ECG - COPIED Flashcards
What is Wolff-Parkinson-White (WPW) Syndrome?
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.
What does a normal U wave look like?
(look in leads V2 and V3)
Abnormalities
- prominent U waves
- Inverted U waves
What is Torsades des Pointes?
- ‘twisting of points’
- focus of VT moves around the myocardium. Appears as a sine wave.
TX: cardioversion + Magnesium
What could a QRS duration of > 120ms indicate?
(wide QRS intervals)
bundle branch block (RBBB or LBBB)
i.e. aberrant conduction
Hyperkalaemia
Pre-excitation (Wolff-Parkinson-White syndrome)
What’s the normal width of a QRS complex?
3-4 small squares
70-100ms
What are the cardinal features of Atrial Fibrillation?
- Irregularly irregular rhythm.
- No P waves.
- Absence of an isoelectric baseline.
- 110-160 ventricular rate
Characteristic of WPW syndrome:
Broad QRS complexes with a slurred upstroke to the QRS complex — the delta wave.
What’s this?
AF
An anterior STEMI results from the occlusion of which artery?
Anterior STEMI results from occlusion of the left anterior descending artery (LAD).
What does the left coronary artery divide into?
circumflex artery
left anterior descending artery
What’s this?
Atrial Flutter
Which conditions are P waves absent?
Atrial fibrillation
Atrial Flutter
Hyperkalaemia; P waves are reduced in amplitude or totally absent; associated with tall T waves and wide QRS complexes.
What is the typical atrial rate of atrial flutter,
what’s the definition?
What are other characteristics?
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
which artery supplies blood to the front and bottom of the LV and the front of the septum?
Left anterior descending artery (LAD)
If px has the below ECG and chest pain, what’s the diagnosis?
(inverted U waves)
evolving M.I.
May be earliest sign of unstable angina
Diagram of heart blood supply
What does QT represent?
total duration of ventricular systole
What is the rhythm which is >100 and has P waves?
sinus tachycardia
If HR is 150 what is the rhythm likely to be?
atrial flutter
What is 1st degree heart block?
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
What is 2nd degree heart block?
(Mobitz I)
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.
What is 3rd degree heart block (complete heart block)?
Complete dissociation of P waves and QRS complexes.
Ventricular contractions only occur because of escape rhythms.
What does broad QRS indicate?
bundle branch block
what happens to the T waves in hypokalaemia?
<< amplitude, flattened or inverted
also U waves can be seen.
What are ST-T changes?
depression of ST segment with T wave inversion.
