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Cardiac STP Interview > ECG > Flashcards

ECG Flashcards

1
Q

Normal HR for sinus rhythm

A

60-100bpm

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2
Q

P wave axis for sinus rhythm

A

Upright in leads 1 and 2 and inverted in aVR

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3
Q

QRS complex length for sinus rhythm

A

<100ms

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4
Q

Normal PR interval

A

120-200ms and constant

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5
Q

How does the QT interval vary with HR

A

Inversely proportional

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6
Q

Main ECG change on STEMI

A

ST elevation

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7
Q

Anterior STEMI ECG

A

Precordial leads V1-6 ST elevation
Reciprocal ST depression in inferior leads 3 and aVF

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8
Q

Lateral STEMI ECG

A

ST elevation in leads 1 aVL and V5-6
Reciprocal ST depression in inferior leads 3 and aVF

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9
Q

High lateral STEMI ECG

A

ST elevation localised to leads 1 and aVL

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10
Q

Inferior STEMI ECG

A

ST elevation in leads 2 3 and aVF
Reciprocal ST depression in aVL
Progressive development of Q waves in 2 3 aVF

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11
Q

ECG NSTEMI findings

A

Regional ST depression
T wave inversion or flattening
Dynamic or new Q or T wave changes

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12
Q

Define atrial fibrillation

A

Dysrhythmia characterised by disorganised atrial activity and contraction resulting in an irregularly irregular ventricular response

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13
Q

Key ECG features of AF (5)

A
  • no p wave
  • irregularly irregular rhythm
  • no isoelectric baseline
  • variable ventricular rate
  • QRS<120 ms (unless existing BBB or accessory pathway)
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14
Q

ECG features of complete heart block

A

Severe bradycardia due to no AV conduction
Complete AV dissociation - independent atrial and ventricular rates

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15
Q

What is left bundle branch block?

A

Conduction delay which means impulses travel first via RBBB to RV and then to LV via the septum (r to l instead of l to r). This reverses septal activation so Q waves eliminated

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16
Q

Normal conduction through bundle branches

A

Impulses travel equally through R and L bundles, septum activated from left to right and formation of small Q waves in lateral leads

17
Q

ECG findings for LBBB (4)

A
  • Broad monophasic R waves in lateral leads (1, aVL, V5-6)
  • deep S waves in right precordial leads (V1-3)
  • QRS> 120ms
  • No Q waves in lateral leads
18
Q

What is right bundle branch block?

A

Delayed activation of right ventricle causing a secondary R wave

19
Q

ECG findings in RBBB (3)

A
  • QRS> 120 ms
  • RSR’ pattern in V1-3
  • wide slurred S wave in lateral leads (1, aVL, V5-6)
20
Q

What is ventricular fibrillation

A
  • shockable arrest rhythm
    Ventricles attempt to contract at rates of up to 500bpm, rapid and irregular activity results in loss of cardiac output
    Prolonged VF results in asystole
21
Q

ECG findings in VF (4)

A
  • chaotic irregular deflections of varying amplitude
  • no identifiable P waves, QRS complexes or T waves
  • rate 150-500bpm
  • amplitude decreases with duration
22
Q

ECG findings in VT ( 5)

A
  • regular, broad complex tachycardia
  • uniform QRS complexes in each lead
    MAY
  • very broad complexes (>160ms)
  • AV dissociation
  • extreme axis deviation
23
Q

What is sinus arrhythmia?

A

Normal phenomenon commonly seen in young healthy people. HR varies due to change in vagal tone during respiratory cycle

24
Q

ECG findings in sinus arrhythmia

A
  • variation in P-P interval of more than 120ms
  • P-P interval gradually lengthens and shortens in cyclical fashion
  • normal P waves
  • constant PR interval
25
Q

Sinus bradycardia

A

HR<60bpm

26
Q

Sinus tachycardia

A

HR >100bpm

27
Q

Atrial flutter vs atrial fibrillation

A

AFib is irregular atrial contraction, atrial flutter is regular atrial activity but more often than ventricles

28
Q

Atrial flutter ecg findings (5)

A

-Narrow complex tachycardia
- atrial activity ~300bpm
- loss of isoelectric baseline
- sawtooth inverted waves in 2,3, aVF
- upright in V1 may resemble P waves

29
Q

Atrial ectopics ECG findings

A
  • abnormal p wave followed by normal QRS
  • may not be conducted
30
Q

First degree AV Block ecg

A

PR>200ms

31
Q

2nd degree AV block (mobitz 1, wenckebach)

A

Progressive prolonging of PR until p wave is dropped

32
Q

What is SVT?

A

Any tachydysrhythmia originating above the bundle of his.
Includes regular atrial, irregular atrial and regular AV tachycardia

33
Q

Atrioventricular re entry tachycardia

A

Form of SVT arising in patients with accessory pathways. Can be orthodromic (through av then accessory) or antidromic (through accessory then AV)

34
Q

AVRT vs AVNRT

A

avrt has an anatomical reentry circuit, in avnrt there is a functional reentry within AV node

Cardiac STP Interview (2 decks)

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