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CR Year 3 > ECG Abnormalities > Flashcards

ECG Abnormalities Flashcards

1
Q

Sinus Tachycardia

A

> 100bpm

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2
Q

Sinus Tachycardia causes

A 
Infection
Pain
Exercise
Anxiety
Dehydration
Bleed
Systemic vasodilation (e.g. sepsis)
Drugs (caffeine, nicotine, salbutamol)
Anaemia
Fever
PE
Hyperthyroidism
Pregnancy
CO2 retention
Autonomic neuropathy
Sympathomimetics
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3
Q

Sinus Bradycardia

A

Sinus rhythm <60bpm

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4
Q

Sinus Bradycardia Causes

A 
Physical fitness
Vasovagal attacks
Sick sinus syndrome
Drugs (beta blockers, digoxin, amiodarone)
Hypothyroidism
Hypothermia
Increased ICP
Cholestasis
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5
Q

AF

A

Absent P waves and irregular QRS complexes

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6
Q

AF causes

A 
IHD
Thyrotoxicosis
Hypertension
Obesity
CCF
Alcohol
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7
Q

Heart block definition

A

Disrupted passage of electrical impulse through AV node

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8
Q

1st degree HB

A

PR interval is prolonged and unchanging/regular

No missed beats

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9
Q

2nd degree HB Mobitz I

A

Wenckebach
PR interval becomes longer and longer until a QRS is missed, then the pattern resets
Regular Irregular

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10
Q

2nd degree HB Mobitz II

A

QRSs regularly missed e.g. P-QRS-P-QRS-P

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11
Q

Causes of 1st and 2nd degree HB

A 
Normal variant
Athletes
Sick sinus syndrome
IHD (especially inferior MI)
Acute myocarditis
Drugs (digoxin, beta-blockers)
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12
Q

3rd degree HB

A

Complete HB
No impulses passed from atria to ventricles
P waves and QRS complexes appear independently from each other
Patient becomes very bradycardic, may lead to haemodynamic compromise
Urgent treatment required

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13
Q

3rd degree HB causes

A 
IHD (esp. inferior MI)
Idiopathic (fibrosis)
Congenital
Aortic valve calcification
Cardiac surgery/trauma
Digoxin toxicity
Infiltration (abscesses, granulomas, tumours, parasites
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14
Q

ST elevation

A 
Normal variant (high take-off)
STEMI
Prinzmetal's angina- coronary artery spasm; pain without exertion triggered by hyperventilation, cocaine, tobacco
Acute pericarditis (saddle-shaped)
Left ventricular aneurysm
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15
Q

ST Depression

A 
Normal variant (upward sloping)
Digoxin toxicity (downward sloping)
Ischaemia (horizontal)
Angina 
NSTEMI
Acute posterior MI (in V1-V3)
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16
Q

T inversion in V1-3

A

Normal (black patients and children)
RBBB
RV strain 9e.g. secondary to PE)

17
Q

T inversion in V2-5

A

Anterior ischaemia
Hypertrophic cardiomyopathy
Subarachnoid haemorrhage
Lithium

18
Q

T inversion in V4-6 and aVL

A

Lateral ischaemia
Left ventricular hypertrophy (LVH)
LBBB

19
Q

T inversion in II, III and aVF

A

Inferior ischaemia

20
Q

NSTEMI/unstable angina

A

ST depression
T wave inversion
non-specific changes, or normal

21
Q

Ischaemia- changes in I, aVL, V4-6

A

Lateral heart

Circumflex artery

22
Q

Ischaemia- changes in V1-3

A

Anterioseptal

LAD

23
Q

Ischaemia- II, III, aVF

A

Inferior heart
RCA in 80%
Circumflex in 20%- left dominant

24
Q

Posterior MI

A

Standard 12 lead ECG will not show Q waves, St elevation of hyperacute T waves
Instead you may find these changes but “upside down” in V1-3- Prominent R waves, flat ST depression, T wave inversion
If record V7-9 leads you may fins classic ST elevation –> posterior MI

25
Q

Pulmonary embolism

A

Sinus tachycardia (commonest)
RBBB
Right ventricular strain pattern- RAD, dominant R wave, T wave inversion/ST depression in V1-2
Rarely- deep S waves in I, pathological Q waves in III and T wave inversion in III

26
Q

Digoxin effect

A

Down sloping ST depression
T wave inversion V5-6
Any arrhythmia may occur

27
Q

Hyperkalaemia

A

Tall tented T waves
Widened QRS
Absent/flattened P waves
Sine-wave appearance

28
Q

Hypokalaemia

A

Small T waves
Prominent U waves
Peaked P waves

29
Q

Hypercalcaemia

A

Short QT interval

30
Q

Hypocalcaemia

A

Long QT interval

31
Q

Right bundle branch block

A

QRS>0.12s
V1: ‘RSR’ pattern, dominant R
V1-V3 or V4: T wave inversion
V6: wide, slurred S wave

32
Q

Right BBB causes

A

Normal variant (isolated RBBB)
PE
Cor pulmonale

33
Q

Left BBB

A

QRS >0.12s
V5: ‘M’ pattern
V1: dominant S
I, aVL, V5-6: T wave inversion

34
Q

Left BBB causes

A

IHD
Hypertension
Cardiomyopathy
Idiopathic fibrosis

35
Q

Bifascicular block

A

LBBB + RBBB

Manifests itself as an axis deviation

36
Q

Trifascicular block

A

Bifascicular block + 1st degree HB

37
Q

Left ventricular hypertrophy

A

R wave in V6 >25mm OR sum of S wave in V1 + R wave in V6>35mm

38
Q

Right ventricular hypertrophy

A

Dominant R wave in V1
T wave inversion in V1-3 or V4
Deep S wave in V6
RAD

39
Q

Causes of low voltage QRS complex (QRS <5mm in all limb leads)

A 
Hypothyroidism
COPD
Changes in chest wall impedance
PE
BBB
Carcinoid heart disease
Myocarditis + other heart muscle diseases
Cardiac amyloid
Doxorubicin cardiotoxicity
Pericardial effusion
Pericarditis

CR Year 3 (7 decks)

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