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Cardiology > ECG abnormalities > Flashcards

ECG abnormalities Flashcards

1
Q

What are the ECG abnormalities in a pulmonary embolism? (3)

A
  • Some normal
  • Sinus tacchycardia
  • Sometimes: complete/incomplete RBBB
  • Rare: “SI QIII TIII” classic sign
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2
Q

What are the ECG abnormalities in a STEMI? (5)

A
  • Equal to and greater than 1mm ST elevation in at least 2 adjacent limb leads
  • Or equal to and greater than 2mm ST elevation in at least 2 adjacent praecordial leads
  • Left bundle branch block new onset
  • Broad QRS complex
  • Or equal to and greater than 1mm horizontal ST depression in reciprocal leads
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3
Q

How does an ECG change as an STEMI progresses? (6)

A
  • Normal
  • Hyperacute T waves (was rounded bump = peaked)
  • ST segment elevation
  • ST segments return to baseline
  • T wave inversion
  • Pathological Q waves
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4
Q

What are the ECG abnormalities in a posterior MI? (2)

A
  • Reciprocal anterior ST depression

- Dominant R wave (reciprocal Q wave) in V1

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5
Q

What are the ECG abnormalities in atrial fibrillation? (2)

A
  • No P waves

- Irregularity of QRS complex from beat to beat

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6
Q

What explains the ECG abnormalities in atrial fibrillation?

A

Rhythm irregular as no coordinated atria activity

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7
Q

In an anterior MI where would ST elevation be seen? (2)

A
  • Mainly in anteroseptal leads (V1-V3)

- In some anterolateral leads (V4-V5)

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8
Q

What part of the heart is damaged in an anterior MI? (2)

A
  • Anterior heart

- Left anterior descending artery

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9
Q

What part of the heart is damaged in a lateral MI? (2)

A
  • Lateral aspect of heart

- Left circumflex artery

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10
Q

In a lateral MI where would ST elevation be seen? (2)

A
  • Anterolateral leads (V4-V6)

- Lateral limb leads: Lead I and Lead avL

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11
Q

In an inferior MI where would ST elevation be seen? (3)

A

(Inferior leads)

  • Lead II
  • Lead III
  • Lead avF
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12
Q

What part of the heart is damaged in a inferior MI? (2)

A
  • Posterior inferior wall

- Right coronary artery

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13
Q

What kind of arrhythmia is common in an inferior MI? (2)

A
  • Severe bradycardia

- Mobitiz type 1 second degree heart block

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14
Q

Why is bradycardia a common complication of an inferior MI?

A

In 90% of patients right coronary artery supplies SAN and AVN

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15
Q

What are the ECG abnormalities in first degree AV block? (5)

A
  • Rate variable
  • Regular narrow QRS
  • P waves present
  • P:QRS 1:1
  • PR interval more than 200ms
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16
Q

What are the ECG changes in sinus arrhythmia?

A
  • RR interval shortens in inspiration

- RR interval lengthens in expiration

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17
Q

What ECG changes are normal with ethnic variation? (3)

A
  • Left ventricular hypertrophy
  • T wave inversion
  • ST elevation
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18
Q

What are the ECG changes seen in acute MI? (7)

A
  • Normal
  • Hyperacute T waves
  • ST segment elevation
  • ST segment depression in recipricoal leads
  • Improvement in ST segments with reperfusion
  • T wave inversion
  • Pathological Q waves
19
Q

What are ECG indications of left ventricular hypertrophy?

A
  • S wave in V1/V2

- R wave in V5/V6 more than equal to 35mm

20
Q

What in an ECG indicates a greater danger of congestive cardiac failure?

A

Downwards sloping ST segment

21
Q

What ECG sign suggests total occlusion of one of the main 3 arteries?

A

ST segment elevation

22
Q

When are Q waves pathological? (2)

A
  • Greater than 1mm

- More than 25% height of R wave

23
Q

What do pathological Q waves indicate?

A

Transmural myocardial infarction

24
Q

How does a transmural myocardial infarction appear on a CT scan? (2)

A
  • Brightness : endocardial to epicardial surface of left ventricle
  • Oedema = enhancement
25
Q

What should be noticed on an ECG to diagnose an arythmia? (5)

A
  • QRS rate
  • QRS complexes regular?
  • QRS broad/narrow?
  • P waves?
  • P:QRS relation?
26
Q

What are the ECG changes for atrial fibrillation? (4)

A
  • No P waves in every lead
  • Irregularly irregular QRS complexes
  • Normal QRS shape (AV node conduction normal)
  • Normal T waves
27
Q

What are the ECG changes in 3rd degree heart block?

A

P waves completely dissociated from QRS complex

28
Q

What are the ECG changes in pulmonary embolism? (6)

A
  • Most common: just tachycardia
  • Rightward axis deviation
  • Incomplete RBBB
  • Lead I: very negative
  • Lead III: Q wave
  • Simulatenous T wave inversion in inferior and anteroseptal leads
29
Q

What is the “classic” PE ECG finding that’s actually very rate?

A

S1Q3T3

30
Q

What is a left bundle branch block?

A

The left ventricle is not directly activated by impulses travelling through the left bundle branch

31
Q

What is the mnuemonic for LBBB?

A

WiLLiaM

‘W’ in lead V1 and an ‘M’ wave in lead V6

32
Q

What is the mnuemonic for RBBB?

A

MaRRoW

‘M’ wave in lead V1 and a ‘W’ wave in lead V6

33
Q

ECG abnormalities in pericarditus (3)

A
  • Widespread saddle shaped ST elevation
  • Concave ST (a little elevated)
  • PR interval depression
34
Q

ECG changes in NSTEMI/unstable angina? (3)

A
  • ST depressions
  • T-wave inversion
  • No pathological Q waves
35
Q

Atrial flutter (2)

A
  • Regular number of P waves in between QRS complex

- But too many P waves between QRS complexes

36
Q

Supraventricular tacchycardia (2)

A

(electrical impulse recycling around AV node)

  • Narrow QRS complexes
  • Tacchycardia
37
Q

Ventricular tacchycardia

A
  • Amplitude of QRS is the same
  • Big hill looking QRS
  • RS interval: more than 100ms
  • Could have pulse
38
Q

Ventricular fibriilliation (3)

A
  • No pulse
  • Small wiggly line
  • Very irregular rhythm with indiscernible P waves or QRS complexes on ECG
39
Q

Sinus bradycardia

A

Slow HR with regular P waveswaves

40
Q

Mobitiz type 1 second degree (2)

A
  • PR interval slowly increases

- Until dropped QRS complex (beat)

41
Q

Mobitiz type 2 second degree (2)

A
  • Regular PR interval

- Random dropped beats

42
Q

Hyperkalaemia (kidney failure/rhamdomyolsis) and eventual change? (4)

A
  • Tall tented T waves
  • Wide QRS
  • P waves flattening
    Eventually: Prolonged PR interval and P waves disappear
43
Q

Hypokalaemia (diarrhoea,DI,furosemide) (4)

A
  • ST segment depression
  • Inverted T waves
  • Large U waves
  • Prolonged PR

Cardiology (18 decks)

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