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Y1 - Cardiovascular > ECG interpretation > Flashcards

ECG interpretation Flashcards

1
Q

Which way does an ECG spike when a signal is moving towards a recording electrode?

A

Upwards

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2
Q

What should the patient’s position be when undergoing an ECG?

A

Lying down 30-40˚

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3
Q

Where should V1 be placed?

A

4th right intercostal space, sternal angle

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4
Q

Where should V2 be placed?

A

4 left intercostal space, sternal angle

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5
Q

Where should V4 be placed?

A

5th left intercostal space

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6
Q

Where should V6 be placed?

A

Mid-axillary line, same level as V4

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7
Q

What is the order in which an ECG should be interpreted?

A
  1. Name, DOB, date and time of ECG
  2. Calibration
  3. Rate
  4. Rhythm
  5. Axis
  6. P wave
  7. PR interval
  8. QRS complex
  9. ST segment
  10. T waves
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8
Q

What’s the usual calibration of an ECG?

A

25 mm/sec

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9
Q

How is heart rate calculated?

A

300/number of large squares between beats

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10
Q

What does the PR interval represent?

A

The delay created by the AV node

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11
Q

What is a normal PR interval?

A

120-200 ms

2-5 small squares

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12
Q

What does the QRS complex represent?

A

Ventricular depolarisation

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13
Q

What is a normal QRS complex length?

A

<120 ms

3 small squares

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14
Q

What is QRS complex elongation caused by?

A

Aberrant conduction or ventricular origin

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15
Q

What does a P wave represent?

A

Atrial depolarisation

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16
Q

What is a normal P wave?

A

<2.5mm in height

<3mm in width

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17
Q

What does a T wave represent?

A

Ventricular repolarisation

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18
Q

What is a normal T wave?

A

Normally same directions QRS and no more than 1/2 QRS height

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19
Q

What is sinus rhythm?

A

Normal rhythm where heart is controlled by SA node

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20
Q

What is sinus arrhythmia?

A

Sinus rhythm but heart rate is irregular

21
Q

What is the origin of supraventricular arrhythmias?

A

Within or above the ACnode

22
Q

What is happening in atrial fibrillation?

A

Atria are in fibrillation, only some of the SA impulses arrive in the AVN

23
Q

What are features of AF on an ECG?

A

Absent P waves
Irregularly irregular
Ragged baseline
Ventricular rate 30-200bpm

24
Q

What is there a risk of in AF?

A

Embolic stroke

25
Q

What are features of atrial flutter on an ECG?

A

Narrow complex tachycardia
Atrial rate of approx. 300bpm
Sawtooth baseline

26
Q

What is Wolf-Parkinson-White syndrome?

A

Arrhythmia with an accessory AV pathway which does not have AVN delay.
This causes pre-excitation and upscoping of the QRS (delta wave)

27
Q

What are features of supraventricular ectopic arrhythmia on ECG?

A

Varying PR and RR interval

28
Q

Why do ventricular arrhythmias have broad QRS complexes?

A

Excitation spreads slower moving through normal myocardium than through the regular conduction system

29
Q

What arrest rhythms are shockable?

A

Ventricular tachycardia or fibrillation

30
Q

For which arrest rhythms would you do CPR?

A

Pulseless electrical activity, asystole

31
Q

What causes ventricular tachycardia?

A

Damaged heart muscle formed scar tissue, creating abnormal (re-entrant) electrical pathways

32
Q

What is the difference between monomorphic and polymorphic ventricular tachycardia?

A

Monomorphic - tachycardia coming from a single focus

Polymorphic - tachycardia coming from multiple foci

33
Q

What are the features of monomorphic ventricular tachycardia on an ECG?

A

Regular broad complex tachycardia

34
Q

What are the features of polymorphic ventricular tachycardia on an ECG?

A

Long QT

Torsade de Pointes (arctic monkeys cover type pattern)

35
Q

What is happening in ventricular fibrillation?

A

Ventricles fibrillate (contract at rates of up to 500bpm), renders heart incapable of synchronised beat

36
Q

What are features of ventricular fibrillation on ECG?

A

Irregular random baseline with no discernible waveform

37
Q

Which leads most detect a lateral MI?

A

1, aVL, V5, V6

38
Q

Which leads most detect an anterior MI?

A

V1-4

39
Q

Which leads most detect an inferior MI?

A

II, III, aVF

40
Q

What are features of ischaemia on ECG?

A

T waves: tall, biphasic, inverted, flattened

ST depression

41
Q

What is classed as ST elevation?

A

ST elevation in 2 contiguous limb (>1mm) or chest (>2mm) leads

42
Q

What are features of NSTEMI on ECG?

A

Transient ST elevation
ST depression
New T-wave inversion

43
Q

What is heart block?

A

Block in conduction between atria and ventricles due to AV node dysfunction

44
Q

What is first degree heart block?

A

PR interval >2s, no progressive lengthening, stable rhythm

45
Q

What is second degree heart block Mobitz I?

A

Progressive PR elongation with eventual missed beat

46
Q

What is second degree heart block Mobitz II?

A

Constant PR interval, every 2nd p-wave (approximately) missing QRS

47
Q

What is third degree/complete heart block?

A

No p-wave and QRS relationship, broad QRS

48
Q

What is bundle branch block?

A

Block in one of the 2 main branches coming off the Bundle of His

49
Q

What does bundle branch block look like?

A

WILLIAM MARROW

  • LBBB: V1 = W, V6 = M
  • RBBB: V1 = M, V6 = W

Y1 - Cardiovascular (11 decks)

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