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Y4 Cardio > ECG > Flashcards

ECG Flashcards

1
Q

what side is I and III on the ECG?

A 
I = left 
III = right
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2
Q

what nervous fibres supply the ventricles after His bundle?

A

purkinje fibres

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3
Q

what is the rhythm for regular QRS but no p waves?

A

nodal rhythm

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4
Q

what does R axis deviation suggest ?

A 
anterolateral MI 
RVH
PE
WPW (wolff parkinsons white syndrome)
ASD secundum
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5
Q

what does bifid p waves suggest?

A

LA hypertrophy

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6
Q

what does peaked p waves suggest?

A

RA hypertrophy

  • as the sinus node starts in the R atrium the signal will be stronger if the muscle is hypertrophied
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7
Q

what causes LA hypertrophy?

A

HTN
AS
MR
MS

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8
Q

what are the measurements of pathological Q wave?

A

> 1mm wide and > 2mm deep

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9
Q

state some cause of wide QRS?

A

Ventricular initiation
􏰁 Conduction defect
􏰁 WPW

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10
Q

what time is prolonged QRS?

A

> 120ms

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11
Q

what time is prolonged PR interval?

A

> 200ms

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12
Q

what causes shortened PR interval?

A

Accessory conduction: e.g. WPW 􏰁
Nodal rhythm
􏰁HOCM

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13
Q

where is the QT interval from and to?

A

Start of QRS to end of T wave

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14
Q

what time is prolonged Qtc interval?

A

> 420ms

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15
Q

what time is shortened Qtc interval?

A

<380ms

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16
Q

what causes short QTc?

A

Digoxin
􏰁 β-B
􏰁 Phenytoin

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17
Q

what causes prolonged QTc?

A 
Toxins
􏰂 - Macrolides
􏰂 - Anti-arhythmics (Ia/III): quinidine, amiod
􏰂 - TCAs
􏰂-  Histamine antagonists

􏰁 Inherited: e.g. Romano-Ward, Jervell ( ̄c SNHL) 􏰁

Ischaemia

􏰁 Myocarditis

􏰁 Mitral valve prolapse

􏰁 Electrolytes: ↓Mg, ↓K, ↓Ca, ↓ temp

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18
Q

state some causes of ST elevation?

A

Acute MI

􏰁 Prinzmetal’s angina

􏰁 Pericarditis: saddle-shaped 􏰁

Aneurysm: ventricular

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19
Q

what is 􏰁 Prinzmetal’s angina?

A

often referred to as “variant” angina, is a temporary increase in coronary vascular tone (vasospasm) causing a marked, but transient reduction in luminal diameter.

20
Q

what causes U waves?

A

hypokalaemia

21
Q

what causes J waves ?

A

hypothermia < 32OC 􏰂

SAH (subarachnoid haemorrhage)

􏰂 Hypercalcaemia

22
Q

where does the U wave occur?

A

after the T wave

23
Q

where does J wave occur?

A

between QRS and ST segment

24
Q

state some cause RBBB?

A 
inferior MI 
ASD, VSD, Fallots 
RVH 
PE 
Cor pulmonale
25
Q

what is Cor pulmonale ?

A

abnormal enlargement of the right side of the heart as a result of disease of the lungs or the pulmonary blood vessels.

26
Q

state some cause LBBB?

A

fibrosis
LVH (caused by AS, HTN)
inferior MI

27
Q

what is Bifascicular Block?

A

RBBB + L axis deviation

28
Q

what is Trifascicular Block?

A

RBBB + LAFB (Left anterior fascicular block) + 1st degree AV block

29
Q

what is seen on ECG with Junctional Escape?

A

no p waves
normal QRS
40-60bpm

30
Q

what is seen on ECG with Ventricular Escape?

A

may have regular p waves or absent p waves
wide QRS complex
20bpm

31
Q

what is seen on ECG with Ventricular Extrasystole?

A

No P wave.

Wide QRS and abnormal T wave.

32
Q

what is seen on ECG with Atrial Flutter?

A

“Saw-toothed” baseline as atria contract @ 300bpm.

AVN can’t conduct > 200bpm 􏰄 AV block occurs.

Normal QRS

33
Q

what is seen on ECG with Atrial Fibrillation?

A

No P waves – irregular line

Irregularly irregular QRS

34
Q

what is seen on ECG with ventricular Fibrillation?

A

No P waves Regular, wide QRS No T waves

35
Q

what are characterised signs of VT?

A

Hx: recent infarction

􏰀 Atrioventricular dissociation

􏰀 Broad QRS complexes (>140ms)

􏰀 Concordant QRS direction in V1-V6

􏰀 Fusion and capture beats

36
Q

what is seen on ECG with wolff parkinsons white syndrome?

A

Short PR interval

Slurred upstroke of QRS called a delta wave (V3/4).

37
Q

what can be seen on ECG for PE?

A

SI QIII TIII (rare)

  • deep S wave in I (RAD)
  • pathological Q in III
  • T inversion in III
38
Q

what is seen on ECG with Brugada syndrome?

A

RBBB

39
Q

what are some causes of bradycardias? (DIVISION)

A

drugs

ischaemia

vagal hypertonia

infection

sick sinus syndrome

infiltration (restrictive/dilated)

hypO thyroidism/kalaemia/thermia

neuro (increased ICP)

septal defect (premum ASD)

surgery/ catheterisation

40
Q

what conditions require Permanent pacing?

A 
Mobitz II
􏰀 Complete AV block
􏰀 Sick sinus
􏰀 AF
􏰀 Drug-resistant tachyarrhythmias
41
Q

what is the management of SVT

A

sedate + DC cardioversion

Vagal manoeuvres (carotid sinus massage, valsalva)

If manoeuvres unsuccessful, give adenosine while recording rhythm strip

If adenosine fails, choose from:
􏰁 Digoxin
􏰁 Atenolol
􏰁 Verapamil (not if on β-blocker) 􏰁 
Amiodarone

􏰀 If unsuccessful → DC cardioversion

42
Q

what are SEs of adenosine

A

Transient chest tightness, dyspnoea, flushing, headache

43
Q

state some broad complex tachycardias ? (Rate >100bmp, QRS width > 120ms)

A

VT
Torsades de points
S V T with BBB

44
Q

state some causes of VT?

A

infarction

myocarditis

increased QTc

mitral prolapse, aortic stenosis (systolic)

digoxin, antiarrhythmias

cardiomyopathy (dilated)

low K, Mg, O2, acidosis

45
Q

what is the action of adenosine ?

A

temporary AVN block

Y4 Cardio (10 decks)

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