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Medicine > ECG > Flashcards

ECG Flashcards

1
Q

What 2 possible diagnoses could it be in someone with a broad complex tachycardia with no P waves?

A

VF/ VT

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2
Q

A patient has a narrow complex tachycardia with abnormal/absent p waves and irregular rhythm - diagnosis?

A

AF

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3
Q

A patient has a narrow complex tachycardia with abnormal/absent p waves and regular rhythm - what are the 3 diagnoses it may be? Which one is most likely?

A

Atrial flutter; SVT; atrial tachycardia

SVT until proven otherwise

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4
Q

What is another name for ‘left anterior fascicular block’? How would this show on ECG?

A

Left anterior hemiblock

Left axis deviation

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5
Q

What is blocked in a bifascicular block?

A

Right bundle branch and left anterior fascicle are blocked

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6
Q

How does a bifascicular block present?

A

Left axis deviation

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7
Q

Name some of the main causes of a bifascicular block

A

IHD, HTN, AS, anterior MI, congenital heart disease hyperkalaemia

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8
Q

What would you call a bifid p wave? What pathology does it suggest? Which part of an ECG would you most commonly see it?

A

P mitrale
Suggests left atrial hypertrophy e.g. caused by MS
Most common in V1

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9
Q

What is the name for a peaked p wave? What pathology does it suggest?

A

P pulmonale.

Suggests right atrial hypertrophy

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10
Q

Define PR interval

A

Start of p wave to start of Q wave

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11
Q

Define PR segment

A

End of p wave to start of Q wave

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12
Q

What does the PR interval represent?

A

Conduction through the AV node

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13
Q

Name 3 ECG changes you may see in someone with WPW?

A
  • Short PR interval
  • Broad QRS
  • Slurred upstroke to the QRS complex (the delta wave)
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14
Q

What 3 treatments should you give to a patient who is stable with broad complex tachycardia?

A

Amiodarone
Class 1 antiarrhythmics
Beta-blockers e.g. metaprolol

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15
Q

What is the treatment for SVT?

A

Valsalva manoeuvre then adenosine

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16
Q

What is the pathophysiology behind atrial flutter?

A

Electrical conduction which goes backwards in the right atria due to a re-entry circuit in RA - the AVN passes some of these impulses on

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17
Q

A patient has large R waves in V5/V6 (>5 large squares) - what does this suggest?

A

Left ventricular hypertrophy

18
Q

What does a dominant R wave in V1 suggest?

A

Right ventricular hypertrophy

19
Q

Define the QT interval

A

Start of Q wave to end of T wave

20
Q

Why is a prolonged QT wave dangerous?

A

Increases risk of ventricular arrhythmias, especially Torsades de pointes which can lead to VF

21
Q

Define ST segment

A

End of S wave to beginning of T wave

22
Q

What ECG change is seen in Digoxin toxicity?

A

Downward sloping/ ‘reverse tick’ ST segment

23
Q

Name 2 times when someone might have biphasic T waves

A

MI or hypokalaemia

24
Q

Define a U wave. Where on an ECG is it best seen?

A

> 0.5 mm deflection after the T wave. Best seen in V2 or V3

25
Q

Name something that might cause U waves

A

Hypokalaemia

26
Q

Name (9) causes of a prolonged QT

A 
Hypokalaemia
Hypomagnesaemia 
Post-cardial arrest 
Congenital long QT syndrome 
Hypocalcaemia 
Hypothermia
MI
Drugs
27
Q

What is Brugada syndrome?

A

Cardiac sodium channelopathy

28
Q

What 2 ECG changes are seen in someone with Brugada syndrome?

A

RBBB w/ ST elevation V1 - 3

29
Q

Talk through the changes you would see in someone who has experienced an acute MI

A

Hyperacute T waves persists for a few mins

ST elevation, T wave inversion (within 24 hours), pathological Q waves

30
Q

When would you see pathological Q waves?

A

Full thickness MI

Develops 8-12 hours after ST elevation if myocardium not reperfused

31
Q

What is the criteria to diagnose a STEMI?

A

ST elevation in >2 small squares in 2 adjacent chest leads or ST elevation >1 small square in 2 adjacent limb leads OR new LBBB

32
Q

What 2 things may you seen on an ecg of someone with hypertrophic cardiomyopathy?

A

Left ventricular hypertrophy signs + dramatic T wave inversion in lateral leads

33
Q

Name 2 changes you might see on the ecg of someone with myocardial ischaemia

A

ST depression and new T wave inversion (but hyperacute T waves may be the first ecg change you notice)

34
Q

What 2 signs on an ecg would suggest that someone has had a previous infarct?

A

T wave inversion and pathological Q waves

35
Q

What would happen to the following in hyperkalaemia…

  • P waves
  • QRS
  • ST segment
  • T waves
A
  • Low flat P waves
  • Wide bizarre QRS
  • Slurring into the ST segment
  • Tall tented T waves
36
Q 
What would happen to the following in hypokalaemia...
- T waves
- PR
- ST segment
Which abnormal wave may appear?
A
  • Small flattened T wave
  • Prolonged PR
  • Depressed ST
  • Prominent U wave
37
Q

What would happen to the QT interval in hypercalcaemia?

A

Short QT

38
Q

What would happen to the QT interval in hypocalcaemia?

A

Prolonged QT

39
Q

What are the ‘classic’ ECG changes seen in someone with a PE?

A

S1Q3T3

Large S wave in lead I, large Q wave in lead III, inverted T wave in lead III

40
Q

What 3 ecg changes are you likely to find in someone with a PE?

A

RBBB + right axis deviation + sinus tachycardia

41
Q

What would happen to the R waves in a posterior MI? Where on the ecg would this be best seen?

A

Tall R waves in V1 + V2

42
Q

Which 2 changes would you see on the ecg of someone with pericarditis? Which one is most specific?

A 
Saddle-shaped ST interval 
PR depression (specific)

Medicine (15 decks)

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