ECG

Question 1

What does the P wave show in an ECG

Answer 1

Atrial contraction

Question 2

What does the QRS complex show in an ECG

Answer 2

Ventricular depolarisation

repolarisation of atria - but this is hidden because of the stronger QRS wave

Question 3

What does the T wave show in an ECG

Answer 3

Ventricular repolarisation

Question 4

How to identify right axis deviation in an ECG

Answer 4

Lead I is negative

Lead II is positive

Lead III is most positive

Question 5

How to identify left axis deviation in an ECG

Answer 5

Lead I is positive

Lead II is negative

Lead III is negative

Question 6

Causes of right axis deviation

Answer 6

not so important

PE

atrial septal defect

Ventricular septal defect

Question 7

What is indicated when the P wave is peaked

Answer 7

Could be hypertrophy of right atrium

Question 8

Causes of right atrium hypertrophy

Answer 8

Tricuspid valve stenosis

Pulmonary Hypertension

Question 9

What is indicated when the P wave is broad or bifid

Answer 9

Left atrial hypertrophy

Question 10

causes of Left atrial hypertrophy

Answer 10

Mitral stenosis

Question 11

When is a QRS complex abnormal

Answer 11

When it is wider than 3 small boxes (120ms)

When the S wave is greater than the R wave in V1

Question 12

When is a QRS wide

Answer 12

If there is a bundle branch block

Wolff-Parkinso -White syndrome

Question 13

Abnormalities of the ST segment

Answer 13

If elevated - MI or pericarditis

Can be depressed - ischaemia, exercise induced angina, treatment with digoxin

Question 14

What can you tell from the leads that have ST elevation

Answer 14

The location of the infarction

Question 15

which leads represent inferior of the heart

Answer 15

II

III

aVF

Question 16

which leads represent Lateral of the heart

Answer 16

I

aVL

V5

V6

Question 17

which leads represent Anterior of the heart

Answer 17

V3

V4

Question 18

which leads represent Septal of the heart

Answer 18

V1

V2

Question 19

When you are looking at the P waves what are you asking yourself?

Answer 19

Are the P waves present

Do they occur regularly

Do they precede each QRS comlex (Sinus rythm)

Are they long, wide, or bifid

Question 20

What can a prolonged PR interval mean

Answer 20

Heart block

Question 21

What can a Shortened PR interval mean

Answer 21

Wolf Parkinson White syndrome.

Question 22

Tell me about the PR interval

Answer 22

from the start of the P-wave to the start of the Q wave

3-5 small squares (200ms)

Are they consistent or changing?

Question 23

Tell me about the ST segment

Answer 23

Starts at end of S wave and ends at start of T wave

Basically it is a flat line

Question 24

Tell me about the T waves

Answer 24

T waves represent Ventricular repolarisation

Can be inverted or Tall

Question 25

Causes of inverted T waves

Answer 25

Hypokalaemia, Pericarditis, myocardial infarction (acute and previous)

Bundle branch block

Wolff Parkinson White syndrome

Inverted T waves in V1 and V2 are normal in healthy individuals

Question 26

Causes of tall T waves

Answer 26

They are descirbed as “tall tented T-waves”

Hyperkalaemia

Myocardial ischaemia (hyper-acute MI)

Question 27

Pulmonary embolism ECG

Answer 27

Right bundle branch block
right axis deviation
inverted T waves

Question 28

ARB SE

Answer 28

hyperkalaemia

Question 29

AF ECG

Answer 29

Irregular without P waves

Question 30

atrial flutter ECG

Answer 30

regular with saw tooth baseline

Question 31

Ventricular tachycardia ECG

Answer 31

fast regular pattern

Question 32

Ventricular Flutter ECG

Answer 32

sh5abee6

Question 33

wolff-parkinson-white (WPW) ECG

Answer 33

short PR interval

Question 34

LVH ECG

Answer 34

R wave >5 big squares in v5/6 and T wave inversion in all lateral leads