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PRES 3 > ECG interpretation > Flashcards

ECG interpretation Flashcards

1
Q

Irregularly Irregular Rhythm

A

Atrial Fibrillation

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2
Q

Atrial Fibrillation features on ECG

A

unidentifiable p waves + irregular R-R interval

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3
Q

Atrial Fibrillation treatment

A

Anticoagulation + Rate control (beta-blockers - atenolol) + Rhythm control (digoxin) +/- cardioversion

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4
Q

Definitive management of Atrial Fibrillation

A

Radio frequency catheter ablation

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5
Q

Concern with Atrial fibrillation

A

Risk of thromboembolic events (stroke)

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6
Q

Patient with irregular pulse + sudden abdominal pain

A

Atrial Fibrillation + Mesenteric ischemia (risk of stroke)

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7
Q

Patient with hyperthyroidism + palpitations + irregular pulse

A

Atrial Fibrillation

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8
Q

Regularly Irregular Rhythm

A

Mobitz type 2 (2nd degree heart block)

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9
Q

3 causes of Mobitz type 2

A

ABC: Anterior MI, Beta-blocker, “Cystemic” (Systemic) sclerosis

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10
Q

Management of Mobitz type 2: next step

A

Immediate hospital admission for cardiac monitoring and back-up temporary pacing

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11
Q

Management of Mobitz type 2: definitive treatment

A

Permanent pacemaker

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12
Q

Wife waits at home, husband comes home at the same time every night, until one night he disappears.

A

Mobitz type 2 - 2nd degree AV block

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13
Q

Wife waits at home, husband comes home later and later every night, until one night he doesn’t come at all.

A

Mobitz type 1 (Wenckebach) - 2nd degree AV block

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14
Q

Wife is no longer waiting at home, wife and husband have each one their own regular but separate schedule, unconnected couple.

A

3rd degree AV block (complete heart block)

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15
Q

Management of Mobitz type 1

A

Atropine (if symptomatic)

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16
Q

Management of 3rd degree heart block

A

Permanent Pacemaker

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17
Q

If the Ps and Qs don’t agree…

A

You have a Mobitz 3

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18
Q

3 causes of Mobitz type 1 (Wenckebach)

A

BACh: Beta-blockers, Amiodarone, calcium Channel blockers (or) MTI: Myocarditis, Tetralogy of Fallot repair, Inferior MI

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19
Q

Management of Mobitz type 1

A

Atropine (if symptomatic)

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20
Q

Management of 1st degree heart block

A

No treatment needed

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21
Q

3 causes of 1st degree AV block

A

ABC: Athletic training, Beta-blockers, Calcium channel blockers (or) AMMO: Athletic training, Mitral valve prolapse, MyOcarditis

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22
Q

3 causes of 3rd degree AV block

A

DICA: Digoxin, Inferior MI, CAlcium channel blockers

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23
Q

Management of 3rd degree AV block: next step

A

Immediate hospital admission for cardiac monitoring and back-up temporary pacing

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24
Q

Management of 3rd degree AV block: definitive treatment

A

Permanent pacemaker

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25
How to calculate rate in Atrial Fibrillation
Number of R-waves in 30 large squares (6secs) x 10
26
How to calculate rate in a regular rhythm
300 / number of large squares between 2 R waves
27
D1 + avF +
normal quadrant
28
D1 + avF -
Left Leaves = LAD
29
4 common causes of LAD
WILL: WPW, Inferior MI; LBBB, LVH
30
D1 - avF +
Right Returns = RAD
31
3 common causes of RAD
RVH, Lateral MI, Ventricular Tachycardia
32
Where to check p-waves on ECG (leads)?
D2, V1
33
Tall peaked p-wave in D2
P-Pulmonale (Right Atrial enlargement)
34
M-shaped p-wave in D2
P-Mitrale (Left Atrial enlargement)
35
3 causes of prolonged PR interval
CHHYPO: Cardiomyopathy, Heart surgery, HYPOthyroidism
36
AV Blocks S/S
Bradycardia, dizziness, syncope
37
Wife waits at home, husband comes home late every night, but always at the same time
1st degree Heart block
38
Management of 1st degree heart block
No treatment needed (asymptomatic patients)
39
Delta-wave
WPW
40
WPW predisposes to develop...
SVT
41
Treatment of WPW
Radiofrequency catheter ablation
42
PR depression + Saddle-shaped ST elevation
Pericarditis
43
Pericarditis on auscultation
Pericardiac friction rub
44
ST elevation in D2, D3, avF
Inferior wall MI
45
ST elevation in V1-V2
Septal wall MI
46
ST elevation in V3-V4
Anterior wall MI
47
ST elevation in D1, avL, V5-V6
Lateral wall MI
48
Inferior MI artery
RCA (right coronary artery)
49
Anterior/Septal MI artery
LAD (left anterior descending)
50
Lateral MI artery
LCC (left circumflex coronary)
51
Q-wave deep in D2, D3, avF
Old-inferior wall MI
52
3 causes of broad QRS (more than 3 small squares)
VVV: Ventricular ectopics, Ventricular tachycardia, Ventricular fibrillation
53
Ventricular tachycardia + pulse present
Amiodarone 300mg
54
Ventricular tachycardia + no pulse
Defibrillate
55
Ventricular fibrillation
Defibrillate
56
QRS in V1 and V6: MARROW
RBBB
57
QRS in V1 and V6: WILLIAM
LBBB
58
Prolonged QT interval: 1 cause
Torsades de pointes
59
ST segment: 2 main abnormalities
Acute MI, Pericarditis
60
ST depression in V1-V3: 2 main causes
Anterior wall MI, Posterior wall MI
61
Name of the test for Posterior wall MI
Flip-test
62
Tall-tented T-waves
Hyperkalaemia
63
3 causes of Hyperkalaemia
3A: AKI, Addison's disease, ACEI
64
Management of Hyperkalaemia
IV calcium gluconate, IV Insulin + dextrose, Nebulised Salbutamol (if no IV access), oral/enema Calcium resonium, Loop diuretics, dialysis (if everything fails)
65
Hyperkalaemia: dose of IV calcium gluconate
10ml
66
Hyperkalaemia: dose of IV insulin
10units fast acting insulin + 50ml 50% dextrose
67
Broad, asymmetric, peaked/hyper-acute T-waves
Early stages STEMI
68
Inverted T-waves: 2 causes
MI, Ventricular hypertrophy
69
2 main causes of LVH
Uncontrolled hypertension, Aortic stenosis
70
3 main causes of RVH
PPM: Pulmonary hypertension, Pulmonary embolism, Mitral stenosis
71
D1+ avL+, "can't say the end"
LVH
72
D1- avF+, strain-pattern (inverted T-wave/ST depression) V1-V4
RVH
73
Saw-Tooth appearance (p-waves)
Atrial Flutter
74
Narrow QRS, tachycardia, regular R-R
SVT
75
SVT s/s
palpitations, lightheaded, sweating, SOB, chest pain
76
Paroxysm SVT - treatment
Vagal manœuvres
77
Persistent SVT - treatment
Adenosine (6mg IV bolus + 20ml NS -> if maintain in 2 min -> double dose slowly -> if maintain other 2 min -> double dose slowly -> if maintain other 2 min: ask for Senior help and think about Amiodarone/ Defribillation)
78
"Camel hump"
Synus tachycardia (p-wave hidden within preceding t-wave)

PRES 3 (12 decks)

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