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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
Q

How to calculate rate in Atrial Fibrillation

A

Number of R-waves in 30 large squares (6secs) x 10

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26
Q

How to calculate rate in a regular rhythm

A

300 / number of large squares between 2 R waves

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27
Q

D1 + avF +

A

normal quadrant

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28
Q

D1 + avF -

A

Left Leaves = LAD

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29
Q

4 common causes of LAD

A

WILL: WPW, Inferior MI; LBBB, LVH

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30
Q

D1 - avF +

A

Right Returns = RAD

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31
Q

3 common causes of RAD

A

RVH, Lateral MI, Ventricular Tachycardia

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32
Q

Where to check p-waves on ECG (leads)?

A

D2, V1

33
Q

Tall peaked p-wave in D2

A

P-Pulmonale (Right Atrial enlargement)

34
Q

M-shaped p-wave in D2

A

P-Mitrale (Left Atrial enlargement)

35
Q

3 causes of prolonged PR interval

A

CHHYPO: Cardiomyopathy, Heart surgery, HYPOthyroidism

36
Q

AV Blocks S/S

A

Bradycardia, dizziness, syncope

37
Q

Wife waits at home, husband comes home late every night, but always at the same time

A

1st degree Heart block

38
Q

Management of 1st degree heart block

A

No treatment needed (asymptomatic patients)

39
Q

Delta-wave

A

WPW

40
Q

WPW predisposes to develop…

A

SVT

41
Q

Treatment of WPW

A

Radiofrequency catheter ablation

42
Q

PR depression + Saddle-shaped ST elevation

A

Pericarditis

43
Q

Pericarditis on auscultation

A

Pericardiac friction rub

44
Q

ST elevation in D2, D3, avF

A

Inferior wall MI

45
Q

ST elevation in V1-V2

A

Septal wall MI

46
Q

ST elevation in V3-V4

A

Anterior wall MI

47
Q

ST elevation in D1, avL, V5-V6

A

Lateral wall MI

48
Q

Inferior MI artery

A

RCA (right coronary artery)

49
Q

Anterior/Septal MI artery

A

LAD (left anterior descending)

50
Q

Lateral MI artery

A

LCC (left circumflex coronary)

51
Q

Q-wave deep in D2, D3, avF

A

Old-inferior wall MI

52
Q

3 causes of broad QRS (more than 3 small squares)

A

VVV: Ventricular ectopics, Ventricular tachycardia, Ventricular fibrillation

53
Q

Ventricular tachycardia + pulse present

A

Amiodarone 300mg

54
Q

Ventricular tachycardia + no pulse

A

Defibrillate

55
Q

Ventricular fibrillation

A

Defibrillate

56
Q

QRS in V1 and V6: MARROW

A

RBBB

57
Q

QRS in V1 and V6: WILLIAM

A

LBBB

58
Q

Prolonged QT interval: 1 cause

A

Torsades de pointes

59
Q

ST segment: 2 main abnormalities

A

Acute MI, Pericarditis

60
Q

ST depression in V1-V3: 2 main causes

A

Anterior wall MI, Posterior wall MI

61
Q

Name of the test for Posterior wall MI

A

Flip-test

62
Q

Tall-tented T-waves

A

Hyperkalaemia

63
Q

3 causes of Hyperkalaemia

A

3A: AKI, Addison’s disease, ACEI

64
Q

Management of Hyperkalaemia

A

IV calcium gluconate, IV Insulin + dextrose, Nebulised Salbutamol (if no IV access), oral/enema Calcium resonium, Loop diuretics, dialysis (if everything fails)

65
Q

Hyperkalaemia: dose of IV calcium gluconate

A

10ml

66
Q

Hyperkalaemia: dose of IV insulin

A

10units fast acting insulin + 50ml 50% dextrose

67
Q

Broad, asymmetric, peaked/hyper-acute T-waves

A

Early stages STEMI

68
Q

Inverted T-waves: 2 causes

A

MI, Ventricular hypertrophy

69
Q

2 main causes of LVH

A

Uncontrolled hypertension, Aortic stenosis

70
Q

3 main causes of RVH

A

PPM: Pulmonary hypertension, Pulmonary embolism, Mitral stenosis

71
Q

D1+ avL+, “can’t say the end”

A

LVH

72
Q

D1- avF+, strain-pattern (inverted T-wave/ST depression) V1-V4

A

RVH

73
Q

Saw-Tooth appearance (p-waves)

A

Atrial Flutter

74
Q

Narrow QRS, tachycardia, regular R-R

A

SVT

75
Q

SVT s/s

A

palpitations, lightheaded, sweating, SOB, chest pain

76
Q

Paroxysm SVT - treatment

A

Vagal manœuvres

77
Q

Persistent SVT - treatment

A

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
Q

“Camel hump”

A

Synus tachycardia (p-wave hidden within preceding t-wave)

PRES 3 (12 decks)

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