ECG changes

Question 1

ECG Changes
Symptoms
Causes
Mx

of SINUS TACHY

Answer 1

ECG Changes: Rate >100. P+QRS = Norm
Symptoms: Palps., dizziness, CP
Causes: MI, exercise, drugs, anxiety, shock, hypoxia
Mx: Stop underlying change or BB if that doesn’t work

Question 2

ECG Changes
Symptoms
Causes
Mx

of SINUS BRADY

Answer 2

ECG Changes: Rate <60
Symptoms: Usually asymptomatic but can cause symptoms of reduced CO
Causes: Drugs, vomiting (vagal response), hypothermia, hypothyroidism
Mx: Stop underlying cause if any. If symptomatic may need atropine or pacer

Question 3

ECG Changes
Symptoms
Causes
Mx

of ATRIAL FLUTTER

Answer 3

ECG Changes: Rate varies, P waves are saw-toothed and may not be 1:1 with QRS, QRS normal
Symptoms: Depends on rate and mirrors tachy/brady
Causes: PE, hypothyroid, IHD, Valve disease
Mx: Depends on the rate. May require pharmaco. cardioversion

Question 4

ECG Changes
Symptoms
Causes
Mx

of ATRIAL FIB

Answer 4

ECG Changes: P wave not clear. QRS normal
Symptoms: Palpitations, Decreased CO, Clot risk
Causes:PIRATES
Mx:Treat underlying cause + anticoagulant +/- cardioversion

Question 5

Mechanism of SVT

Answer 5

1. Wolff-Parkinson-White: a tract bypasses the node allowing all atrial impulses to transmit to the vents.
2. Accessory pathway formation which leads to AV Re-entry

Question 6

ECG Changes
Symptoms
Causes
Mx

of SVT

Answer 6

ECG Changes: QRS normal and reg. P waves absent
Symptoms: Similar to tachycardia + chest pain
Causes: Stimulation of preexisting pathway
Mx: ABCDE + valsalva manoeuvre + ablation
Adenosine
Beta-blocker
Calcium channel antagonist
Digoxin
Excitation (vagal stimulation)

Question 7

ECG Changes
Symptoms
Causes
Mx

of VT

Answer 7

ECG Changes: P absent, QRS+T merge and regular
Symptoms: CP, Palps, reduced CO
Causes: MI, Met.Acidosis,Electrolyte imbalance
Mx: Pulseless = Arrest, Unstable = Sedate+DCCV, Lignocaine or amiodarone if not symptomatic

Question 8

ECG changes in pericarditis

Answer 8

Saddle shaped ST elevation

Question 9

ECG features of hyperkaleamia

Answer 9

Peaked T
Flattened P
Increased PR
Wide QRS
Sine wave look like VF