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S.N Pathophys final > ECG Basic > Flashcards

ECG Basic Flashcards

1
Q

1 mm X axis= __ sec

A

0.04

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2
Q

P wave normal length

A

Less than 0.1 sec

2.5 small squares

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3
Q

PR interval=

A

0.12-0.2 sec

3-5 small squares

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4
Q

QRS compex=

A

Less than 0.12

3 small squares

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5
Q

Q=

A

Less than 0.04 sec

1 small square

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6
Q

Normal T shape

A

Rounded but asymmetrical

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7
Q

Normal axis is from

A

-30 to +90

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8
Q

Inferion leads MI means which coronary artery?

A

RCA

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9
Q

Inferior leads

A

II
III
aVF

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10
Q

Anterolateral leads

A

I
aVL
V1-6

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11
Q

Lateral leads

A

I
aVL
V5-6

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12
Q

ECG rapid interpretation steps

A 
Rhythm
Rate
P wave
QRS
PR
Axis
Q wave
STE
Other abnormalities
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13
Q

What does Q wave > 0.04 sec tells as?

A

Injury

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14
Q

Atrial flutter important features

A

Rhythmic
HR 250-300 BPM
No P wave but F wave
QRS is normal

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15
Q

Atrial fibrillation important features

A

Arrhytmic
HR 300-350 BPM
NO P WAVE

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16
Q

Where can we best see A.Fib?

A

V1

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17
Q

Common example for pre-excitation syndrome

A

Wolf Parkinson White syndrome

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18
Q

What is the name of the accessory bandle in WPW syndrome?

A

Kent byndle

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19
Q

ECG of WPW

A

Delta wave connects the PR and PR is very short

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20
Q

Why PR interval is very short in WPW?

A

The AP doesnt go through the junction so it doesnt slow down

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21
Q

WPW can commonly procead to

A

A.FIb

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22
Q

QRS in WPW

A

Wide due to Delta wave

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23
Q

First degree AV block

A

Rhythmic

PR unterval > 0.2

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24
Q

Second degree AV block Mobitz type I

A

Arrhythmic
PR gradually increases until QRS “falls”
PR last&raquo_space;> PR first

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25
Q

Second degree AV block Mobitz type II

A

Arrhythmic
PR is normal
PR last = PR first

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26
Q

Second degree AV block 2:1

A

For every 2 P only 1 has QRS

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27
Q

Third degree AV block

A

Rhythmic

No connection btw. P to QRS

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28
Q

What does RBBB means regarding the heart?

A

RV is activated slower from the LV through the muscle cells

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29
Q

Mnemonics for RBBB

A

MaRoW

V1- M pattern

V6- W pattern

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30
Q

ECG features of RBBB

A

QRS > 0.12 sec
rSR in V1
Slurred S wave in I, aVL, V5, V6

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31
Q

V1 in RBBB

A

rSR pattern

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32
Q

Incomplete RBBB ECG features

A

rSR in V1 BUT! QRS is not longer than 0.12 sec

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33
Q

Clinically importance of incomplete RBBB

A

Acute PE
COronary disease
Myocarditis

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34
Q

What does LBBB means regarding the heart?

A

Activation of LV and the septum is abnormal

LV is activated from the RV

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35
Q

Mnemonics for LBBB

A

WiLiaM

V1- W

V6- M (Notched R)

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36
Q

ECG features of LBBB

A

QRS > 0.12 sec

Notched R in V5, V6, I, aVL

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37
Q

V1 in LBBB

A

rS

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38
Q

V6 in LBBB

A

Notched R in V5, V6, I, aVL

Lack of Q

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39
Q

VAT time is=

A

Time from the beginning of QRS and the point where R goes down (from his pick)

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40
Q

VAT time in RBBB and LBBB

A

Prolonged

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41
Q

LAH explenation

A

The Ant. fascicle doesnt conduct so the left ventricle is activated from the posterior fascicle

42
Q

ECG features of LAH

A

Exterme LEFT axis deviation
I, aVL: qR
II, III aVF: rS
QRS narrow

43
Q

LAH I, aVL:

A

qR

44
Q

LAH II, III aVF:

A

rS

45
Q

LPH explenation

A

Posterior fascicle doesnt conduct, so the left ventricle is activated from the anterior fascicle

46
Q

ECG features of LPH

A

Extreme RIGHT axis deviation
I, aVL: rS
II, III, aVF: qR
QRS is narrow

47
Q

LPH I, aVL:

A

rS

48
Q

LPH II, III, aVF:

A

qR

49
Q

Angina types

A

Stable
Unstable
Prinzmetal’s
Silent

50
Q

ECG of a patient with Prinzmetal’s angina

A

STE at rest or with physical exercise

51
Q

Which angina shows STE on ECG?

