ECG Flashcards
2 instances where ST segment may be raised
Acute myocardial infarction
Pericarditis uniformly all leads
2 instances where ST segment may be depressed
Ischaemia
Digoxin
List characteristics observed in an ECG of a pt. on digoxin
Downward sloping ST segments
‘Reverse tick’
Inverse t waves
What do deep q waves indicate?
Myocardial infarction if Q wave > 1mm across 2mm deep.
Q wave does not indicate age of infarction
3 things inverted T waves are associated with:
Bundle branch Block
Ischaemia
Ventricular hypertrophy
3 characteristics of PE ECG
MOST commonly: normal ECG sinus tachy
Right axis deviation
Inverted t waves V2 V3
Possibly right ventricular hypertrophy
Low electrical voltage electrical alterans.
Cardiac tamponade
Tall R wave V1
Tall S wave V5/6
Right ventricular hypertrophy
What is observed L Atrial hypertrophy ?
Biphasic P waves in V1
What is observed in right atrial hypertrophy/ strain?
Peaked T waves (>2.5mm) leads II, V1
What are some causes of right atrial overload ?
Pulmonary hypertension
Right heart failure
4 causes of right heart strain that can lead to R BBB
Pulmonary hypertension
Pulmonary emboli
Chronic lung disease
Mitral valve pathology
4 potential causes of LBBB
Ischemic heart disease
Hypertension
Aortic stenosis
Cardiomyopathy
2 points on Type 1 Second-degree heart block
- Wenkebach phenomenon
- gradual prolongation of PR interval until one P wave is not conducted to ventricles
- association with inferior myocardial infractions
2 points on Type 2 Second-degree heart block
- normal sinus rate
- more P waves than QRS complexes
PR interval remains constant ! - block is 2:1, 3:1 or more
- associated with anterior myocardial infarcts
Patients with HOCM (2)
Non specific ECG features may be seen
Evidence of left ventricular hypertrophy
Widespread broad Q waves
In the cardiac axis, what angles constitute as being positive?
Angles -30 to 90 are positive
Dagger q waves
Hypertrophic obstructive cardiomyopathy
Right axis deviation
RBBB
S1Q2T3
Sinus tachy.
Pulmonary embolism
Causes of inverse T waves
Ischemia Bundle branch block Ventricular hypertrophy Digoxin Normal in Iii, VR and V1 and aVL
What is Wolf-Parkinson White and what are the signs
Form of AVRT (atrioventricular reciprocal tachycardia), whereby alternative conducting pathway Bundle of Kent allows for antidromic or orthodontic types of WPW.
Short PR interval
Slurred upstroke- delta wave
First degree heart block
Long PR interval, >0.20 sec or >5small squares
Second degree type 1 heart block
Wenkebach phenomenon
PR interval extending in length, eventually culminating in a dropped beat
Second degree type 2 heart block
PR interval normal, fixed ratio of dropped beat.
(Requires pacing) indicates problem with septal conducting fibres
Third degree heart block
Complete disassociation between p waves and q waves
Supra ventricular tachycardia vs junctional tachycardia
No p waves , continual fast depolarisation through AV node
4ddx for STEMI
STEMI
Lv hypertrophy
Ventricular Aneurysm
Benign early polarisation
Criteria for LVh
7 big squares
SVT
ST depression in lateral leads effect of going fast
Young females
Treat with adenosine
Torsades
Long qt syndrome
Wenkebach - what sort of people get it?
High vagal turn over in young people at night time
Very fit
Signs of hyper kalaemia
Peaked T waves
Sine waves
Broad QRS
Eventually ventricular tachycardia
