ECG 2- Abnormalities Flashcards
ECG: ST elevation.
MI
ECG: Wavy baseline, no p waves, narrow QRS complexes.
Atrial fibrillation
What do pathological Q waves indicate?
Necrotic tissue
What is the difference between ST elevation and ST depression
Elevation: injury
Depression: ischaemia
What would be seen with hyperkalaemia?
A bit raised: High T wave. Prolonged PR interval. ST depression
Raised higher: P wave absent, atrial standstill
Very high, ventricular fibrillation
What would you see in atrial fib?
ECG: Wavy baseline, no p waves, narrow QRS complexes.
ECG: Normal apart from pathological Q wave
Has had MI in the past
ECG: Abnormal chaotic baseline. No QRS
Ventricvular fibrillation
Give 7 questions you would ask when viewing an ecg
Heart rate?
Regular or irregular
Broad or narrow QRS (Broad would suggest impulse is orginating in the ventricle)
P waves present?
What are the P waves like?
Relationship of P waves to QRS? (Heart block)
ST segment
ECG: High T wave. ST depression.
Hyperkalaemia
ECG: Prolonged PR interval. Otherwise normal
First degree heart block
ECG: ST depression
Ischaemia
When will you see ST elevation?
When the muscle injury extends the full thickness from endo to epicardium
Describe third degree heart block
AV node nnot conducting the atrial signal through to the ventricles. Ventricular escape rhythm takes over
What would be seen in hypokalaemia?
Low T wave
The presence of a U wave after the T wave
If very low, some ST depression
What is first degree heart block?
Prolonged PR interval due to slow conduction of AV to His bundle
Danger of mobitx type 2?
Likely to progress to third degree heart block
Two causes of heart block?
MI
Degenerative disease
define ventricular tachycardia
run of 3 or more ectopic beats
What two factors make a Q wave pathological?
> 1 square wide
>2 squares deep (Small)
Describe what you would do if you get a patient in VF
CPR
Defibrillation
ECG: Low T wave. A wave present after the T wave
Kypokalaemia
Describe the ecg of third degree heart block
ECG: P waves not associated with QRS complex. Heart rate slow (30-40). wide QRS complex
Describe what you will see over time with STEMI
Acute: ST elevation
Hours: ST elevation, decreased R wave, Beginning of a Q wave
Days: The above. Inverted T wave.
Weeks: Pathological Q wave. Rest normalises
How is a ventricular ectopic beat different to the escape rhythm?
Escape rhythm regular
Ventricular ectopic beat random and just find opportunistic moment
What is atrial fibrillation?
Multiple foci with chaotic impulses
ECG: Progressively lengthening PR interval. Sudden QRS complex dropped. resets.
Second degree heart block, mobitz type 1 (WEnchebach)
ECG: Every couple of QRS complexes, one is missed. Otherwise normal
Second degree heart block, mobitz type 2
ECG: P waves not associated with QRS complex. Heart rate slow (30-40). wide QRS complex
third degree heart block
Describe the ecg of a ventricular ectopic beat
ECG: Random, wide QRS complex. Otherwise normal. Proceeded by normal sinus rhythm
What would you see with Second degree heart block, mobitz type 1 (WEnchebach)
ECG: Progressively lengthening PR interval. Sudden QRS complex dropped. resets.
ECG: Random, wide QRS complex. Otherwise normal. Proceeded by normal sinus rhythm
Ventricular ectopic beat
