ECG - Myocardial infarction Flashcards
What does AV stand ford?
Augmented view
What position can V1 and 2 be found in?
- Either side of the sternum,
- At the 4th intercostal space
What position is V3 found in?
In between V2 and V4.
What position is V4 found in?
- In the 5th intercostal space
- along the mid clavicular line
What position is V5 found in?
- Anterior Auxilia line
- Along a vertical plane with V4
What position is V6 found in?
- Mid auxilla line
- On a vertical plane with V4/5
How long is recorded in each section of a 12 lead ECG?
- 2.5 seconds
Where should R Wave progression be seen?
- V1-4
What causes increased QRS complexes?
- Increased Potassium and Sodium, due to increased contraction of myocardial cells.
Where should upright P waves be found?
- Leads 1 and 2
- V2 - V6
How wide should Q waves be in L1, L2, V2- V6?
< 0.4s
Where may show elevation even on an otherwise normal ECG12?
V1 - V2
Where would upright T waves be found?
- Leads 1 and 2
- V3-V6
What is a J point?
The Point where the QRS end and the ST Segment starts
What does ST Depression indicate, in relation to the Myocardial issue?
Ischemia
What is an inferior MI likely to cause?
Bradycardia
What may show an ECG with a Pt symptomatic of angina?
- Wide spread ischemia
- T wave inversion
What occurs in an area of ischemia?
- Metabolic changes
- CP and discomfort
- Nerve fibers remain intact.
What occurs at the area of injury?
- Severe metabolic changes
- Increased permeability of cell membranes
- Increased sodium and water transport
- Increased odeama
What is a Physiological P Wave?
The negative deflection that follows a P wave.
What are the key features of a physiological P wave?
- QRS >o.03
- Amplitued .1/3 of the QRS
What is pathological Q a sign of?
A Previous MI
What needs to be taken into consideration with a pathological Q wave?
- Presence of a LBB
- The wide and depth of the Q qave
- Specific leads Q waves appear
- The other ECG appearance of the MI.
Where would elevation be shown in a septal MI?
- V1 and V2
Where would elevation be shown in an Anterior MI?
V3 and V4
Where would elevation be shown in an inferior MI?
- L1, L2 and AVF
Where would elevation be shown in a lateral MI?
L1, AVL, V5, V6,
When should a posterior ECG be taken?
In a depressed V2
What percentage of patients have MI with ventricular involvement?
- 30-50%
Why should GTN be given with caution for a posterior/ right ventricular MI?
GTN can open up the right blood vessels and cause further pre load on the right side of the heart.
What leads can be moved for a right sided view of the heart?
V3 and V4
Where would you see reciprocal changes in an interior Mi?
L1, AVL
Where would you see reciprocal changes of a lateral Mi?
L2, L3, AVF
Where would you see reciprocal changes in a posterior MI?
V1, V2 and V3
What is a posterior Mi?
An occlusion of the left circumflex or right coronary artery.
What are the anterior lead changes in a posterior MI?
- Tall and slightly wide
- Depression of the ST segment
- Upright T Waves
What rhythms commonly imitate a ST elevation/ Depression?
- LBBB
- Paced rhythms
- Ventricular rhythms
- Pericarditis
