ECG - COPIED

Question 1

What is Wolff-Parkinson-White (WPW) Syndrome?

Answer 1

A type of pre-excitation syndrome (early activation of the ventricles due to impulses bypassing the AV node via an accessory pathway.)

a combination of the presence of a congenital accessory pathway and episodes of tachyarrhythmia.

Question 2

What does a normal U wave look like?

(look in leads V2 and V3)

Abnormalities

• prominent U waves
• Inverted U waves

Answer 2

Question 3

What is Torsades des Pointes?

• ‘twisting of points’

Answer 3

• focus of VT moves around the myocardium. Appears as a sine wave.

TX: cardioversion + Magnesium

Question 4

What could a QRS duration of > 120ms indicate?

(wide QRS intervals)

Answer 4

bundle branch block (RBBB or LBBB)

i.e. aberrant conduction

Hyperkalaemia

Pre-excitation (Wolff-Parkinson-White syndrome)

Question 5

What’s the normal width of a QRS complex?

Answer 5

3-4 small squares

70-100ms

Question 6

What are the cardinal features of Atrial Fibrillation?

Answer 6

• Irregularly irregular rhythm.
• No P waves.
• Absence of an isoelectric baseline.
• 110-160 ventricular rate

Question 7

Characteristic of WPW syndrome:

Answer 7

Broad QRS complexes with a slurred upstroke to the QRS complex — the delta wave.

Question 8

What’s this?

Answer 8

AF

Question 9

An anterior STEMI results from the occlusion of which artery?

Answer 9

Anterior STEMI results from occlusion of the left anterior descending artery (LAD).

Question 10

What does the left coronary artery divide into?

Answer 10

circumflex artery

left anterior descending artery

Question 11

What’s this?

Answer 11

Atrial Flutter

Question 12

Which conditions are P waves absent?

Answer 12

Atrial fibrillation

Atrial Flutter

Hyperkalaemia; P waves are reduced in amplitude or totally absent; associated with tall T waves and wide QRS complexes.

Question 13

What is the typical atrial rate of atrial flutter,

what’s the definition?

What are other characteristics?

Answer 13

300

Atrial flutter is a type of supraventricular tachycardia caused by a re-entry circuit within the right atrium.

“saw-tooth pattern” - look at leads II, III, aVF

loss of isoelectric baseline

Question 14

which artery supplies blood to the front and bottom of the LV and the front of the septum?

Answer 14

Left anterior descending artery (LAD)

Question 15

If px has the below ECG and chest pain, what’s the diagnosis?

Answer 15

(inverted U waves)

evolving M.I.

May be earliest sign of unstable angina

Question 16

Diagram of heart blood supply

Answer 16

Question 17

What does QT represent?

Answer 17

total duration of ventricular systole

Question 18

What is the rhythm which is >100 and has P waves?

Answer 18

sinus tachycardia

Question 19

If HR is 150 what is the rhythm likely to be?

Answer 19

atrial flutter

Question 20

What is 1st degree heart block?

Answer 20

P-waves before each complex, but a delay in AV conduction (hence prolonged P-R interval in all beats).

No dropped beats.

If the PR interval is > 200 ms (one large square), first degree heart block is said to be present

Question 21

What is 2nd degree heart block?

(Mobitz I)

Answer 21

Not all P-Waves followed by a QRS complex.

The baseline PR interval is prolonged, and then further prolongs with each successive beat, until a QRS complex is dropped.

Question 22

What is 3rd degree heart block (complete heart block)?

Answer 22

Complete dissociation of P waves and QRS complexes.

Ventricular contractions only occur because of escape rhythms.

Question 23

What does broad QRS indicate?

Answer 23

bundle branch block

Question 24

what happens to the T waves in hypokalaemia?

Answer 24

<< amplitude, flattened or inverted

also U waves can be seen.

Question 25

What are ST-T changes?

Answer 25

depression of ST segment with T wave inversion.