ECG MED ED CONDITIONS Flashcards
What does an irregular transition point represent?
Poor R wave progression
What are the p waves like in AF?
absent
What are the QRS complexes like in AF?
narrowed
What is the rythm like in AF and why?
irregularly irregular rhythm: variable ventricular response
Is the baseline affected in AF?
baseline not isoelectric - hard to see lik at V1
What are characteristic features of AF?
- Irregularly irregular rhythm: variable ventricular response
- Absent P waves
- QRS complexes narrowed
- Baseline not isoelectric (can be hard to see) – look at V1
What is fast AF?
with tachycardia
What is slow AF?
without tachycardia
If there are signs of an unstable arrhythmia what is needed?
electrical treatment
What are the signs of unstable arryhtmia?
- Ischaemia: chest pain
- Shock: low BP
- Syncopal: losing consciousness
- Acute HF: SOB with flash pulmonary oedema
What are the p wave like in atrial flutter?
absent
What is the rhythm like in atrial flutter?
regularly irregular rhythm
What are QRS complexes like in atrial flutter?
narrow - sawtooth pattern
What are characteristric features of atrial flutter?
- Regularly irregular rhythm
- Absent P wave, with sawtooth baseline:
- Narrow QRS
What is rate and conduction ratio in atrial flutter? How do you calculate this
rate of around 300bpm with a fixed ratio of conduction but HR not 300pm so conduction ration is like 2:1 so for every 2 flutter waves there is 1 QRS, so HR will be either 150bpm, 100bpm or 75bpm depending on conduction ratio 2:1 (150), 3:1, (100), 4:1 (75bpm) – count QRS as a flutter
What is a supraventiruclar tachycardia?
- any tachyarrhythmia that starts above the bundle of His is an SVT
- however we normally use this when it is not AF or atrial flutter
What is needed to look out for in SVT?
retrograde P waves (after QRS) and sometimes inverted)
How do you know if it is a retrograde P wave or a biphasic T wave?
biphasic T wave but if no P wave before QRS, narrow QRS and no flutter waves or fibrillation so must be P waves somewhere
What is the PR interval like in 1st degree heart block?
prolonged
What is the P wave like in 1st degree heart block?
sometimes hide inside T wave as so prongled
If 1st degree heart block is found what can it suggest?
- not necessarily a sign of pathology
2. fit young healthy person
What is the general description of 2nd degree heart block mobitz 1?
Prolonged PR interval and then drop QRS then reset of PR interval
What is 2nd degree mobitz Type 1 also known as?
Wenckebach phenomenon
