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Phase 2 Mine > ECG > Flashcards

ECG Flashcards

1
Q

What can identify with ECG?

A
  1. Arrythmia
  2. MI/infarction
  3. Pericarditis
  4. Chamber hypertrophy
  5. Electrolyte disturbance
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2
Q

Pacemakers of the heart and rate?

A
  1. SAN = 60-100bpm
  2. AVN = 40-60bpm
  3. Ventricular cells = 20-45bpm
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3
Q

What are the trace parameters for ECG?

A

25mm/sec

10mm/mV

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4
Q

PR interval length

A

120-200ms

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5
Q

QRS complex width

A

<110ms

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6
Q

QRS should be upright in

A

Lead I,II

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7
Q

All waves are negative in

A

aVR

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8
Q

R wave and S wave grows in which leads?

A
  1. R = V1–>V4

2. S = V1–>V3

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9
Q

ST segment should be isoelectric except

A

Leads V1, V2 may be elevated

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10
Q

P and T waves should be upright in?

A

Lead I,II, V2-V6

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11
Q

Two ways to calculate rate in ECG?

A
  1. 60/ (RR interval /25)

2. 300/number of QRS complexes in 10s

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12
Q

What are the causes of bradycardia?

A
  1. Conduction tissue fibrosis
  2. Ischaemia
  3. Inflammation/infiltrative disease
  4. Drugs
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13
Q

Tachycardia classification?

A
  1. Narrow complex tachycardia

2. Broad complex tachycardia

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14
Q

What is narrow complex tachycardia?

A
  1. Ventricular fibrillation
  2. Sinus tachycardia
  3. Supraventricular tachycardia
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15
Q

Broad complex tachycardia?

A

Ventricular tachycardia -

Sinus tachy/SVT/AF with aberrant conduction

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16
Q

What does P wave absent?

A

Ectopic pacemaker rhythm
Atrial flutter
Regular tachycardias

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17
Q

What does regularly irregular rhythm suggesy?

A
  1. Sinus arrhythmia
  2. 2nd degree heart block
  3. Regular ectopics
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18
Q

What could irregularly irregular be?

A
  1. AF

2. Irregular ectopics

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19
Q

What is AF?

A

Irregularly irregular tachycardia at 300-600bpm

Can be paroxysmal or persistent AF

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20
Q

What is parosxysmal AF?

A

Intermittent AF usually terminates within 7 days spontaneously

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21
Q

What is persistent AF?

A

Not self terminating

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22
Q

What is the RF for AF?

A
  1. HTN, HF
  2. CAD, MI
  3. Valvular Heart Disease
  4. Pneumonia, caffeine, alcohol, hyperthyroidism
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23
Q

AF on ECG?

A
  1. Absent P waves

2. Irregularly irregular QRS complex

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24
Q

AF on other tests?

A
  1. Bloods - cardiac enzymes, TFT,

2. Echo - atrial enlargement, mitral valve disease

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25
Q

Effects of AF?

A
  1. Atria respond electrically to randomly depolarising wavelets - no coordinated response, only proportion of impulses reach ventricles
  2. Irregularly often rapid ventricular response
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26
Q

Clinical presentation of AF?

A
  1. May be asymptomatic

2. Palpitations, dyspnoea, fatigue, dizziness, angina, and decompensated heart failure

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27
Q

What is atrial flutter?

A

Organised atrial tachycardia ~300bpm

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28
Q

Causes of atrial flutter?

A
  1. Idiopathic - 50%
  2. CHD
  3. HTN
  4. Obesity, XS alcohol
  5. HF, Pericarditis
  6. COPD
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29
Q

Presentation of AF?

A
  1. Asymptomatic/ chest pain
  2. Palpitations, dizzy, fatigue
  3. Syncope, dyspnoea
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30
Q

ECG of Atrial flutter

A

Sawtooth pattern with tracings of P waves on the ECG

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31
Q

What is normal QRS axis?

A

-30 and +90

32
Q

Left axis deviation range

A

-30 - -90

33
Q

Right axis deviation range

A

+90 - +180

34
Q

Causes of left axis deviation

A
  1. Left ventricular hypertrophy
  2. Left bundle branch block
  3. Left anterior fascicular block
35
Q

Causes of right axis deviation?

A
  1. Left posterior fascicular block

2. Right heart hypertrophy/strain

36
Q

Right atrial hypertrophy on ECG?

A

P pulmonale - tall pointed P waves, right atrial enlargent

37
Q

Left atrial hypertrophy on ECG?

A

P mitrale: notched/bifid P wave in limb leads, left atrial enlargement

38
Q

What does PR interval mean?

