ECG Flashcards
outline the artery territories and what position they supply
- Left coronary artery
- ANTEROLATERAL
- Right coronary artery
- INFERIOR
- Circumflex
- LATERAL
- LAD
- ANTERIOR/SEPTAL
what does each artery supply
- RCA
- RA
- RV
- inferior aspect of LV
- posterior septal area
- Circumflex
- left atrium
- posterior aspect of LV
- LAD
- anterior aspect of LV
- anterior aspect of septum
outline ECG territories
- lateral
- anterior
- inferior
- septal
- Lateral
- aVL, I, V5, V6
- Anterior
- V4, V3
- Septal
- V1, V2
- Inferior
- II,III, aVF
what is a normal axis?
both I and II +ve
how is left axis deviation seen?
I +ve and II -ve
how is right axis deviation seen?
I -ve and II +ve
what does left axis deviation indicate?
- inferior MI
- LVH
what does Right axis deviation indicate?
- anterolateral MI
- RVH, PE
summary table of artery, heart area it supplies and ECG leads
outline ECG changes in RBBB
MaRRooN
- M shape in V1
- N shape in V6
- N=Normal QRS, just a bit wider
(rSR= small rise, big drop, and even bigger rise)
outline ECG changes in LBBB
ViLLhelM
- V shape in V1
- M shape in V6
outline the waves in the JVP and what they signify
- a wave= atrial systole
- c wave= tricupsid valve closing
- v wave= passive atrial filling
in what instance would you have a raised JVP?
- RHF
- fluid overload
- SVC obstruction
- pericardial tamponade
- constrictive pericarditis
in what pathology would large JVP A waves be seen?
- PHT
- Tricuspid stenosis
- Pul stenosis
when would JVP a waves be absent?
AFib
in what pathology would you see large JVP V waves?
tricuspid regurgitation
in what pathologies would you see cannon A waves on JVP
- complete heart block
- certain arrythmias
causes of LBBB
- IHD
- LVH
- Aortic valve disease
- Cardiomyopathy
- Myocarditis
causes of RBBB
- normal variant
- RVH/RV strain
- IHD
- Myocarditis
- congenital heart disease
what is bundle branch block?
delay or blockage along the pathway that electrical impulses travel to make heart beat
ECG findings in RVH
- right axis deviation
- +ve right wave in V1
causes of a low voltage ECG? ie small complexes
- COPD
- hypothyroidism
- pericardial effusion
- dextrocardia
- cardiomyopathy
causes of ST depression?
- NSTEMI
- Digoxin
causes of ST elevation?
- MI
- Pericarditis
- Hyperkalaemia
- Prinzmental’s angina
- LV aneurysm
- takotsubo cardiomyopathy
- normal variant - high take off
causes of T wave inversion?
- Ischaemia
- Digoxin
- PE
- Ventricular hypertrophy
- Cardiomyopathy
mnemonic to read ecg
ARI BAR TIME CAN’T WAIT IN A STEMI
Any electrical activity?
Rate?
Irregular or regular rhythm?
Broad QRS?
Any P waves?
Relationship between P waves and QRS
T/Q waves
Cardiac axis (LAD/RAD)
Wave morphology (P waves + QRS wave- LBBB/RBBB?)
ST segment / PR interval / QT interval
Causes of PR interval lenghtening
Heart Block
Causes of PR interval shortening?
- HOCM
- Accessory condiction ie WPW
Normal PR interval?
120-200ms
Normal QT interval?
380-420 ms
Causes of QT lengthening?
Toxins
- TCA
- Anti-arrhythmics (amiodarone, quinidine)
- Anti-histamine
- Macrolides
Ischaemia / Inherited conditions
Myocarditis
Mitral valve prolapse
Electrolytes: ↓ Mg, Ca, K, reduced temp
Causes of QT shortening? (<380ms)
- Digoxin
- B-Blockers
- Phenytoin
in which leads are inverted T waves an abnormal finding?
I, II and V4-6