A

Prinzmetal’s

52
Q

Which angina shows STD on ECG?

A

Stable and unstable angina

53
Q

STE/ No STE on ECG + No cardiac symptoms with chest pain may indicate

A

Unstable angina

54
Q

Serum cardiac biomarkers (3)

A 
Troponin I + Troponin T
Creatine Phosphokinase (CK)
Lactate Dehydrogenase (LDH)
55
Q

Troponin levels in regarding to MI

A

Increases after 3-6 hours
Peaks at about 20 hours
Remains elevated for 7-10 days

56
Q

When do Troponin levels peak?

A

20 hours after MI

57
Q

Which Troponin are cardiac specific?

A

I and T

58
Q

Is CK specific in STEMI?

A

No

59
Q

CK-MB levels after MI

A

Rises within 3-6 hours

60
Q

Which LDH predominent in the heart?

A

LDH1

LDH2

61
Q

LDH levels peak _____ after the injury

A

3-4 days

62
Q

General treatment of MI (5)

A 
Anti coagulant (Aspirin)
Vasodilators (Nitrates)
Statins
Ca2+ channel blockers
B blockers
63
Q

Order of process of MI

A

Ischemia
Injury
Necrosis

64
Q

ECG in subendocardial ischemia

A

T upright but symmetrical

65
Q

ECG in subpericardial ischemia

A

Inverted T and symmetrical

66
Q

ECG in subendocardial injury

A

ST depression

V1-6 < 1mm

67
Q

ECG in subpericardial injury

A

STE

V1-6 > 2mm
Limbs > 1mm

68
Q

ECG sign of necrosis

A

Pathological Q wave

69
Q

Definition of pathological Q wave

A

Q > 0.04 sec

Q > 1/4 size of R

70
Q

We usually dont see Q wave in ______ leads

A

V1-4

71
Q

RCA responsible for blood supply where?

A

Inferior and posterior

72
Q

Stages of MI (4)

A

Hyperacute
Acute
Subacute
Old

73
Q

Hyperacute MI ECG sign

A

STE

74
Q

Hyperacute MI ECG sign will be visual when?

A

1-3 hour post MI

75
Q

Acute MI ECG sign

A

STE and Pathological Q wave

76
Q

Acute MI ECG sign will be visual when?

A

< 7 days post MI

77
Q

Subacute MI ECG sign will be visual when?

A

1-4 weeks post MI

78
Q

Subacute MI ECG sign

A

Pathological Q wave and inverted T

79
Q

Old MI ECG will be visual when

A

> 4 weeks post MI

80
Q

Right atrial Hypertrophy is also called

A

P pulmonale

81
Q

In RAH, P wave is > than 0.1 sec

A

P wave < 0.1 sec

82
Q

RAH ECG sign

A

Large P wave with tall initial part

83
Q

Left atrial Hypertrophy is also called

A

P mitrale

84
Q

LAH ECG sign

A

Large P wave with wide terminal part

85
Q

Where can we best see atrial hypertrophy?

A

II

V1

86
Q

RVH on ECG

A

RIght axis deviation

In V1, R > S (Remember RRRR)

In V5/V6, S > R

Strain pattern

87
Q

LVH on ECG

A

Left axis deviation

In V5, R > 25 mm

In aVL, R > 11 mm

Sokolof Lyons index

88
Q

Sokolof Lyons index=

A

S wave in V1 + R wave in V5/V6 > 35 mm

89
Q

K+ EC normal

A

3.5-5.1 mM

90
Q

Moderate hypokalemia ECG signs

A

U waves
Flat T and inversion
Long QT
STD

91
Q

Hyperkalemia on ECG

A

Peaked T
P flat and wide
Long PR
Wide QRS

92
Q

PE on ECG

A

S1Q3T3

Large and wide S on I
Large Q on III
Inverted T on III

93
Q

PE is the cause of _____

A

Acute cor pulmonale

94
Q

Digitalis mechanism of action

A

Blocks Na+/K+ ATPase
IC Na+ Increased
NCX reversed
IC Ca+2 Increases

95
Q

ECG features of digitalis toxicity

A

Scooped ST depression

96
Q

ECG features of Pericarditis

A

STE in multiple independent leads

97
Q

What can cause Left axis deviation

A

Inferior MI
LVH
LAH
LBBB

98
Q

What can cause Right axis deviation

A 
Lateral MI
RVH
LPH
Hyperkalemia
PE
COPD
99
Q

Necrotic tissue will shoft the axis _____ the side of the necrotic part

A

Away

100
Q

RBBB Does/Doesnt cause axis deviation

A

Doesnt

S.N Pathophys final (11 decks)

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