ECG rhythm identification

Question 1

Inverted P wave

Answer 1

Junctional rhythm

Question 2

Regular rhythm
QRS >0.12 seconds
P waves: can be identified by not related
P-R interval: n/a
Rate: >100

Answer 2

VT

Question 3

Irregular rhythm
QRS >0.12 seconds
P waves: not discernible
P-R interval: n/a
Rate: >150

Answer 3

Torsades

Question 4

Irregular rapid rhythm
QRS: not discernible
P waves: not discernible 
P-R interval: n/a
Rate: non measurable

Answer 4

VF

nothing is discernible, just rapid

Question 5

Regular rhythm
QRS: <0.12 seconds
P waves: present, normal
P-R interval: 0.12-0.2 seconds
Rate: 60-100 bpm

Answer 5

Normal sinus rhythm

Question 6

Regular rhythm
QRS: <0.12 seconds
P waves: present, normal
P-R interval: 0.12-0.2 seconds
Rate: 100-160 bpm

Answer 6

Sinus tachycardia

normal just fast

Question 7

Regular rhythm
QRS: <0.12 seconds
P waves: present, normal
P-R interval: 0.12-0.2 seconds
Rate: <60 bpm

Answer 7

Sinus bradycardia

normal just slow

Question 8

Irregular rhythm
QRS: <0.12 seconds
P waves: present, normal
P-R interval: 0.12-0.2 seconds
Rate: 60-100 bpm

Answer 8

Sinus arrhythmia

p-p intervals vary but everything else is normal

Question 9

Irregular rhythm
QRS: <0.12 seconds
P waves: present, normal
P-R interval: 0.12-0.2 seconds
Rate: varies, pauses

Answer 9

Sinus pause/arrest

Everything is normal but there will be a pause between T and P waves every now and again

Question 10

Irregularly irregular rhythm
QRS: <0.12 seconds
P waves: not discernible 
P-R interval: n/a
Rate: varies, fast atrial rate
R-R intervals vary

Answer 10

Atrial fibrillation

(Everything is normal except there are no p waves, instead after T waves there are little bumps - this is because the SA node doesn’t fire, the AV node fires, doesn’t allow for full atrial depol)

Question 11

Rhythm may be irregular
QRS: <0.12 seconds
P waves: multiple, don't relate to QRS
P-R interval: n/a
Rate: fast atrial rate
R-R intervals are consistent, regular

Answer 11

Atrial flutter

SA node isn’t conducting electrical activity, AV node steps in, less rapid and more organised than fibrillation

Refractory period prevents QRS from being rapid, shows multiple p waves not leading to anything

Question 12

Regular rhythm, rapid
QRS: Normal, narrow
P waves: buried in proceeding T waves
P-R intervals: not measurable
Rate: rapid, fast

Answer 12

SVT (supraventricular tachycardia)

Heart is beating so fast it can’t relax between contractions, doesn’t allow for full refill of blood

Question 13

Regular rhythm
QRS: <0.12 seconds
P waves: normal
P-R intervals: >0.20 seconds
Rate: 60-100 bpm

Answer 13

First degree heart block

Question 14

Irregular rhythm
QRS: <0.12 seconds
P waves: normal, some single P waves with no QRS
P-R intervals: irregular
Rate: varies

Answer 14

Second degree heart block

Question 15

Regular rhythm
QRS: <0.12 seconds (can be wide)
P waves: do not relate to QRS
P-R intervals: none
Rate: varies

Answer 15

Third degree heart block

Question 16

Upright P wave in front of a QRS, not constant

Answer 16

premature atrial complex (PAC)

Question 17

Hidden or inverted P wave every now and then

Answer 17

premature junctional complex (PJC)

Question 18

No P wave bizzare QRS every now and then

Answer 18

premature ventricular complex (PVC)

Question 19

Explain paced rhythms

Answer 19

Random small spikes (show pacemaker shocking the heart to generate impulse)

Before P wave: atrial pacer
Before QRS: ventricular pacer