increased p wave amplitude over 2.5mm in lead II (p pulmonale) and biphasic p waves in v1

Question 16

Where to view ventricular enlargement?

Answer 16

The QRS complex in v1&v2 and v5&v6

Question 17

LVH

Answer 17

Left ventricular hypertrophy
Deepest S wave in v1v2 and tellers R wave in v5v6 add up to 35+
AND / OR
R-wave in aVL 12mm or over

Question 18

RVH

Answer 18

Right ventricular hypertrophy
Harder to diagnose
Findings include:
RAD
RAE
Low voltage QRS
Strain in v1-3 or inferior leads
Tall R wave v1

Question 19

Where is t waves inversion clinically relevant?

Answer 19

Lead II, lead III and aVF

Question 20

What makes a Q wave pathological?

Answer 20

Over 1 small box wide or 1/3 deflection length of the R wave
(Sign of previous MI)

Question 21

Orthodromic AVRT

Answer 21

Antegrade conduction through atrioventicular node
(No delta wave)

Question 22

Antidromic AVRT

Answer 22

Retrograde conduction through atrioventricular node
(Delta wave often hides p wave)

Question 23

Where to assess axis deviation?

Answer 23

Lead I and aVF

Question 24

Pneumothorax

Answer 24

Gas that has entered and accumulated in the plural space causing separation of the visceral and parietal pleura

Question 25

Cystic fibrosis

Answer 25

Autosomal recessive gene disorder caused by mutations in a pair of genes in chromosome 7.
Causes excessive production and accumulation of thick mucus in the tracheobronchial tree and hyper inflation of the alveoli

Question 26

Obstructive lung disease

Answer 26

C
Bronchitis
A
Bro
E
S

Question 27

What is the R-R interval?

Answer 27

The time between 2 ventricular depolarizations.

Question 28

What is elevation of all leads indicative of?

Answer 28

Pericarditis

Question 29

Spodick signs

Answer 29

Downsloping TP segment seen as an early ECG manifestation in ~30% of patients with pericarditis, best visualised in leads II and the lateral precordial leads

Question 30

Epsilon wave

Answer 30

Small deflection (“blip” or “wiggle”) buried in the end of the QRS complex
On Standard 12-lead ECG (S-ECG), best seen in ST segment of V1 and V2, they are usually present in leads V1 through V4
Caused by post-excitation of myocytes in the right ventricle
Characteristic finding in patients with arrhythmogenic right ventricular dysplasia (ARVD)