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HSE320 PRAC EXAM > ECG and BP > Flashcards

ECG and BP Flashcards

1
Q

HR recording: 6-lead ECG

A

Used for:

  • Athletes over 35yrs; and
  • Asymptomatic, low risk individuals over 35yrs.H
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2
Q

HR recording: 12-lead ECG

A

Used for:

  • All other individuals over 35yrs, who have cardiorespiratory signs, symptoms, multiple risk factors or medical conditions.
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3
Q

Cardiac conduction system (1)

specific conduction pathways allow for coordinated transmission of ____ _____ through the _____

A

action potentials

heart

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4
Q

Cardiac conduction system (2)

An action potential is created by the

A

sinoatrial (SA) node

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5
Q

Cardiac conduction system (3)

the signal spreads across the ___ causing them to ____, before reaching the _______ _____, where it is delayed allowing the ventricles to fill.

A

atria

contract

atrioventricular (AV) node

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6
Q

Cardiac conduction system (4)

it then travels to the ___ ___ ___, then along the inter-ventricular septum via the left and right bundle branches, then spreads along the ventricles via the ___ ___ causing them to contract.

A

bundle of His

Purkinje fibres

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7
Q

Cardiac conduction system (5)

What is captured by ECG?

A

Depolarisation (contraction); and

Repolarisation (relaxation)

…of cardiac muscle

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8
Q

ECG Lead V1

A

Fourth intercostal space just to the right of the sternal border

Septum

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9
Q

ECG Lead V2

A

Fourth intercostal space just to the left of sternal border

Septum

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10
Q

ECG lead V3

A

At the midpoint of a straight line between V2 and V4

Anterior

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11
Q

ECG lead V4

A

On the midclavicular line in the fifth intercostal space

Anterior

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12
Q

ECG lead V5

A

On the anterior axillary line and on a horizontal plane through V4

Lateral

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13
Q

ECG lead V6

A

On the midaxillary line and on a horizontal plane through V4 and V5

Lateral

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14
Q

BP reading consists of two figures ___ and ___, with the difference between the two being

A

systolic

diastolic

pulse pressure

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15
Q

for adults, typical systolic BP ranges between

A

120 and 145 mmHg

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16
Q

for adults, typical diastolic BP ranges between

A

60 and 85 mmHg

17
Q

if BP exceeds normal range

A

high = hypertension

18
Q

if BP is below normal range

A

low = hypotension

19
Q

Measuring BP in individuals with coronary artery disease

A
  • Combining BP and HR measures allows us to estimate cardiovascular stress that can be sustain during exercise.
  • Coronary artery disease = imbalance between oxygen demand and supply to the heart - narrowing or blockage of coronary arteries which then limits supply of oxygenated blood to the heart.
  • when heart oxygen supply is insufficient to meet demands (myocardial ischemia)
  • angina, excessive shortness of breath, fatigue, palpitations or abnormally fast heartbeat, onset of nausea or need to vomit.
20
Q

Measuring BP in individuals with coronary artery disease

we cannot measure myocardial oxygen supply during a standard stress test, but we can estimate myocardial oxygen demands using the rate pressure product (RPP) formula

A

RPP = heart rate (bpm) x systolic blood pressure (mmHg)

  • oxygen demand depends on how fast and frequently a muscle is contracting (heart rate) and how much force it needs to contract with (systolic BP)
  • calculated at each stage of the stress test.
  • onset of ischemia or symptoms can indicate severity of disease.
21
Q

YMCA cycle test protocol

A
  1. determine age-predicted max HR and criteria for terminating exercise test
  2. setup bike with correct positioning
  3. collect resting HR and BP
  4. 25 watts, 50rpm for 3 min
  5. based on HR at end of first stage, use the table to decide subsequent work rates for next 3 stages
  6. 3 mins per stage, collect HR and BP, monitor for ST-depression at each stage
22
Q

ECG criteria for stopping an exercise test (absolute - must stop)

A
  • technical difficulties in monitoring ECG tracings
  • sustained ventricular tachycardia
  • ST-elevation of more than 1mm in leads without Q waves
23
Q

ECG criteria for stopping an exercise test (relative)

A
  • ST or QRS changes (excessive horizontal or downsloping ST depression of more than 2mm)
  • Arrhythmias
24
Q

BP criteria for stopping an exercise test (absolute - must stop)

A
  • drop is systolic BP of greater than 10 mmHg from baseline when accompanied by other indications of ischemia.
  • technical difficulties in monitoring systolic BP
25
Q

BP criteria for stopping an exercise test (relative)

A
  • hypertensive response (systolic BP of 250 mmHg and diastolic BP higher than 115 mmHg).
26
Q

P wave

A

Atrial depolarisation

electrical activity in atria (2x upper chambers of the heart)

27
Q

QRS complex

A

Ventricular depolarisation

electrical activity in ventricles (2x lower chambers of the heart) that stimulate them to contract

28
Q

T wave

A

Ventricular repolarisation

electrical activity in heart’s ventricular repolarisation, reset of heart as it prepares for next cardiac cycle.

29
Q

Atrial fibrillation

A
  • Heart beats irregularly and fast
  • reduces hearts ability to pump blood properly
  • causes incl. high BP, coronary heart disease.
  • without treatment, risk of stroke or heart attack is high
30
Q

Ventricular ectopic - premature ventricular contraction

A
  • Extra heartbeats that begin in one of the heart’s two lower pumping chambers (ventricles)
  • extra beats disrupt regular heart rhythm, causes fluttering or palpitations in the chest.
  • occur with or without heart disease.
  • occurs in healthy athletes at rest, disappear with exertion.
  • may need treatment if they are frequent or bothersome, or if you have underlying heart condition.
31
Q

S-T segment depression

A
  • caused by ischemia
  • horizontal or down sloping ST segment
32
Q

S-T segment elevation

A
  • myocardial infarction
  • total blockage of arteries that supply heart with blood.
  • upward ST segment

HSE320 PRAC EXAM (5 decks)

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