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Pathophysiology Jenny > ECG midterm > Flashcards

ECG midterm Flashcards

1
Q

ID point

A

Where the QRS turns downwards the last time

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2
Q

Normal ID values (left+right)

A

V1 & V2 (right): ID < 40 ms

V5 & V6 (left): ID < 60 ms

*Fra start av QRS til ID point (siste peak)

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3
Q

Incomplete bundle branch block

A

QRS characteristics of a BBB, but not pathologically wide (>0,12s)

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4
Q

Extreme left deviation

A

More than -30*

Often LAH

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5
Q

Extreme right deviation

A

More than 110*

Often LPH

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6
Q

Lenegre syndrome

A

Type of bifascicular block

RBBB + LAH

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7
Q

Bifascicular block

A

RBBB + LAH/LPH

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8
Q

Trifascicular block

A

Bifascicular block + 1* AV block

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9
Q

RBBB

A
  • QRS > 0,12s
  • “MoRRoW”: V1, Right, V6
  • Wide S in lead I as well
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10
Q

LBBB

A
  • QRS > 0,12s
  • “WiLLiaM”: V1, Left, V6
  • rS or QS in V1-V4
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11
Q

When consider BBB

A

When:

  • QRS is wide
  • Impulse of supraventricular origin
  • and WPW excluded
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12
Q

WPW

A

Wolff-Parkinson-White preexcitation syndrome

  • Kent bundle
  • δ wave (-> short PR, wide QRS)
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13
Q

LGL

A

Lown-Ganong-Levine preexcitation syndrome

  • James bundle (atrio-hisian)
  • Short PR
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14
Q

AVNRT

A

Atrioventricular nodal reentrant tachycardia

  • Regular tachycardia ~140-280 bpm.
  • QRS narrow (< 0,12s)
  • QRS alternans – phasic variation in QRS amplitude
  • P waves if visible exhibit retrograde conduction with P-wave inversion in leads II, III, aVF.
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15
Q

AVRT antidromic

A
  • HR: 200-300 bpm

- Wide QRS

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16
Q

AVRT orthodromic

A
  • HR: 200-300 bpm
  • Narrow QRS (after wide QRS’s in WPW)
  • QRS alternans - variation in amplitude
  • T inversion common
  • ST depression
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17
Q

Hyperacute STEMI

A
  • ST elevation
  • Peaked T wave (=T en dome)

*Ischemia and lesion

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18
Q

Acute STEMI

A
  • ST elevation
  • Inverse T
  • Pathological Q
  • Ischemia, lesion and necrosis
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19
Q

Subacute STEMI

A
  • Inverse T (coronary)
  • Pathological Q (and/or reduction R)

*Ischemia and necrosis

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20
Q

Definitive/ Old STEMI

A
  • Pathological Q

* Necrosis

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21
Q

Subendocardial lesion

A
  • TP and PR elevation
  • ST depression
  • Pathological Q og R reduction
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22
Q

Subepicardial/transmural lesion

A
  • TP and PR depression
  • ST elevation
  • Pathological Q or QS
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23
Q

Transitional zone shift

A 
Normal: V3-V4
Right shift (V1-V2): Right ventricular hypertrophy
Left shift (V5-V6): Left ventricular hypertrophy
24
Q

Missing R-progression

A

“R-regression”

- Often necrosis (MI)

25
Q

P wave morphology not symmetrical in same lead

A

Multifocal

26
Q

Pre-excitation definition

A

PQ shorter than 0,12 s

27
Q

AV block definition

A

PQ longer than 0,2 s

28
Q

PQ interval time

A

0,12-0,2 s (3-5mm)

29
Q

LAH

A

Left anterior hemiblock

Extreme left deviation (more than -30)

30
Q

LPH

A

Left posterior hemiblock

Extreme right deviation (more than 110)

31
Q

Always isoelectric

A

TP segment

32
Q

Ascending ST segment

A

Can be normal

33
Q

Max normal deviation J-point

A

Up: 0,1 mV
Down: 0,05 mV

34
Q

Escape beats vs premature contractions

A

Escape beats: comes after pause

Premature beats: comes too early, then pause

35
Q

Paroxysmal supraventricular tachycardia (PSVT)

A
  • Sudden onset and termination
  • Rhythmic
  • HR: 150-250 bpm
  • No P wave
  • Can be terminated by carotid massage
36
Q

Atrial flutter

A
  • F-waves (constant and rhythmic)
  • Regular ventricular rhythm
  • Functional AV block (2:1, 3:1, 4:1…)
37
Q

Atrial fibrillation

A
  • Numerous impulse generation sites
  • Absolute arrhythmia
  • No P waves (small f-waves may be seen)
38
Q

MAT

A

Multifocal atrial tachycardia

  • P waves present!
  • Diff. sites of impulse generation, but do not fire simultaneously
  • Absolute arrhythmia
  • Compare to atrial fibrillation!
39
Q

Angina pectoris types

A

Classic: ST depression
Prinzmetal: ST elevation

Stable
Unstable

40
Q

Atrial enlargement

A

Leads II and V1

41
Q

Right ventricular hypertrophy

A
  • V1: R > S (R>7mm)
  • V6: S > R
  • Right deviation
42
Q

Anterior infarction

A
  • V1-V4

- Proximal LAD occlusion

43
Q

Lateral infarction

A
  • I, aVL, V5 and V6
  • High lateral: I and aVL
  • Circumflex occlusion
44
Q

Inferior infarction

A
  • II, III and aVF

- Distal posterior descending

45
Q

Posterior infarction

A
  • Mirror V1-V4

- Branches posterior descending

46
Q

Septal infarction

A
  • (V1), V2, V3, (V4)

- Septal branches (LAD or post desc)

47
Q

Anterolateral infarct

A
  • I, aVL, V1-V5
48
Q

Extensive anterior infarct

A

I, aVL, V1-V6

49
Q

Posteroinferior infarct

A
  • II, III, aVF

- Mirror V1-V4

50
Q

Sokolow criteria left ventricular hypertrophy

A

R in V5/V6 + S in V1/V2 > 35 mm

51
Q

Scoop-like ST

A

Digitalis toxicity

52
Q

Hypercalcemia

A

Shorter QT

53
Q

Hypocalcemia

A

Longer QT

54
Q

Hyperkalemia

A

Tented T

55
Q

Hypokalemia

A
  • Flat T
  • U wave
  • ST depression
56
Q

Arythmogenic factors

A

HIS DEBS

  • Hypoxia
  • Ischemia + Irritability
  • Sympathetic stimulation
  • Drugs
  • Electrolyte disturbances
  • Bradycardia
  • Stretch
57
Q

AV dissociation

A

No correlation between P and QRS

Pathophysiology Jenny (3 decks)

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