ECG rhythm spotting

Question 1

how long should a QRS be?

Answer 1

0.12 s

3 boxes

Question 2

how long should the PR interval be?

Answer 2

0.2s

5 boxes

Question 3

how long should the QT interval be?

Answer 3

0.44 s

11 boxes

Question 4

how to calculate HR on an ECG?

Answer 4

number of cardiac cycles in 6s (30 large squares) x10

or number of cardiac cycles in 3s (15 large squares) x20

Question 5

what are the 6 steps in reading a rhythm strip?

Answer 5

1. is there electrical activity?
2. what is the ventricular (QRS) rate?
3. is the QRS rhythm regular or irregular?
4. Is the QRS width normal (narrow) or broad?
5. is atrial activity present? (P waves/other)
6. how is atrial activity related to ventricular activity?

Question 6

ECG of Brugada syndrome?

Answer 6

ST elevation with RBBB in V1,2,3

Question 7

ECG of LQTS?

Answer 7

extended QT interval (more than 440 ms)

Question 8

ECG of hypertrophic cardiomyopathy?

Answer 8

Inverted T waves

Question 9

ECG of Arrhythmogenic left ventricular cardiomyopathy?

Answer 9

Epsilon waves (late spikes in QRS)

Question 10

ECG of normal sinus rhythm

Answer 10

rate 60-100, regular P wave to each regular QRS, normal P wave and PR interval

Question 11

ECG of sinus tachycardia?

Answer 11

rate >100, regular P wave to each regular QRS, normal P wave and constant PR interval

Question 12

ECG of sinus bradycardia?

Answer 12

Rate <60, regular P wave to each regular QRS, normal P wave appearance and PR interval

Question 13

ECG of Atrial flutter?

Answer 13

atrial rate 250-250bpm, usually a regular QRS
usually 2:1 atrial to ventricular activity
“saw tooth”

Question 14

ECG of AF?

Answer 14

Irregularly irregular QRS, no P waves, atrial rate over 350bpm, irregular baseline

Question 15

ECG of ventricular tachycardia?

Answer 15

100-200 bpm, regular QRS, occasionally dissociated P waves, WIDE QRS

Question 16

ECG of torsade de pointes?

Answer 16

Rate 200-250bpm, regular or irregular,

SINUSOIDAL PATTERN

Question 17

ECG of 1st degree heart block?

Answer 17

varying HR, but regular

prolonged PR interval >0.2 secs

Question 18

ECG of 2nd degree heart block: Mobitz type I?

Answer 18

Varying heart rate- irregularly irregular
increasing PR interval
dropped beat, repeat

Question 19

ECG of 2nd degree heart block: Mobitz type II?

Answer 19

varying rate, but constant PR interval.
regular P waves but some not conducted
2:1, 3:1, 4:1 ratio to QRS

Question 20

Mobitz type I is more likely to lead to complete heart block, true/false?

Answer 20

FALSE

mobitz type II

Question 21

ECG of 3rd heart degree heart block?

Answer 21

AV dissociation
no relation between P waves and QRS complexes
varying heart rate

Question 22

What is another name for 3rd stage heart block?

Answer 22

complete heart block

Question 23

An ECG showing ST elevation in leads I, aVL, V5 and V6 would indicate a thromboembolism in which artery?

Answer 23

circumflex artery

lateral MI

Question 24

a thromboembolism in the left anterior descending artery would cause what changes on ECG?

Answer 24

ST elevation in V1, V2

or NSTEMI

Question 25

which leads represent the inferior heart and what artery is this area supplied by?

Answer 25

II, III, aVF

right coronary artery

Question 26

VF ECG?

Answer 26

bizarre irregular waveform
no recognisable QRS complexes
random amplitude and frequency

Question 27

monomorphic VT ECG?

Answer 27

broad complex rhythm
rapid rate
constant QRS morphology

Question 28

asystole ECG?

Answer 28

absent QRS, may have persistent P waves