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MS4 - Dermatology > ECG > Flashcards

ECG Flashcards

1
Q

System to analyse ECG

A

Rate

Rhythm

Axis

P wave

P-R

QRS length

QT

T wave

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2
Q

How to calculate rate

A

300 divided by big squares between 2 QRS

OR

count 30 large boxes (6seconds)

count the no. of R-R interval

Multiply by 10

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3
Q

How to tell axis on ECG

A

Leaving- LEFT axis deviation

Reaching- RIGHT axis deviation

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4
Q

P wave normal measurements

A

<2.5 squares high

<3 small squares wide

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5
Q

Normal PR length

A

3-5 small squares

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6
Q

QRS normal length

A

<3 small squares

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7
Q

How to tell if it is a Q wave

A

negative deflection before an R wave

If no R wave, assume it is S wave

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8
Q

Q wave a sign of

A

cardiac damage - prvs MI

normal in limb leads

Should be less than a quarter of depth of QRS otherwise pathological

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9
Q

How to tell if Q wave pathological

A

normal in limb leads

Should be less than a quarter of depth of QRS otherwise pathological

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10
Q

ST elevation a sign of

A

infarction if more than 1mm

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11
Q

ST depression a sign of

A

ischaemia if > 0.5mm

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12
Q

Where to expect downward T waves

A

aVR

V1

sometimes III

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13
Q

Normal amplitude of T wavs

A

<5 mm in limbs

<10 in chest leads

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14
Q

Peaked T wave a sign of

A

hyperkalaemia

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15
Q

T wave inversion a sign of

A

Ischaemia

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16
Q

What is a prolonged QT

A

>440 in men

>460 mm in women

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17
Q

What does a QT of >500 ms increase the risk of

A

torsades de pointes

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18
Q

Causes of prolonged QTc

A

Low K, Ca, Mg

Low Temp

Drugs

MI

congenital

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19
Q

U wave

A

small deflection after T

delayed repolarisation of Purkinjee fibres

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20
Q

How big is a prominent U waves

A

>1mm or >25% of T wave

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21
Q

Causes of prominent u wave

A

Low HR, K, Temp

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22
Q

Inverted U wave causes

A

ischaemia

CAD

HTN

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23
Q

Regions associated with ECG leads

A
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24
Q

Lateral heart supplied by

A

LCX

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25
Inferior heart supplied by
LCS or RCA
26
Septal/anterior heart supplied by
LCS
27
Reperfusion (PCI) criteria
ischaemic sx + ST elevation \>2 mm in 2 x contiguous chest leads or ST elevation \>1mm in 2 x contiguous limb leads or New LBBB
28
Left vs right BBB
Left bundle: WiLLiaM W shape in V1 M shape in V6 Right bundle: MaRooN M shape in V1 N shape in V6
29
Posterior STEMI
V 1-3 ST depression looking at ECG upside down = STEMI
30
Progression of STEMI
31
T wave inversion or flattening
At least 1 mm deep Present in ≥ 2 continuous leads that have upright QRS complexes
32
Narrow complex tachyarrhythmias
AF Atrial flutter Re-entrant tachycardia (AVNRT)
33
Broad complex tachyarrhythmias
VT Torsades de pointes VF
34
pathophysiology of Atrial flutter
Re-entry circuit within the right atrium. Regular atrial activity, ventricular rate can be regular or irregular. Saw tooth
35
Commonest cause of atrial flutter
IHD
36
Wolff-Parkinson-White syndrome ecg changes
- ST Segment and T wave opposite direction - delta waves in the inferior / anterior leads (“pseudo-Q waves”), - a prominent R wave in V1-3 (mimicking posterior infarction)
37
VT ECG
Broad QRS AV dissociation Tachy
38
Ventricles rapidly attempt to contract (up to 500bpm)
39
Shockable rhythms
VF VT
40
Non shockable rhythms
Asystole Pulseless electrical activity
41
Causes of Cardiac arrest
4 H + 4 T Hypoxia Hypovolemia High K, Low K, glucose, Ca Hypothermia Thrombosis Tension pneumothorax Tamponade Toxins
42
Whats the ECG showing
1st degree heart block prolonged PR
43
Causes of 1st degree heart block
increased vagal tone (eg due to athletic training) inferior MI myocariditis
44
Whats the ECG showing
2nd degree HB - Mobitz T1 Progressive prolongation of PR interval- leads to non conducted P waves
45
another name for Mobitz T1 HB
Wenkebach phenomenon
46
Management of Mobitz T1 HB
if asymptomatic none If sx-\> atropine
47
Whats the ECG showing
Mobitz T2 HB intermittent non conductive P No PR prolongation
48
Causes of Mobitz T2 HB
Anterior MI (sepetal infarct) Idiopathic fibrosis Inflammatory conditions (Lyme disease, rheumatic fever, myocarditis) Autoimmune (SLE, systemic sclerosis)
49
Mangament of Mobits T2
Temporary pacing PPM
50
Causes of Mobits T1 vs T2
T1 due to functional suppression, eg drugs or ischaemia T2 due to structural damage eg infarct, fibrosis
51
Whats this
3rd degree HB No AV conduction dissociation between atrial and ventricular activity
52
Hyperkalaemia on ECG
Tall tented T waves Prolonged PR interval (or loss of P wave) Wide QRS complexes
53
whats this
hyperkalaemia
54
Hypokalaemia on ECG
T wave inversion Prominent U waves Long QU interval ST depression
55
Main effect of Ca level on ECG
low-\> long QT high-\> short QT
56
PE ECG findings
Sinus Tachycardia (most common!) RBBB Right Axis Deviation Right atrial enlgargement (P pulmonale) S1Q3T3 Right ventricular strain – TWI V1-V4 + inferior leads
57
S1 Q3 T3
Deep S wave in lead I, Q wave in III, inverted T wave in III
58
ECG of
PE RBBB Extreme right axis deviation (+180 degrees) S1 Q3 T3 T-wave inversions in V1-4 and lead III
59
Pericarditis ECG
Concave ST elevation PR depression Sinus tachy
60
ECG of
pericarditis
61
Premature ventricular complex
ectopic beat: ## Footnote Broad QRS Premature — i.e. occurs earlier than would be expected for the next sinus impulse Discordant ST segment and T wave changes Usually followed by a full compensatory pause
62
Bigeminy
premature ventricular complex every other beat
63
Trigeminy
premature ventricular complex every third beat
64
Pulseless electrical activity
clinical features of cardiac arrest ECG shows normal rhythm cardiac contractions absent despite electrical activity
65
Describe ECG
Asystole
66
Describe ECG
VT
67
Describe ECG
Supravebtricular tachy (AV node re-entry)
68
Describe ECG
Atrial flutter
69
Describe ECG
prvs STEMI
70
Describe ECG
Posterior STEMI
71
Describe ECG
ANTERO-SEPTAL STEMI
72
Drugs causing sinus bradycardia
Beta-blockers Ca channel blocker (verapamil & diltiazem) Digoxin Central alpha-2 agonists (clonidine & dexmedetomidine) Amiodarone Opiates GABA-ergic agents (barbiturates, benzodiazepines, baclofen, GHB) Organophosphate poiso

MS4 - Dermatology (3 decks)

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