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CARDIOLOGY > ECG REVISION > Flashcards

ECG REVISION Flashcards

1
Q

Sinus Rythm - normal characteristics

A
  1. HR : 50-100 BEATS/MIN
  2. P wave precedes every QRS complex
  3. P wave is positive in lead II
  4. PR interval is constant
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2
Q

Causes of bradycardia

A

1.Sinus bradycardia
2.SA Block
3.Sinoatrial arrest / inhibition
4.2nd Degree AV block
5.3rd Degree AV block
Escape rythm may arise during bradycardia
Bradycardia due to dysfunction in SA node is referred to as sinus node dysfunction (SND)

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3
Q

Causes of tachycardia ( tachyarrythmia ) with narrow QRS complexes ( QRS duration <0,12s )

A
  1. Sinus tachycardia
  2. Inappropriate sinus tachycardia
  3. SA re-entry tachycardia
  4. Atrial fibrillation
  5. Atrial flutter
  6. Atrial tachycardia
  7. Multifocal atrial tachycardia
  8. AVNRT ,AVRT ( pre- excitation ,WPW )
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4
Q

Causes of tachycardia ( tachyarrythmias ) with wide QRS complexes ( QRS duration >= 12 s)

A

1.Ventricular tachycardia ( the most common cause )

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5
Q

In which leads P wave is always positive ?

A

II, III , aVF

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6
Q

P mitrale

A

Increased P wave duration , enchanced second humpin lead II and enhanched negative deflection in V1

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7
Q

P pulmonale

A

Increased P wave amplitudes in lead II and V1

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8
Q

PR INTERVAL > 0.22 s

A

1st degree AV block

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9
Q

PR interval < 0.12 s

A

Pre - excitation ( WPW syndrome )

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10
Q

2nd degree AV - block Mobitz type I ( Wenckebach block )

A

Repeated cycles of gradually increasing PR interval until an atrial impulse ( P wave ) is blocked in the AV node + QRS does not appear

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11
Q

2nd degree AV - block Mobitz type II

A

Intermittently blocked atrial impulses ( no QRS seen after P ) but PR = Constant

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12
Q

3rd degree AV - block

A

All atrial impulses ( P waves ) are blocked by the AV node .
An escape rythm arises ( cardiac arrest ensues otherwise ) which may have narrow or wide QRS complexes , depending on its origin

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13
Q

QRS duration must be less than ?

A

< 0.12 s

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14
Q

High voltage example

A

S wave V1 or V2 + R wave V5 > 35 mm

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15
Q

Pathological Q waves >= ?

A

> = 0.03s

Amplitude >= 25% of R wave amplitude in the same lead , in at least 2 anatomically contiguous leads

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16
Q

Wide QRS complex ( ORS duration > 0.12s )

A
  1. Left Bundle Branch Block
  2. Right Bundle Branch Block
  3. Hyperkalemia
  4. Class I antiarrythmics
  5. Trucyclic Antidepressants
  6. Ventricular Rythm + ventricular extrasystoles ( premature complexes )
  7. Artificial pacemaker which stimulates in the ventricle
  8. Abberant conduction ( Abberancy )
  9. Pre - excitation ( WPW syndrome )
17
Q

High voltage

A
  1. Hypertrophy
  2. LBBB ( leads V5 ,V6 , I , avL )
  3. RBBB ( V1 - V3 )
18
Q

Low voltage

A
  • Normal variant. Misplaced lead
  • Cardiomyopathy
  • COPD
  • Perimyocarditis
  • Hypothyreosis ( typically accompanied by bradycardia)
  • Pneumothorax
  • Extensive myocardial infarction
  • Obesity
  • Pericardial effusion
  • Pleural effusion
  • Amyloidosis
19
Q

