ECG Flashcards

(34 cards)

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
Sinus bradycardia
HR<60bpm
26
Sinus tachycardia
HR >100bpm
27
Atrial flutter vs atrial fibrillation
AFib is irregular atrial contraction, atrial flutter is regular atrial activity but more often than ventricles
28
Atrial flutter ecg findings (5)
-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
Atrial ectopics ECG findings
- abnormal p wave followed by normal QRS - may not be conducted
30
First degree AV Block ecg
PR>200ms
31
2nd degree AV block (mobitz 1, wenckebach)
Progressive prolonging of PR until p wave is dropped
32
What is SVT?
Any tachydysrhythmia originating above the bundle of his. Includes regular atrial, irregular atrial and regular AV tachycardia
33
Atrioventricular re entry tachycardia
Form of SVT arising in patients with accessory pathways. Can be orthodromic (through av then accessory) or antidromic (through accessory then AV)
34
AVRT vs AVNRT
avrt has an anatomical reentry circuit, in avnrt there is a functional reentry within AV node