ECG Flashcards

1
Q

The p wave is?

A

Atrial depolarization

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2
Q

The PR interval is?

A

conduction from SA to AV node

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3
Q

QRS interval is

A

ventricular muscle depolarization

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4
Q

T wave is

A

ventricular muscle repolarization

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5
Q

Which lead is used for amplitude measurements?

A

Lead II- right shoulder to left leg

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6
Q

Positive waves are?

A

waves traveling toward the positive electrode

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7
Q

ECG is best to evaluate?

A

Heart rate, heart rhythm, and conduction

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8
Q

What are the 4 steps to evaluate and ECG?

A
  1. Evaluate for artifacts, quality, and calibrations
  2. Determine the heart rate
  3. Name the cardiac rhythm
  4. Evaluate the P-QRS-T complex configurations and morphologies
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9
Q

What does amplitude increase indicate?

A

Chamber enlargement

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10
Q

What is standard calibration for ECG?

A

Gain: 10mm/mV = 1cm/mV

- each small box is 1mm

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11
Q

at 50mm/sec, 1 small box =?

A

0.02 seconds

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12
Q

Name some artifacts that can render ECG uninterpretable?

A

purring, respiration movememt, motion, muscle twitches

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13
Q

Normal feline heart rate

A

140-220

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14
Q

Normal canine heart rate

A

60-160

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15
Q

What are the two most common cardiac rhythms?

A

Sinus rhythm and sinus arrhythmia

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16
Q

What is a sinus rhythm?

A

normal P wave with similar shaped QRS and similar P-P interval

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17
Q

What is sinus arrhythmia?

A

irregular rhythm originated from the SA node, normal in many species, normal QRS for every P with varying normal heart rate because of high vagal tone, may see varying P height

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18
Q

What is a wandering pacemaker?

A

varying P height, seen with sinus arrhythmia

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19
Q

How tall should the T wave be

A

< 1/3 QRS, can even be negative or biphasic

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20
Q

When may you see a sinus bradycardia in cattle?

A

Lack of food intake

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21
Q

What are the normal cardiac rhythms of horses?

A

sinus rhythm
sinus arrhythmia
first or second degree AV block

22
Q

What is the difference between a premature and and escape ectopic beat?

A

PVC occurs earlier than expected and escape beats occur later than expected

23
Q

What is an atrial ectopic beat (atrial premature contraction)?

A

Has P wave that is too early, may be on top of T wave or not visible, normal QRS

24
Q

What is sinus bradycardia/bradyarrhythmia?

A

Normal p with every QRS, but at a slow rate

25
Q

Treatment for sinus bradycardia?

A

Identify and address underlying cause, can give atropine if because of anesthetic complications

26
Q

What is sick sinus syndrome?

A

abnormal rhythm disturbance in older small breed dogs, combo of:

  • sinus bradycardia
  • sinus arrest (pause with no P)
  • AV block
  • Supraventricular tachycardia- after a long pause
27
Q

What are first, second, and third degree AV block?

A

1st: prolonged PR
2nd: intermittent blocked P wave
3rd: P and QRS unrelated

28
Q

How do you differentiate pathologic 2nd degree AV block from high vagal tone?

A

Give atropine- if block disappears, high vagal tone

29
Q

What is the only treatment fr 3rd degree AV block?

A

Pacemaker

30
Q

What are the 3 types of tachycardia?

A
  • sinus
  • supraventricular
  • ventricular
31
Q

Describe sinus tachycardia

A

Normal p, normal qrs

32
Q

Describe supraventricular tachycardia:

A

abnormal p, normal QRS

*3 or mor APCs or SVPCs in a row

33
Q

Describe ventricular tachycardia:

A

no associated p, wide/bizarre QRS

34
Q

What are the causes of sinus tachycardia?

A

Response to systemic issue, pain, excitement, hypotension

35
Q

What are causes of supraventricular tachycardia?

A

Atrial enlargement (most common in small animals)
Enlarged hilar lymph nodes
Thoracic masses
Pulmonary inflammation
Electrolyte disturbances
*can occur in horses without structural heart disease

36
Q

T/F: Atrial fibrillation is not a type of supraventricular tachycardia

A

False- no clear p-waves, but QRS are normal

37
Q

T/F: All cases with atrial fibrillation will show bumpy baseline

A

False- small patients may not show bumpy baseline

38
Q

What are the most common causes of atrial fibrillation in small animals?

A

Severe atrial enlargement caused by dilated cardiomyopathy or chronic valvular disease

39
Q

T/F: Atrial fibrillation is uncommon in cats

A

T

40
Q

What is the treatment goal for SVT or A fib?

A

Decrease heart rate to normal range

41
Q

What drugs could be used to decrease heart rate in patients with SVT or A fib?

A

Digoxin,
Calcium Channel Blockers (Diltiazem)
Beta blockers (Atenolol)

42
Q

T/F: “Lone a-fib” occurs in horses, humans.

A

True-

lone a-fib means there is no underlying heart disease

43
Q

T/F: The most common cause of bovine a-fib is primary GI disease

A

True

44
Q

T/F: Equine lone fib can successfully be converted with medical treatment (quinidine + digoxin or amiodarone)

A

True

45
Q

T/F: Recurrence of a-fib in converted horses is uncommon.

A

False

46
Q

T/F: V-tach can result in sudden death.

A

True

47
Q

T/F: Anti-arrhythmics can have pro-arrhythmic effects, potentially making arrhythmias worse.

A

True: you must make sure you have reason to treat arrhythmias

48
Q

Name some indications to treat arrhythmias:

A
  1. Paroxysms or sustained VT > 140-160bpm
  2. > 20 VPCs per minute
  3. Multiform VPCs
  4. Arrhythmias with myocardial failure present
  5. Breeds at risk for sudden death (dobys and boxers)
  6. Clinical hypotension
  7. VPCs close to the T wave of the proceeding complex
  8. Critically ill patients
49
Q

What is the acute/emergency treatment for arrhythmias?

A

Lidocaine- IV in a bolus

- side effects can include seizures and vomiting

50
Q

What are chronic treatments for arrhythmias available orally?

A
Mexilitine (similar to lidocaine)
Sotalol (B blocker and class 3)
Atenolol (B blocker)
51
Q

T/F: V-fib is fatal unless electrical defribrillation is done in time.

A

True- no pulses, antiarrhythmics inneffective