Pathological Q waves

A
  1. MI
  2. Left - sided pneumothorax
  3. Dextrocardia
  4. Perimyocarditis
  5. Cardiomyopathy
  6. Amyloidosis
  7. Bundle Branch blocks
  8. Anterior Fascicular Block
  9. Pre- excitation
  10. Ventricular hypertrophy
  11. Acute cor pulmonare
  12. Myxoma
20
Q

Abnormal R - wave progression

A
  1. MI
  2. Right ventricular hypertrophy ( reversed R wave progression )
  3. Left ventricular hypertrophy ( amplified Rwave progression )
  4. Cardiomyopathy
  5. Chronic cor pulmonale
  6. LBBB
  7. Pre - excitation
21
Q

Right axis deviation

A
  1. Right ventricular hypertrophy
  2. Acute cor pulmonale ( COPD , pulmonary hypertension , pulmonary valve stenosis )
  3. Lateral ventricular infarction
  4. Pre - excitation
  5. Situs inversus
  6. Left posterior fascicular block is diagnosed when axis b/w : 90-180 with rS complex in I and avL as well as qR complex in III + avF ( with QRS <0.12s), provided that other causes of right axis deviation have been excluded
22
Q

Left axis deviation

A
  1. LBBB
  2. Left ventricular hypertrophy
  3. Inferior infarction
  4. Pre - excitation
  5. Left anterior fascicular block is diagnosed if the axis is b/w 45 - 90 with qR complex in aVL + QRS > 0.12s , provided that other causes of left axis deviation have been excluded
23
Q

Causes of ST segment elevation

A
  1. Ischemia
  2. ST segment elevation MI ( STEMI /STE - AKS)
  3. Prinzmetal’s angina ( coronary vasospasm )
  4. Early repolarization
  5. Perimyocarditis
  6. LBBB
  7. Left ventricular hypertrophy
  8. Hyperkalemia
  9. Pulmonary embolism
  10. Pre - excitation
  11. Aortic dissection engaging the coronary arteries
  12. Left ventricular aneurysm
24
Q

Cause of ST segment depression

A
  1. Ischemia
  2. Non ST segment elevation MI ( NSTEMI / NSTE - AKS)
  3. Hyperventilation
  4. Hypokalemia
  5. High sympathetic tone
  6. Digoxin
  7. LBBB
  8. RBBB
  9. Pre - excitation
  10. Left ventricular hyperthrophy
  11. Right ventricular hypertrophy
  12. Heart failure
  13. Tachycardia
25
Q

In limb leads the amplitude is highest in 1)____

In chest leads the amplitude is highest in V2-V3 2)____

A

1) Lead II

2) V2-V3

26
Q

T wave inversion w/o simultaneous ST segment deviation

A
  1. Post ischemic sign
  2. Pulmonary embolism
  3. Perimyocarditis ( after normalization of the ST segment elevation , T waves become inverted in perimyocarditis )
  4. Cardiomyopathy
27
Q

T wave inversion with simltaneous ST segment deviation

A

Acute ( ongoing ) myocardial ischemia

28
Q

High T waves

A

1.Nrmal variant
2.Early repolarization
3.Hyperkalemia
4.Left ventricular hypertrophy
5.LBBB
6.Ocassionally perimyocarditis
High (hyperacute) Twaves may be seen in very early phase of STEMI

29
Q

ECG features of Junctional Escape Rhythm

A
  • Junctional rhythm with a rate of 40-60 bpm
  • QRS complexes are typically narrow (< 120 ms)
  • No relationship between the QRS complexes and any preceding atrial activity (e.g. P-waves, flutter waves, fibrillatory waves)
30
Q

Terminology of junctional rhythms

A

Junctional bradycardia = junctional rhythm at a rate of < 40 bpm
Junctional escape rhythm = junctional rhythm at a rate of 40-60 bpm
Accelerated junctional rhythm = junctional rhythm at 60-100 bpm
Junctional tachycardia = junctional rhythm at > 100 bpm

CARDIOLOGY (19 decks)

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