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HLB > ECG interpretation > Flashcards

ECG interpretation Flashcards

1
Q

P wave represents

A

represents the wave of depolarisation that spreads from the SA node throughout the atria

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2
Q

What does the isoelectric period after the P wace represent?

A

the time in which the impulse is travelling within the AV node

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3
Q

How long should a normal P wave last?

A
  • 0.08-0.1 seconds
  • 80-100 milliseconds
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4
Q

P-R interval

A

time from the onset of the P wave to the beginning of the QRS complex

represents the time between onset of atrial depolarisation and onset of ventricular depolarisation

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5
Q

Normal P-R interval usually lasts?

A
  • 0.12-0.20 seconds
  • 3-5 little squares
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6
Q

QRS complex

A

represents ventricular depolarisation

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7
Q

QRS complex normal time

A

upto 3 little squares
no more than 120 ms

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8
Q

ST segment

A
  • isoelectric period following QRS
  • represents the period in which the entire ventricle is depolarised and roughly corresponds to the plateau phase of ventricular action potential
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9
Q

T wave

A

represents ventricular repolarisation

longer in duration than depolarisation

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10
Q

U wave

A

a small ppositive U wave may follow the T wave which represents the last remnants of repolarisation

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11
Q

Q-T interval

A

represents the time for both ventricular depolarisation and repolarisation to occur, therefore roughly estimates the duration of a ventricular action potential

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12
Q

Normal Q-T duration

A

0.2-0.4 seconds depending on heart rate

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13
Q

at high heart rates Q-T segment will

A

shorten
ventricular action potentials shorten in duration

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14
Q

Names of 12 lead ECG

A
  • 1,2,3, aVR, aVL, aVF, (frontal plane)
    V1,V2,V3,V4,V5,V6 (horizontal plane)
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15
Q

Normal PQRST waves label

A

insert diagram
may not always see all waves in QRS

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16
Q

degree of heart standards ecg leads

A

insert

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17
Q

chest lead positions

A

insert

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18
Q

vertical and horizontal calibration markers

A
  • vertical: 10 mV
    • generally, 1 small = 1mV, 1 big =
      5 squares
  • horizontal: 1 small = 40ms, 5 small squares = 200 seconds, 5 big sqaures = 1 second
19
Q

initial analysis of ecg

A
  • check calibration is 2 high 1 wide
  • rate
  • QRS axis
  • rhythm
20
Q

calculation of heart rate from an ECg:

A
  • count the squares between complexes:
    • 5 large = 60bpm
    • 4 large = 75 bpm
    • 3 large = 100 bpm
    • 2 = 150 bpm
    • 6 = 50bpm
  • for an irregular rhythm:
    • count number of complexes in 30 large squares and multiply by 10
    • 30 large squares = 6 seconds (in uk)
21
Q

How to calculate the (mean frontal) QRS axis?

A
  • overall direction of the electrical signal in the FRONTAL plane (not V leads)
  • find the most isoelectric complex (goes up as much as it goes down) from leads: 1,2,3,aVF,aVR,aVL
  • axis is 90 degrees from this
  • normal QRS axis is between -30 and +120 degrees
  • going toward which side?
22
Q

Insert mean frontal QRS axis question

A

insert
- lead II is most isoelectric
- 90 degrees either side is +150 or -30
- look at AVL and lead I both have QRS waves upwards
- lead three has QRS downwards
- hence must be -30

23
Q

Cardiac Rhythm (sinus)

A
  • sinus rhythm = norm = atria contract before ventricles
  • 1 p wave infront of every QRS complex
  • resting generally between 60-90bpm
24
Q

Tachycarda (3 common)

A
  • fast heart
  • atrial fibrillation
  • supraventricular tachycardia
  • ventriculary tachycardia
25
Q

Atrial fibrillation on ECg

A

no p waves
irregular

multiple short circuits in atria hence very irregular to AV node

26
Q

Supraventiruclar tachycardia on ECG

A

regular, narrow complexes

short circuuit that runs regularly in atria
fairly bengin

27
Q

Ventricular tachycardia

A

regular, broad complexes

short circuit that runs regularlry in ventricle
very dangerous

28
Q

insert ecg what does it show

A

atrial fibrillation

29
Q

insert ecg what does it show

A

supraventricular tachycardia
150bpm

30
Q

insert ecg what does it show

A

ventricular tachycardia
broad regular complexes

31
Q

Bradycardia (2)

A

slow heart rate
- problems at AV node = heart block, doesnt get to ventricle
- sinus node dysfunction

32
Q

insert ecg what does it show

A

complete heart block (AV node problem)
30bpm

33
Q

Heart Block ECG features

A

number of QRS complexes, ten square gap, 30 bpm,
lots of p waves at normal rate
not getting through AV node

34
Q

insert ecg what does it show

A

sinus node dysfunction
intermittent p waves

35
Q

Sinus node dysfunction ecg features

A
  • no p waves on first because no sinus beat
  • second and third have p waves
  • 30 bpm
36
Q

Tall complexes on ecg show signify

A

ventriculr hypertrophy

37
Q

broad complexes on ecg signify

A

bundle branch block
more than 3 squares wide QRS

38
Q

ST elevation on ecg signify

A

MI or pericarditis

39
Q

ST depression/ T wave inversion signifies

A

many causes

40
Q

insert ecg what does it show

A

left ventricular hypertrophy (complexes go off the page or run into each other)
T waves may also be inverted when complexes are big

41
Q

insert ecg what does it show

A

left bundle branch block
broad complexes
V1 lead generally will go downwards
eight squares between p and QRS
still attached tho so first degree heart block

42
Q

insert ecg what does it show

A

triphasic large downwards qrs
V1 and V2 mostly above baseline
right bundle branch block

43
Q

insert ecg what does it show

A

st segment elevated above baseline

on standard leads st segment elevated
v leads st segment is depressed, reciprocal change
sixth complex is an ectopic beat

acute inferior ST segment elevation myocardial infarc (acute inferior STEMI)

44
Q

Q wave MI

A

deeply inverted Q waves
virtually no R waves
T waves may be inverted

  • extensive damage to myocardium

HLB (49 decks)

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