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Cardio > ECG > Flashcards

ECG Flashcards

1
Q

Position of ECG leads

A 
V1 - R 4th intercostal
V2 - L 4th intercostal
V3 - Between V2 and V4
V4 - Midclavicular line 5th intercostal
V5 - Between V4 and V5
V6 - midaxiallary line 5th intercostal

(Place V3 after V4)

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2
Q

What is the algorithm to follow when reading an ECG?

A
  1. Rate
  2. Rhythm
  3. Axis
  4. Interval
    - PR
    - QRS (and R wave progression)
    - Q wave
    - ST elevation/depression + T wave inversion
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3
Q

How to calculate HR?

A

No. of QRS in rhythm strip x6

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4
Q

When the flow of depolarisation is following towards LL (positive electrode) what kind of wave will be produced on an ECG?

A

Positive upstroke

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5
Q

How big should a PR interval be?

A

0.12-0.2s

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6
Q

How long should a QRS complex be?

A

<0.12s

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7
Q

One small square represents how many seconds?

A

0.04s

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8
Q

How do you define an irregular HR with present P waves?

A

Sinus arrythmia

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9
Q

What limb leads will be most positive for left axis and right axis deviation?

A

Left axis - aVL

Right axis - III

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10
Q

In normal axis deviation what limb leads should be most positive?

A

I/II

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11
Q

What is the name for a short PR interval with a slurred upstroke and what is this associated with? Briefly describe the condition

A

Delta waves
Wolff-Parkinson-White syndrome
Presence of accessory pathway (e.g. Bundle of Kent) in heart aside from AV node so V contract quicker

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12
Q

What defines brady- and tachy- cardia?

A

Brady - <60bpm

Tachy - >100bpm

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13
Q

What does presence of P waves mean?

A

Heart is in sinus rhythm

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14
Q

What is the mnemonic for remembering what leads relate to what areas of the heart?

A

LII
LI
SSA
ALL

(big lie, wee lie, ass backward, all)

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15
Q

ECG displaying narrow and v tall QRS complexes in chest leads is indicative of?

A

LVH

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16
Q

How may an NSTEMI display on ECG?

A

T wave inversion

ST depression

17
Q

What is a raised ST elevation associated with?

A

STEMI

18
Q

If a patient’s ECG is showing poor R wave progression, what is this a sign of?

A

Problem with conduction e.g. prior MI

19
Q

Describe the ECG patterns for all the types of heart block

A

Type 1 - long PR interval always followed by QRS
Mobitz type 1 - increasing PR interval with eventual missing QRS
Mobitz type 2 - regular large PR interval with nth missing QRS
Complete - no relationship between P wave and QRS (sometimes P wave sometimes not)

POEM =
If the R is far from the P then you have FIRST DEGREE
Longer, longer, longer, drop! Then you have a WANKEBACH
If P doesn’t always come through then you have MOBITZ II
If Q and P don’t agree then you have THIRD DEGREE

20
Q

What is characteristic of LBBB?

A

Prolonged QRS
QRS is negative in V1
L Axis deviation
QRS positive in I and V6

21
Q

What is characteristic of RBBB?

A

Bunny rabbit ears (left is smaller than right) in QRS

Slurred S wave in V6 and I

22
Q

What is the problem with BBB

A

It means if one working branch fails they can go into complete heart block

23
Q

What are causes of physiological bradycardia? (3)

A

Very fit
Nocturnal
Medication

24
Q

what does broad and narrow bradycardia QRS mean?

A

Narrow QRS - working beyond the AV node

Broad QRS - not working beyond the AV node - problem with conduction e.g. His bundle

25
Q

What is junctional rhythm? How would you identify it?

A

Sinus node not working AV node takes over
Bradycardia
Narrow QRS
No P waves/buried in QRS complex/just after QRS

26
Q

What is a broad QRS generally suggestive of in bradycardia?

A

Branch block

27
Q

What happens when SA node doesn’t work properly?

A

Junctional rhythm

28
Q

Trifascicular block

A

RBBB
Left/right axis deviation
Prolonged PR

fascicle not working properly

(LAD = left ant fascicular block
RAD = left post fascicular block)
29
Q

Fixed AV block

A

Same as mobitz type 2

30
Q

How may an NSTEMI present?

A

ST depression

T wave inversion

31
Q

What is associated with U waves, small/absent T waves and prolonged PR interval?

A

Hypokalaemia

32
Q

What is significant about JVP waves in AF?

A

A waves absent

33
Q

What arrythmia is associated with saw tooth markings?

What will the HR be?

A

Atrial flutter

250-400 bpm

Cardio (15 decks)

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