A

Atrial depolarisation + delay to AV junction

39
Q

What does constant long PR interval suggest

?

A

1st degree heart block

40
Q

What does nonconstant long PR interval?

A

2nd degree heart block

41
Q

What does short PR interval mean?

A
  • often associated with a delta wave
  • accessory connection between atria and ventricles
  • Wolf - Parkinson White Syndrome = short PR + delta wave - accessory pathway - early activation of ventricles
42
Q

What is 1st degree heart block

A

Slowed AV conduction - asymptomatic - longer PR > 0.22s

43
Q

Causes of 1st degree heart block?

A
  1. Hypokalaemia
  2. Myocarditis
  3. Inferior MI
  4. AVN blocking drugs
44
Q

What can 2nd degree heart block be divided to?

A
  1. Mobitz Type 1

2. Mobitz Type II

45
Q

What is Mobitz Type I heart block also known as?

A

Wenckebach’s phenomenon

46
Q

What is Mobitz Type I?

A

PR interval gets longer and longer until skipped beat - no QRS produced.

47
Q

Causes of Mobitz Type I?

A
  1. AVN blocking drugs

2. Inferior MI

48
Q

Clinical presentation of Mobitz Type I?

A
  1. Light headedness
  2. Dizzy
  3. Syncope
49
Q

What is Mobitz Type II aka?

A

2:1 block

50
Q

What is Mobitz Type II on ECG?

A
  1. Every other P wave fails to conduct
51
Q

Causes of Mobitz Type II?

A
  1. Anterior MI
  2. Mitral valve surgery
  3. SLE and lyme disease
  4. Rheumatic fever
52
Q

What is 3rd degree heart block?

A

No relationship between P waves and QRS
QRS typically abroad:
- ventricular spontaneous escape rhythm
Usually bradycardic

53
Q

LVH on ECG?

A

R in V5.6 >30mm

S in V1 > 30mm

54
Q

Causes of 3rd degree heart block?

A
  1. SHD
  2. IHD
  3. HTN
  4. Endocarditis/lyme disease
55
Q

Treatment of recent onset narrow complex AV block/ broad complex escape rhythm?

A

IV atropine

56
Q

Causes of RBBB?

A

PE
IHD
ASD/VSD

57
Q

Causes of LBBB?

A

IHD,

Aortic valve disease

58
Q

ECG of RBBB?

A

Tall late R waves in V1

Deep S wave in V6 and Lead I

59
Q

ECG of LBBB

A

Deep S wave in V1

Tall late R waves in V6, Lead I

60
Q

Causes of prolonged QRS

A
  1. Ventricular ectopic
  2. Ventricular tachycardia
  3. Complete heart block
  4. Pre-excitation delta wave
61
Q

Small QRS complexes seen in

A
  1. Obese patients
  2. Percardial effusion
  3. Infiltrative cardiac disease
62
Q

Tall QRS in

A
  1. LVH

2. Thin patients

63
Q

What are pathological q waves?

A

Deeper > 2mm
Broader > 1mm
May represent full thickness infarction

64
Q

What leads would show an inferior infarct and what artery do they represent

A

Lead II, III, aVF

Right coronary artery

65
Q

What leads would show an anterior infarct and what artery do they represent

A

V2,3,4

Left anterior descending artery

66
Q

What leads would show an lateral infarct and what artery do they represent

A

V5,6, Lead II

Circumflex artery

67
Q

Congenital abnormal QT?

A

Long QT syndrome

Short QT syndrome

68
Q

Acquired abnormal QT?

A
  1. Ischaemia
  2. Metabolic disturbances
  3. Drugs e.g. macrolide abx, anti-epileptics, anti-depressants, 1st generation anti-histamines
69
Q

Equation for QT correction?

A

QTc = QT duration/ Squarroot(RR interval)

70
Q

What suggests an abnormal T wave?

A
  1. Symmetrical
  2. Biphasic
  3. Tall/peaked
  4. Inverted
71
Q

Causes of abnormal QTs?

A
  1. Ischaemia/infarction
  2. Myocardial strain (hypertrophy)
  3. Myocardial disease (cardiomyopathy)q
72
Q

Hyperkalaemia ECG?

A

Tall tented T waves
Flattened P waves
Broad QRS

73
Q

Hypokalaemia on ECG?

A

Flat T waves, QT prolongation

74
Q

Hypercalcaemia

A

QT shortening

75
Q

What is Wolff Parkinson White Syndrome

A

Congenital remnant muscle strands between atrium and ventricles
Early activation of ventricles result in delta wave before QRS on the ECG

Phase 2 Mine (12 decks)

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