ECG Flashcards
describe the angles and location of the ecg leads?
aVF - from the bottom
aVR - from right armpit - diagonal
aVL - from left armpit diagonal
I - left 0 degree flat
II - bottom left
III - bottom right
when putting on the limb leads, what sides are the + and -?
I = + on left arm, - on right arm
II = + on left leg, - on right arm
III = + on left leg, - on left arm
always + on left leg
what does 1 small square and 1 large square mean on ecg?
small = 0.04s
large = 0.2s
what should the normal size of a PR interval be?
120-200ms
3-5 little squares
what should the normal size of a QRS complex be?
shouldn’t exceed 110ms
less than 3 little squares
P wave
- positive in I and II
- negative in aVR
- <3 small squares long
- < 2.5 high
- commonly biphasic in V1
- best seen in leads II
what is a pulmonale P wave and what does it indicate?
tall pointed P wave
R atrial enlargement
what is a mitral P wave and what does it indicate?
notched / bifid Pwave
mitrale
short PR interval <120 and delta wave
WPW syndrome
long PR interval >120?
first degree heart block
what is a pathological Q wave?
> 2mm deep
1mm wide
25% amplitude of R wave
how to determine HR?
300 / n.o of large boxes between R waves
HR of tachycardia
> 100bpm
normal HR?
60-100bpm
HR of bradycardia?
<60bpm - bardycardia
sinus tachycardia
> 100bpm tachycardic
consistant RR
short PR
narrow QRS
atrial flutter
> 100bpm tachycardic
flutter (F) waves
2:1 (atrial beats 2 to every 1 ventricle)
QRS normal bc AV absorbs some of this
narrow QRS
paroxysmal supraventricular tachycardia
> 100bpm tachycardic
no P waves
narrow QRS
atrial fibrilation
variable R-R intervals
indistinct P waves with variable activity
narrow QRS
taccycardic
atrial flutter with variable block
narrow QRS
tachycardic
irregular R-R
multifocal atrial tachycardia
narrow QRS
inconsistant R-R
>3 morphologically different P waves
ventricular tachycardia
wide QRS
tachycardic
regular R-RF
ventricular fibrillation
no visible p waves
tachycardic
wide QRS
torsades de pointes
wide QRS
tachycardic
irregular
sinus bradycardia
normal P-R
long R-R
no drop in QRS
bradyc
first degree AV block
prolongues P-R >200
no drop in QRS
bradyc
2nd degree heart block mobitz 1
P-R getting progressively longer
drops a QRS complex
bradyc
2nd degree heart block mobitz 2
constant P-R
drops a QRS
bradyc
3rd degree heart block
wide QRS
lots of space between them
bradyc
right axis deviation- RBBB / RVH / LPFB
lead 1 - neg
lead avF - pos
left axis deviation - LBBB / LVH / LAFB
lead 1 - pos
aVF - neg
lead 11 - neg
(if lead 11 was pos it would be a normal reading)
extreme R axis deviation - Vtach
lead 1 - neg
avF - neg
hyperCa / hyperK
short QT
LA enlargement
lead II - bifid P
leav VI - biphasic P
RA enlargement
lead II - > 2.5 P wave
lead V1 - biphasic
LBBB
V1/V2 - very long inverted RS
V5/V6 - notches R wave
causes of LBBB
LHF
MI
LVH
RBBB
V1/V2 - biphasic equal QRS
V5/V6 - wide slurred S wave
LVH
V1/V2 - deep S wave
V5/V6 - tall R wave
RVH
V1/V2 - tall R wave
V5/V6 - deep S wave
pericarditis
PR depression
