ECG + Heart Anatomy

Question 1

Irregular rhythm- slight but regular lengthening and then shortening

Answer 1

Sinus arrhythmia

Common in young

Question 2

AF

Answer 2

no P waves

Irregularly irregular QRS

Question 3

Atrial Flutter

Answer 3

Sawtooth P wave

Regular QRS

Question 4

P waves in different leads

Answer 4

Upright in II, III, aVF

Inverted in aVR

Question 5

P-mitrale

Answer 5

bifid P wave

Indicates left atrial hypertrophy

Question 6

P-pulmonale

Answer 6

Peaked P wave

Indicates right atrial hypertrophy

Question 7

Hyperkalaemia

Answer 7

Pseudo-P pulmonale seen

Question 8

Prolonged PR interval

Answer 8

Delayed AV conduction

1st degree heart block

Question 9

Short PR interval

Answer 9

Unusually fast AV conduction down an accessory pathway

e.g. Wolff-Parkinson White

Question 10

Prolonged QRS

Answer 10

Ventricular conduction defects (e.g. bundle branch block)
Metabolic disturbance
Ventricular origin

Question 11

High amplitude QRS complex

Answer 11

Ventricular hypertrophy

Question 12

Q wave normal

Answer 12

<0.04s
Often seen I, aVL, V5, V6
Reflects normal septal depolarisation

Question 13

Pathological Q waves

Answer 13

Deep and wide

Acute MI

Question 14

Prolonged QT interval

Answer 14

Brugada syndrome (sudden cardiac death)

Question 15

Congenital Prolonged QT

Answer 15

Romano-Ward syndrome
Jervell syndrome
Lange-Nielsen syndrome

Question 16

Cardiac Prolonged QT

Answer 16

MI
Ischaemia
Mitral valve prolapse

Question 17

Metabolic Prolonged QT

Answer 17

Hypokalaemia
Hypomagnesaemia
Hypocalcaemia
Starvation
Hypothyroidism
Hypothermia

Question 18

Toxins Prolonged QT

Answer 18

Organosphosphates

Question 19

Anti-arrhythmic drugs Prolonged QT

Answer 19

Quinidine
Amiodarone
Procainamide
Sotalol

Question 20

Antihistamines Prolonged QT

Answer 20

Terfenadine

Astimazole

Question 21

Motility drugs Prolonged QT

Answer 21

Domperidone

Question 22

Psychoactive drugs Prolonged QT

Answer 22

Haloperidol
Risperidone
TCAs
SSRIs

Question 23

Herbalism Prolonged QT

Answer 23

Chinese folk remedies
Cocaine
Quinine
Artemisins (anti-malarials)

Question 24

ST Elevation

Answer 24

> 1mm

Infarction

Question 25

ST depression

Answer 25

> 0.5mm

Ischaemia

Question 26

Normal T wave

Answer 26

Normally inverted in aVR, V1 (and V2)
Normal if inverted in isolation in III
Abnormal if inverted in I, II, V4-V6

Question 27

Peaked T wave

Answer 27

Hyperkalaemia

Question 28

Flattened T wave

Answer 28

Hypokalaemia

Question 29

J wave

Answer 29

Where S wave finishes + ST segment starts
J wave is a notch at this point
Seen in hypothermia, SAH, hypercalcaemia

Question 30

Normal Axis

Answer 30

-30 to 90
Lead I (0) +
Lead II (60)` +

Question 31

Left Axis Deviation

Question 32

Right Axis Deviation

Answer 32

>90
Lead I (0) -
Lead II (+60) +