ECG Interpretation

Question 1

What do P, QRS, and T waves represent?

Answer 1

P: atrial contraction
QRS: ventricular contraction
T: relaxation of the ventricles

Question 2

What are the valves of the heart and their anatomical location on the exterior of the body?

Answer 2

AV Valves
Tricuspid valve: R atrium and R ventricle
Mitral valve: L atrium and L ventricle
SL Valves
pulmonary valve: pulmonary artery meets the R ventricle
aortic valve: L ventricle and aorta

Question 3

Define tachycardia and bradycardia

Answer 3

mild tachycardia: 100 to 130 bpm, usually compensatory and don’t compromise BP
faster tach: >130 bpm at rest, imminently life threatening
1) supraventricular tach (above ventricles): narrow QRS complex
2) ventricular tach: broad QRS complex

bradycardia: < 60 bpm

Question 4

What is the normal ECG complex?

Answer 4

P wave: atrial depolarization, broad and shallow. 0.08 s, should be rounded, missing could see fibrillation/flutter/pacing spikes
PR interval
Q wave
QRS complex
ST segment
T wave and sometimes a U wave

Question 5

If atrioventricular synchronization is lost, how does this affect SV?

Answer 5

Decreases by 20-30%

Question 6

Describe 3 types of AV heart blocks

Answer 6

1st degree (delay): Tx is not usually needed
2nd degree (incomplete): more likely to cause symptoms, two types Type 1 (Wenkebach or Mobitz type I) and Type 2 (Mobitz type 2)
3rd degree (complete): no signal conducted to ventricles, ventricles produce slow wide QRS complex at 30-40 bpm, compromises CO, produces hypotension and needs urgent pacing

Question 7

What are your primary steps when your ECG registers an arrhthymia?

Answer 7

1) Tx pt not monitor
2) check pt VS (pulse, BP, RR, O2 sats)
3) LOC/light headed
4) skin colour
5) chest pain / shortness of breath
6) Tx s/s of hyptotension, chest pain, shortness of breath
7) rule out non-medical causes of abnormal tracing

Question 8

What is PEA and what conditions can cause it

Answer 8

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Question 9

What are the properties of a normal sinus rhytm?

Answer 9

1) rate (60-100)
2) P waves upright, same between complexes, 1 per each QRS
3) regular pattern
4) PR nterval 0.12-0.20
5) QRS upright, same, <0.44s