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Arrhythmia > ECG from My first ECG handbook > Flashcards

ECG from My first ECG handbook Flashcards

1
Q

LQTS risk score to diagnose congenital long qts

A

> = 3.5

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2
Q

QTc to diagnose congenital long qts

A

> = 500 ms in the absence of secondary cause for long qt

or

480-499 + unexplained syncope in the absence of secondary cause for long qt and absence of pathogenic mutation

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3
Q

Qtc to diagnose short Qt

A

<= 330 ms

or if QTc < 360 ms with > 1 of the ff
> pathogenic mutation
> FMhx of SQTS
> FMHx of SCD age < 40
> Survival from a VT/VF episode in the absence of HF

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4
Q

PVC found inserted between 2 sinus beats without alteration of sinus rate, that is not followed by a compensatory pause

A

interpolated PVC

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5
Q

Onset of QRs to its peak that favors VT

A

> = 50 msec

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6
Q

RP interval that favors SVT

A

<= 100 msec

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7
Q

QRS duration that favors VT

A

140 ms

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8
Q

What sign signifies RSr’ pattern in VT

A

Marriott’s sign

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9
Q

What sign corresponds to the notching of the S wave near its nadir

A

Josephson

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10
Q

What sign corresponds to distance from onset f QRS to S wave nadir > 100 ms

A

Brugada sign

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11
Q

Where do you place the RA lead in lewis leads?

A

Manubrium

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12
Q

Where do you place the LA lead in lewis leads?

A

5th ICS R parasternal border

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13
Q

Where do you place the LL lead in lewis leads?

A

right lower costal margin

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14
Q

St depression of ____ in 2 contiguous leads may signify acute mi

A

> = 0.05mv/ 0.5 mm

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15
Q

T wave inversion of ___ in 2 contiguous leads may signify acute mi

A

> = 0.1 mV/ 1mm with a prominent R wave or R/S >1

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16
Q

STEMI criteria for all leads except V2-v3

A

> = 0.1 mV elevation in 2 contiguous leads

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17
Q

STEMI criteria for v2-v3 in women

A

> =0.15mV or 1.5 mm

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18
Q

STEMI criteria for v2-v3 in men < 40 yrs old

A

> = 0.25 mV or 2.5 mm

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19
Q

STEMI criteria for v2-v3 in men > 40 yrs old

A

> = 0.2 mV or 2 mm

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20
Q

Duration of p wave (lead ii) : PR segmet ratio in Left atrial abnormality

A

> 1.6

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21
Q

Expected axis of terminal p wave in left atrial abnormality

A

-30 to -90

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22
Q

Prominent initial positivity in lead v1 or v2 of ____ may be expected in right atrial abnormality

A

> =1.5mm

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23
Q

Increased area under the initial positive portion of the p wave in lead v1 to _ is expected in Right atrial abnormality

A

> 0.06 mm/sec

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24
Q

Expected rightward shift of mean p wave axis to ____ is seen in right atrial abnormality

A

> 75 deg

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25
Q

R peak time of ____ in V5 and V6 but normal in V1-v3 is expected in CLBBB

A

> 60 ms

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26
Q

S wave of greater duration than R wave or > ____ in I and v6 is seen in CRBBB

A

> 40 ms

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27
Q

Normal r peak time in v5 and v6 but > ___ ms in v1 is seen in CRBBB

A

> 50

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28
Q

What constitutes sgarbossa criteria

A

ST sement elevation >=1 mm and concordant QRS - 5 points

ST sement depression >=1 mm in v1-v3 - 3 points

ST segment deviation >= 5mm and discordant with QRS

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29
Q

duration of q wave in v2-v3 that may signify prior MI

A

> =0.02sec or QS complexes

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30
Q

Q wave ___ sec and ___ mv deep may signify prior MI

A

> = -.03 and >=0.1mv

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31
Q

r wave ___ sec in v1 and v2 and R/S >1 with a concordant positive t wave in the absence of conduction defect may signify prior MI

