ECG

Question 1

What ECG change is never normal?

Answer 1

Left BBB - ischemic or structural problem

Question 2

What causes T wave inversion of the anterior leads?

Answer 2

Wellens syndrome

- cardiac ischemia in unstable angina

Question 3

How does the ECG change over the course of an MI?

Answer 3

1) within hours, hyperacute T waves and ST elevation or new LBBB
2) 24 hours the T wave inverts, ST begins to resolve
3) within days, pathological Q waves

Question 4

How many small squares is 0.2 seconds?

Answer 4

5 small (or one large)

This is how long the PR interval in in 1st degree heart blocked (measured from beginning of P wave to beginning of QRS)

Question 5

What ECG changes do you get in HOCM

Answer 5

LVH
Progressive T wave inversion
Deep Q waves
Artial fib (occasionally)

Question 6

ECG changes in hypokalemia

Answer 6

U have no Pot you have no T, but a long PR and a long QT

U waves 
Small or absent T waves
ST depression
PR long
QT long

Question 7

What ECG change in MI can occur before ST elevation?

Answer 7

Hyperacute T waves

Question 8

Type A vs Type B WPW on ECG changes??

Answer 8

Type A - left sided pathway
- dominant R wave in V1 and RAD

Type B- right sided pathway
- no dominant R wave in V1 and LAD

Question 9

ECG changes indicating need for urgent PCI or thrombolysis?

Answer 9

New LBBB
ST el >2mm in 2 or more consecutive anterior leads v1-v6
Or
ST el > 1mm in greater than 2 consecutive inferior leads (II, III, avF or avL)

Question 10

What does digoxin do in ecg leads?

Answer 10

Downsloping ST segment in all leads