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Cardiology > ECG > Flashcards

ECG Flashcards

To learn the different ECG presentations

1
Q

Describe first degree heart block?

A

PR interval is delayed:
Not an issue in itself but maybe sign of coronary heart disease, acute rheumatic carditis, digoxin toxicity or electrolyte disturbances

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2
Q

Describe second degree heart block Wenckebach (Mobitz type I)?

A

Progressive lengthening of PR interval with eventual dropped ventricular conduction

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3
Q

Describe 2nd degree heart block (Mobitz type 2)

A
  1. PR interval is constant

2. One P wave isn’t followed by QRS complex

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4
Q

Describe 2nd degree heart block with 2:1 type?

A
  1. Two P waves per QRS complex

2. Normal and constant PR interval in conducted beat

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5
Q

Describe third degree heart block?

A

Complete heart block is said to occur when atrial contraction is normal but no beats are conducted to the ventricles.

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6
Q

In 3rd degree heart block what is the association between the atria and ventricles?

A

Complete dissociation between atria and ventricles

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7
Q

How is an anterior STEMI recognised?

A
  1. ST elevation with Q wave formation in the precordial leads V1-6 +/-the high lateral leads (I & aVL)
  2. Reciprocal ST depression in the inferior leads mainly III and aVF
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8
Q

Which artery distribution causes an anterior MI?

A

An anterior MI results from occlusion of Left Anterior Descending coronary artery LAD

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9
Q

What are the patterns for an anterior infarction?

A
  1. Septal V1-2
  2. Anterior V3-4
  3. Lateral V5-6
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10
Q

What names are given to the different infarct patterns?

A
  1. Septal V1-2
  2. Anterior V3-4
  3. Anteroseptal V1-4
  4. Anterolateral V3-6, I & aVL
  5. Extensive anterior/ anterolateral V1-6, I & aVL
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11
Q

When does a posterior wall MI occur?

A
  1. Posterior myocardial tissue lose blood due to intracoronary thrombosis
  2. Usually supplied by posterior descending artery, a branch of the right coronary artery in 80% of individuals
  3. Frequently coincides with an inferior wall MI
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12
Q

What are the ECG findings of an acute posterior wall MI?

A
  1. ST depression in septal and anterior precordial leads V1-4. EcG seen backwards
  2. R/S ratio > 1 in leads V1-2
  3. ST elevation in additional leads V7-9
  4. ST segment elevation in leads II, III and aVF if inferior MI present
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13
Q

What is an inferior wall MI?

A

Occurs when inferior tissue supplied by the right coronary artery , RCA is injured due to a thrombosis

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14
Q

What is a lateral STEMI?

A
  1. Lateral wall of LV supplied by branches of left anterior descending LAD and left circumflex LCx
  2. Infarction usually occurs as part of larger territory infarct eg antereolateral STEMI
  3. Immediate reperfusion
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15
Q

How is a Lateral STEMI recognised?

A
  1. ST elevation in lateral leads I, aVL, V5-6
  2. Recipricol ST depression in inferior leads III and aVF
  3. ST elevation localised to leads I and aVL. referred to as high lateral STEMI
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16
Q

What patterns of lateral infarction are there?

A

There are three broad categories:

  1. Anterolateral STEMI due to LAD occlusion
  2. Inferior posterior lateral STEMI due to LCx oclu
  3. Isolated lateral due to occlu of smaller branch
17
Q

What is left posterior fascicular block (LPFB)?

A

Impulses are conducted to the left ventricle via the left anterior fascicle, which inserts into upper lateral wall of the left ventricle

18
Q

What are the ECG criteria for left posterior fascicular block?

A
  1. Right axis deviation
  2. Small R waves with deep S waves r’S in leads I and aVL
  3. Small Q waves with tall R waves q’R in leads II, III and aVF
  4. Prolonged R wave peak time in aVF
  5. No evidence of any cause for right axis deviation
19
Q

What is left anterior fascicular block?

A

Impulses are conducted to the left ventricle via the left posterior fascicle. Takes 20 ms longer so longer QRS complex wider

20
Q

What are the ECG criteria for left anterior fascicular block?

A
  1. Left axis deviation
  2. Small Q waves with tall R waves ‘qR in I and aVL
  3. Small R waves with deep S waves ‘rS in II, III and aVF
  4. QRS duration normal or longer 80-110ms
  5. Prolonged R wave in aVL

Cardiology (23 decks)

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