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Cardiology > ECG patterns > Flashcards

ECG patterns Flashcards

1
Q

Describe the ECG findings in Brugada syndrome.

A
  • RSR` pattern - incomplete RBBB pattern
  • “Coved” ST segments (>2mm) in more than one of V1-3
  • Inversion of the terminal T-wave

This is Brugada’s sign.

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2
Q

Describe the ECG criteria for LVH.

A

Many criteria exist:

Need voltage criteria PLUS non-voltage criteria to diagnose LVH.

Non-voltage criteria:

  • Intrinsicoid deflection > 50ms in V5 or V6
  • STD and TWI in lateral leads -> LV strain pattern

Voltage criteria:

Most common is Sokolov-Lyon:

S in V1 + tallest R in V5 or V6 >35mm

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3
Q

Describe the ECG findings in pericarditis.

A
  • Widespread STE
  • PR depression
  • Reciprocal STD and PR elevation in aVR +/- V1
  • Sinus tachy common
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4
Q

Describe the ECG findings in PE.

A
  • Sinus tachy (44%)
  • RBBB (complete or incomplete (18%)
  • RV strain pattern(34%)
    • TWI in right precordial leads V1-4 +/- inf’r leads
  • RAD (16%)
  • R-wave in V1
  • Right atrial enlargement (9%)
    • Peaked p-wave in II >2.5mm height
  • S1QIIITIII
    • S-wave in lead I
    • Q-wave in lead III
    • T-wave inversion in lead III
  • Atrial tachycardias - AF, Aflutter, atrial tachycardia
  • Non-specific ST segment and T-wave changes (50%)
  • 18% will have normal ECG
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5
Q

Describe the ECG criteria for RVH.

A
  • RAD (>110degrees)
  • Dominant R-wave in V1
  • Dominant S-wave in V5-6
  • QRS <120ms
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6
Q

Describe the STE ECG indications for STEMI (cath lab activation criteria).

A
  • Males >40y: >2.0mm in V2-V3 and >1mm in all other leads
  • Males <40y: >2.5mm in V2-V3 and >1mm in all other leads
  • Females: >1.5mm in V2-V3 and >1mm in all other leads
  • All: >0.5mm in right-sided or posterior leads
  • All: Reciprocal STD >0.5mm in V2-3 (posterior MI) and 1mm in all other leads
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7
Q

Describe the ECG findings in hyperkalaemia.

A
  1. K >5.5: (repolarisation problems)
    1. Peaked T-waves
  2. K >6.5 (atrial paralysis)
    1. P-waves wider and flatter
    2. PR int increases
    3. P-waves disappear
  3. K >7.0 (conduction probs and bradycardia)
    1. Prolonged, bizarre QRS
    2. High-grade AV block with junctional escape
    3. Conduction blocks (fascicular, BBBs)
    4. Sinus brady or slow AF
    5. Sine wave rhythym
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8
Q

Describe the ECG findings in hypokalaemia.

A

K<3.0mmol/L

  • T-waves wider and flatter -> TWI
  • STD
  • P-wave amp, duration and interval may increase
  • U-waves esp in V2-3 -> apparent long QT (due fusing of T+U waves)
  • Frequent atrial and vent’r ectopics
  • SVTs - AF, Aflutter, AT
  • VT, VF, TdP
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9
Q

Describe the ECG findings in LAFB.

A
  • QRS <120ms
  • LAD
  • qR in I, aVL
  • rS in II, III and aVF
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10
Q

Describe the ECG findings in RBBB.

A
  • QRS > 120ms
  • RsR` in V1-3
  • Slurred S-wave in lateral leads I, aVL and V5-6
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11
Q

Describe the ECG findings in LBBB.

A
  • QRS > 120ms
  • Dominant S wave R/S <1 in V1
  • Broad, monophasic R-wave in lateral leads
  • Absence of Q-waves in lateral leads
  • Intrinsicoid deflection >60ms in V5-6
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12
Q

Describe the ECG findings in LPFB.

A
  • QRS <120ms
  • RAD
  • qR in II, II and aVF
  • rS in I, aVL
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13
Q

Describe the ECG findings in first degree heart block.

A

PR > 200ms

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14
Q

Describe the ECG findings in complete heart block.

A
  • Complete AV dissociation
  • Junctional or ventricular escape rhythym
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15
Q

Describe the ECG findings in second degree, Mobitz Type I heart block.

A
  • Lengthening PR intervals until one beat dropped
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16
Q

Describe the ECG findings in second degree, Mobitz Type II heart block.

A
  • Constant PR intervals with dropped beats at regular intervals
17
Q

What is Brugada Syndrome.

A

A sodium channelopathy that affects the myocardium and can lead to sudden cardiac death.

The syndrome is diagnosed if the following are present:

  • Characteristic ECG findings:
    • Coved STE >2mm in more than one of V1-3
    • RSR / incomplete RBBB pattern in V1-3
    • Inversion of the terminal T-wave
  • PLUS one or more of the following clinical criteria:
    • Syncope
    • Documented VF or VT
    • Family hx of SCD <45yrs
    • Nocturnal agonal respiration
18
Q

Outine the common progression of the ECG during an episode of pericarditis.

A

Stage 1: Classic changes of widespread STE and PR depression w/ reciprocal STD and PR elevation in aVR +/- V1 (0-2wks)

Stage 2: Normalisation of ST changes with T-wave flattening (1-3wks)

Stage 3: Flattened T-waves become inverted. 3-several weeks)

Stage 4: ECG returns to normal.

19
Q

Describe the ECG findings in posterior MI.

A
  • STD in V1-3
  • RS >= 1 in V1-3
  • Peaked T-waves in V1-3
  • V7-9 STE
20
Q

Describe the criteria for pathological Q-waves.

A
  • >40ms wide
  • >2mm deep
  • >25% height of QRS
  • Located in V1-3
21
Q

Describe the ECG findings in WPW.

A
  • Short PR <120ms
  • Delta waves
  • QRS prolongation >110ms

Cardiology (11 decks)

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