A

> =0.4s

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32
Q

In the myocyte action potential, Phase 0 represents

A

rapid depolarization phase where Na enters the cell

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33
Q

In the myocyte action potential, Phase 1 represents

A

early rapid REpolarization phase which is a balcne between Ca entering and K leaving the cells

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34
Q

In the myocyte action potential, Phase 2 represents

A

plateau phase which occurs because of Ca entering through slow channels

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35
Q

In the myocyte action potential, Phase 3 represents

A

final rapid repolarization where K enters the cell

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36
Q

In the myocyte action potential, Phase 4 represents

A

Resting membrane potential

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37
Q

In the pacemaker action potential, Phase 4 represents

A

Spontaenous depolarization due to inward depolarizing Na current (If)

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37
Q

In the pacemaker action potential, Phase 0 represents

A

Depolarization phase caused by inward movement of long lasting (L type_ Ca channels to reach potential threshold of -40mV

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38
Q

at ___ mV, transient (T type) Ca channels open causing further depolarization

A
  • 50mv
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39
Q

In the pacemaker action potential, Phase 3 represents

A

Repolarization phase caused by inward movement of K

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40
Q

At the end of the repolarization in the pacemaker action potensial, the membrane potential is ____ mv

A

-60mv

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41
Q

Lead v4 is placed along the

A

L mid clavicular line

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42
Q

Lead v5 is placed along the

A

L AAL

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43
Q

Lead v6 is placed along the

A

L mid axillary line

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44
Q

What is Eithovens law?

A

At any given instant the potential in lead II is equal to the sum of potential in lead I and III

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45
Q

Most useful lead to look at when considering RV infarction

A

V4R

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46
Q

Lead v7 is placed along the

A

left posterior axillary line

47
Q

Lead v8 is placed along the

A

mid scapular line

48
Q

Lead v9 is placed along the

A

left paravertebral line

49
Q

normal duration of p wave

A

0.12 s

50
Q

normal amplitude of p wave

A

< 0.25 mV

51
Q

By convention deflections on the ECG that are greater than ___ mV are referred to in capital letters

A

0.5 mV or > 5 mm

52
Q

QT represents

A

total ventricular activation and repolarization

53
Q

Qt varies as much as ___ s

A

0.05 to 0.065s

54
Q

QT interval is best determined in the lead with ____

A

longest QT interval (usually V2, V3) without a u wave

55
Q

Usual amplitude of u wave

A

< 0.1 mV in height

56
Q

U waves are sually largest in leads ___

A

v1 and v2

57
Q

Axis deviation of tricuspid atresia

A

LAD

58
Q

Axis deviation of ostium primum ASD

A

LAD

59
Q

Axis deviation of pectum excavatum

A

RAD

60
Q

Axis deviation of VSD

A

RAD

61
Q

Axis deviation of ASD

A

RAD

62
Q

Axis deviation of ventricular arrhythmia

A

Extreme

63
Q

Amplitude of R in V1 to qualify for RVH

A

> = 7 mm or >5 mm if R/S >1

64
Q

Amplitude of S in V5 or V6 to qualify for RVH

A

> = 7 mm

65
Q

Amplitude of S in V1 to qualify for RVH

A

< 2 mm

66
Q

Amplitude of R in V5, V6 to qualify for RVH

A

< 3mm

67
Q

Duration of the notch of p wave to qualify for LAA

A

> 40ms

68
Q

Most common IVCD

A

LAFB

69
Q

Most common cause of marked LAD

A

LAFB

70
Q

Percent of people with LBBB with no heart disease

A

10%

71
Q

Type of MI related to PCI

A

4a

Troponin must be >5x the 99th percentile of URL

72
Q

Type of MI related to stent thrombosis

A

4b

73
Q

Type of MI related to CABG

A

5

Troponin must be >10x the 99th percentile of URL

74
Q

Pathologic q waves occur within ___ hrs of MI

A

6-16h

75
Q

When do you consider RV infarction (STE in what leads)

