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Cardiology > ECG > Flashcards

ECG Flashcards

1
Q

Inferior leads

A

Lead II, III and aVF

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2
Q

Lateral leads

A

V5, V6,
Lead I
aVR, aVL

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3
Q

Anterior leads

A

V3, V4

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4
Q

Leads giving septal view

A

V1, V2

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5
Q

Course of electrical activity in the heart

A 
Begins at sinoatrial node
Spreads to atrioventricular node
Through Bundle of His
To purkinje fibres
Causing ventricular contraction
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6
Q

What deflection is produced when electrical activity moves in the direction of a lead?

A

Positive

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7
Q

If the R wave is bigger than the S wave in which direction is depolarisation heading relative to the lead?

A

Towards the lead

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8
Q

What term is used when Leads III and aVF are the most positive on ECG?

A

Right axis deviation

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9
Q

What causes right axis deviation?

A

Right ventricular hypertrophy

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10
Q

What conditions are associated with right axis deviation?

A

Pulmonary hypertension

May be normal in tall individuals

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11
Q

What term is used for negative deflection in leads III and II?

A

Left axis deviation

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12
Q

What leads to left axis deviation?

A

Conduction issues

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13
Q

What is the normal cardiac axis?

A

Between -30 degrees and

+90 degrees

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14
Q

What is a normal heart rate?

A

60-100bpm

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15
Q

What heart rate indicated tachycardia?

A

Greater than 100 bpm

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16
Q

What heart rate indicates bradycardia?

A

Less than 60 bpm

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17
Q

How do you calculate the heart rate using ECG in a patient with regular heart rhythm?

A

Count number of large squares within one R-R interval

Divide 300 by number of large sqaures

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18
Q

How do you calculate the heart rate on ECG in a patient with irregular heart rhythm?

A

Count number of complexes on rhythm strip and multiply by 6

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19
Q

What condition is indicated by an irregularly irregular heart rhythm?

A

Atrial fibrillation

20
Q

What atrial activity is indicated by a sawtooth baseline?

A

Flutter waves

21
Q

What atrial activity is indicated by a chaotic baseline in absence of p waves?

A

Fibrillation

22
Q

What is the normal PR interval?

A

120-200 ms

3-5 small squares

23
Q

What is the value of a prolonged PR interval?

A

Greater than 0.2s

24
Q

What is indicated by a prolonged PR interval?

A

Atriventricular delay (AV block)

25
Q

A fixed prolonged PR interval indicates which type of heart block?

A

First degree

26
Q

What is seen on ECG in Mobitz Type I/Second degree type 1 / Wencheback phenomenon?

A

progressive prolongation of the PR interval until eventually the atrial impulse is not conducted and the QRS complex is dropped.

27
Q

What is seen on ECG in Mobitz type 2/ Second degree Type 2 AV block?

A

consistent PR interval duration with intermittently dropped QRS complexes due to a failure of conduction

28
Q

What is a 3:1 and 4:1 block?

A

Second degree AV block Type 2
Consistent prolonged PR, QRS complexes dropping intermittently

3: 1 = QRS dropping after every 3rd p wave
4: 1 = dropping after every 4th

29
Q

What are the typical ECG findings in 3rd degree heart block?

A

No association between P waves and QRS complexes

Narrow and broad complexes

30
Q

Where do narrow complexes fire from in 3rd degree heart block?

A

Above the bifurcation of the bundle of His

31
Q

Where do broad complexes originate in 3rd degree heart block?

A

Below the bifurcation of the bundle of His

32
Q

What condition presents on ECG with a slurrede upstroke of the QRS complex and shortened PR interval?

A

Wolff parkinson White syndrome

Delta wave - bunny ears

33
Q

What is indicated by a tall QRS complex?

A

Ventricular hypertrophy

34
Q

What is required to diagnose Wolff parkinson white?

A

Delta wave AND tachyarrythmias

35
Q

Define a pathological Q wave

A

> 25% the size of the R wave that follows it or > 2mm in height and > 40ms in width.

36
Q

What are Q waves indicative of if found with inverted t waves in a territory?

A

Previous MI

37
Q

ST elevation indicates?

38
Q

ST depression indicates?

A

Myocardial ischaemia

39
Q

Tall T waves are associated with?

A

Hyperkalaemia

Hyperacute STEMI

40
Q

Causes of inverted T wave

A

Ischaemia
Bundle branch blocks (V4-6 in LBBB and V1-V3 in RBBB)
Pulmonary embolism
Left ventricular hypertrophy (in the lateral leads)
Hypertrophic cardiomyopathy (widespread)
General illness

41
Q

Biphasic T waves indicate

A

Ischaemia

Hypokalaemia

42
Q

Flattened T waves indicate?

A

Ischaemia

Electrolyte imbalance

43
Q

What is a U wave?

A

Deflection not often seen after the T wave

Best seen in V2 or V3

44
Q

What can a U wave indicate?

A

electrolyte imbalances, hypothermia and secondary to antiarrhythmic therapy (such as digoxin, procainamide or amiodarone).

45
Q

Which antiarrhythmic drugs can cause a U wave on ECG?

A

Digoxin
Procainamide
Amiodarone

Cardiology (7 decks)

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