ECG Basic

Question 1

ECG Precordial leads location corresponding

Answer 1

V1,2 - Septal
V3,4 - Anterior
V5,6 - Lateral

Question 2

Hyperacute T waves

Answer 2

“Fitting QRS complex into T wave”
“straight upsloping T wave”
-> abnormal until proven otherwise, for serial ECG

Question 3

Wellen Syndrome

Answer 3

Patient pain free, but display characteristic pattern. (hx of angina)
Critical LAD stenosis (high risk progression to ant MI).
Deeply inverted T waves/ Biphasic T in V2-3 (type A), no ST segment changes.
Isoelectric

Question 4

Wellens Waves

Answer 4

If pt symptomatic with changes - Wellens Waves.

Question 5

De Winter’s T wave

Answer 5

Highly specific to anterior STEMI & LAD occlusion (acutely unstable)
Mid precordial (V2,3,4) tall, symmetrical, peaked T waves
Concurrent ST depression >1mm

Question 6

Modified Sgarbossa Criteria

Answer 6

1. Concordant STE ＞1mm in Any lead.
2. Concordant ST Depression ＞1mm in V1-V3
3. STE to S ratio of 25% in any lead

Question 7

Pathological Q waves

Answer 7

Indicate dead tissue.
>2 contiguous leads : V1-V3
>40ms (1 sq wide)
>2mm deep (2 small sq)
>25% depth of QRS complex

Question 8

LMCA Occlusion (STEMI equivalent)

Answer 8

STE >1mm in avR, STE in avR >V1, Widespread horizontal ST dep most prominent in I, II, V4-6

Question 9

STEMI criteria

Answer 9

STE >2mm in precordial leads
STE >1mm in limb leads

Question 10

Brugada Syndrome
Causes

Answer 10

Ischaemia
Temperature
Exertion
Drugs - CCB, B blockers, Na channel blockers, Etoh, Cocaine
Hypokalaemia, Post DCCV