ECG Flashcards

1
Q

How fast is standard ecg paper travelling?

A

25mm/s

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2
Q

What is a large ecg square equal to?

A

5mm

0.2s

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3
Q

What is a small ecg square equal to?

A

1mm

0.04s

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4
Q

Which leads measure the inferior surface of the heart?

A

II
III
aVF

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5
Q

Which leads measure the anterior surface of the heart?

A

V1
V2
V3
V4

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6
Q

Which leads measure the lateral surface of the heart?

A

I
aVL
V5
V6

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7
Q

Which leads measure the right atrium and LV cavity?

A

V1

aVR

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8
Q

How do you perform a 15-lead ECG?

A

V4 to the right 5th IC space MCL
V5 round backwards to the inferior tip of scapula
V6 to midway between V5 and spinal column.

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9
Q

What is the P wave showing?

A

Spread of electrical activation through atrial myocardium starting from SA node
Atrial depolarisation

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10
Q

What is the PR interval showing?

A

Time taken by atrial depolarisation

Conduction of impulse through Av node

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11
Q

What is the QRS complex showing?

A

Ventricular depolarisation

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12
Q

What is the ST segment showing?

A

Pause in ventricular electrical activity before repolarisation

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13
Q

What is the T wave showing?

A

Ventricular repolarisation

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14
Q

What is the U wave showing?

A

Uncertain
Possible due to after potentials at beginning of systole
Repolarisation of the mid-myocardial cells, that is, those between the endocardium and the epicardium and the His-Purkinje system

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15
Q

What is the cause of a U wave?

A

Hypokalemia
Hypercalcemia
Can be normal (athletes)

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16
Q

What is a sinus rhythm on ecg?

A

Regular p waves followed by QRS complex

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17
Q

What is the difference between atrial fibrillation and atrial flutter?

A

Atrial fib = irregular ventricular rate

Atrial flutter = regular ventricular rate

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18
Q

How do you calculate ventricular rate?

A

Count number of large squares from R to R

Divide by 300

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19
Q

How do you calculate atrial rate?

A

Count number of large squares from P to P

Divide by 300

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20
Q

What is a left axis?

A

QRS + in I

- in aVF

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21
Q

What is a right axis?

A

QRS - in I

+ in aVF

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22
Q

What is a normal axis?

A

QRS + in I and + in aVF

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23
Q

What is an extreme right axis?

A

QRS - in I and - in aVF

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24
Q

Give causes of left axis deviation

A

Systemic hypertension
IHD
AMI
Increased LV

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25
Q

Give causes of right axis deviation

A

COPD
Increased RV
Pulmonary hypertension
Pulmonary embolism

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26
Q

What does a tall peaked P wave in leads II, III and aVF show?

A

Right atrium hypertrophy

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27
Q

How do you diagnose right atrium hypertrophy on ecg?

A

A tall peaked P wave in leads II, III and aVF

28
Q

What does a notched broad P wave on ecg show?

A

Left atrium hypertrophy

29
Q

How do you diagnose left atrium hypertrophy on ecg?

A

Notched broad P wave

30
Q

Give a cause of left atrium hypertrophy

A

Mitral stenosis

31
Q

Where do you check on the ecg for atrial hypertrophy?

A

P wave in V1

32
Q

What is the p wave in atrial hypertrophy on ecg also known as?

A

P pulmonale

33
Q

Give causes of a prolonged PR interval

A

Beta blocker
Heart blocker
Digitalis

34
Q

Give causes of a shortened PR interval

A

Tachycardia

35
Q

How do you measure a normal P wave?

A

≤2,5 small squares wide and <2,5 small squares high

36
Q

How do you measure a normal PR interval?

A

≤5 small squares wide)

37
Q

How do you measure a normal QRS complex?

A

≤2,5 small squares wide

38
Q

Give causes of a wide QRS complex

A

Bundle branch block

39
Q

Give causes of tall R waves in V1

A

Right ventricular hypertrophy

40
Q

Give causes of tall R waves in V6

A

Left ventricular hypertrophy

41
Q

What is the transition point?

A

When R and S waves are equal in the chest lead over the interventricular septum, normally V3 or V4

42
Q

Give causes of a flat/depressed ST segment

A

Ischaemia

Digoxin

43
Q

Give causes of an elevated/raised ST segment

A

AMI

44
Q

Give the cause of a saddle shaped ST segment elevation with small complexes

A

Pericarditis

45
Q

How does pericarditis appear on ecg?

A

A saddle shaped ST segment elevation with small complexes

46
Q

How do you measure a normal T wave?

A

< 5 small squares wide and <3 small squares high

47
Q

Give causes of a peaked T wave

A

Hyperkalaemia

Increased LV

48
Q

Give causes of a flat T wave

A

Hypokalemia

49
Q

Give causes of an inverted T wave

A
Ischaemia
AMI
Pericarditis
LV hypertrophy
Pulmonary embolism
BBB
50
Q

Which leads always have a positive T wave?

A
I
II
V4
V5
V6
51
Q

Which leads always have a negative T wave?

A

aVR

52
Q

If the T wave is inverted in V1/2, then…?

A

Must be upright in V4/5/6

53
Q

How do you measure a normal Q wave?

A

<1 small square wide and <2 small squares deep

54
Q

What is the cause of a Q wave?

A

Septal depolarization

AKA septal Q waves

55
Q

Small Q waves are normal in which leads?

A
I
II
aVL
V5
V6
(The leads that look at the heart from the left)
56
Q

Q waves are the only firm electrocardiographic evidence of what?

A

Myocardial necrosis

57
Q

How do you measure a normal QT interval?

A

0.35-0.45s

Should not be more than half of the interval between adjacent R waves (R-R interval).

58
Q

Name causes of a prolonged QT interval

A
Females
Older age
Torsades de pontes
Anti-malarials
Anti-epileptics
Anti-psychotics
Anti-depressants
Antibiotics
Antiarrythmics
Digoxin
59
Q

What is amiodarone?

A

An antiarrythmic

60
Q

Give a cause of shortened QT interval

A

Ventricular fibrillation

61
Q

Regarding S waves and R waves, how do you see RV hypertrophy on ecg?

A

V1 tall R waves

V5/6 deep S waves

62
Q

Regarding S waves and R waves, how do you see LV hypertrophy on ecg?

A

V5/6 all R waves

V1/2 deep S waves

63
Q

What is a U wave?

A

Small deflection following T wave
Prominent in V2/3/4
Upright except in aVR

64
Q

Which lead is the U wave depressed?

A

aVR

65
Q

Give signs of pulmonary embolism on ECG

A
Sinus Tachycardia (with a normal ECG)
Peaked P waves
RBBB/incomplete RBBB
Right ventricular strain
Axis change (right axis deviation)
ST segment and T wave changes
Deep S waves in V6