A

STE in V1 or STE in III>II

76
Q

Most common correctable cause of AF

A

Hyperthyroidism

77
Q

2 ddx for long RP

A

Atrial tachycardia, Atypical AVNRT

78
Q

Most likely diagnosis for short RP < 90 ms

A

AVNRT

79
Q

Most common type of arrhythmia

A

Sinus arrhythmia

80
Q

Most common form of pSVT

A

AVNRT

81
Q

Another term for Typical AVNRT

A

Slow -fast type

More common (>80% of AVNRT)

82
Q

Percentage of wide complex tachycardia caused by VT

A

80%

83
Q

Mechanism of AIVR in digitalis intoxication

A

Triggered activity

84
Q

Most likely mechanism of VT in the absence of structural heart disease

A

Abnormal automaticity or triggered activity

85
Q

Most likely mechanism of VT WITH structural heart disease

A

Re entry

86
Q

ECG stages of pericarditis

A

Stage I - diffuse concave upward STE with PR depression

Stage II - resolution PR depression

Stage III- T wave inversion

Stage IV- normal

87
Q

ST/T of acute pericarditis

A

> 25%

88
Q

ECG changes of hypothermia occur at body temperatures at ___

A

< 34C

89
Q

Osborne waves are most prominent in which leads

A

v2-v5

90
Q

most common ECG changes in cerebrovascular accident

A

diffuse deep inverted t waves

91
Q

First ECG change in hyperkalemia

A

tall, peaked, symmetrical T wave

92
Q

K level that causes widening of QRS

A

K> 6.5 mmol/l

93
Q

K level that may cause dec p wave amplitude and prolonged PR, possible AV blocks

A

K > 7 mmol/l

94
Q

most common ECG finding in PE

A

sinus tachycardia

95
Q

Lead reversal that causes inversion of lead I and positive p and t in avr

A

LA/RA

96
Q

Lead reversal that causes inversion of p and t waves in inferior leads with negative QRS in III and avf

A

RA/LF

97
Q

Lead reversal that causes flat line in lead III

A

LA/RF

98
Q

most common mode of dual chamber pacemaker

A

DDD

99
Q

Name of mode with asynchronous firing

A

VOO

100
Q

Class I Indications for ICD insertion in ventricular arrhythmia

A

Survivor of cardiac arrest by VF/VT without reversible cause
Structural heart disease with spontaneous sustained VT
Unexplained syncope with hemodynamically significant VT or VF during EPS

101
Q

Class I Indications for ICD insertion in heart failure

A

LVEF <= 35% in NYHA II and III and has not had an MI within 40 days

LVEF <= 30% in NYHA I > 40 days post MI

Non sustained VT due to prior MI with LVEF <=40% and inducible VF or sustained VT in EPS

102
Q

other term for biventricular pacing

A

Cardiac Resynchronization Therapy

103
Q

Class I indications for CRT

A

If NYHA II,III and IV +

LVEF <= 35%, QRS >=150 ms, LBBB, NSR

104
Q

Most SCDs are attributable to ____

A

CAD

105
Q

In CAD, what is the major determinant of inc risk of SCD

A

LV dysfuncion

106
Q

In CAD, short term risk of SCD is associated with

A

acute ischemic phase of MI

107
Q

In CAD, long term risk of SCD is associated with

A

myocardial scarring, remodeling, cardiomyopathy and HF

108
Q

Mechanism of SCD in HF or dilated CM

A

tachyarrhythmia (VT/VF) or non shockable bradyarrhythmia or asystole

109
Q

Major gene mutation associated with ARVC

A

Plakophillin 2

110
Q

Mutation assoc with Brugada syndrome

A

SCN5A

111
Q

Mutation assoc with Catecholaminergic polymmorhic ventricular tachycardia

A

heterozygos missense mutations in RyR2 as well as mutations in calsequestrin gene

112
Q

Associated arrhythmia with WPW

A

AVRT and AF with preexcitation

113
Q

Abnormal q wavesin inferior and lateral walls reflect _____

A

septal depolarization of the hypertrophied myopathic tissue

114
Q

Apical variant of HCM may have these ECG findings

A

LAD, deeply inverted t waves

115
Q

DOC for HCM

A

beta blocker and non DHP CCB

Arrhythmia (13 decks)

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