ECG The Rhythm Of The Heart Flashcards
Changes in heart rate in young people are called what
Sinus arrhythmia
Sinus bradycardia can be associated with diseases/ pursuits
Athletic training
Fainting
Hypothermia
Myxoedema
Often seen after a heart attack
Sinus tachycardia Is associated with what
Exercise
Fear Pain
Haemorrhage
Thyrotoxicosis
Abnormal rhythms can start in three different places in the heart? Normal rhythm begins where?
sinus node
the atrial muscle
The region of the AV node (junctional)
The ventricular muscles
Sinus rhythm
Atrial rhythm Junctional rhythm Are called what
Super-ventricular rhythms
Super-ventricular rhythms will have a normal QRS yes are no
Yes
Super ventricular rhythms will have ———- QRS
Narrow QRS
Ventricular rhythms have ———QRS
Wide QRS complexes
Usually super ventricular rhythms have narrow QRS
Ventricular rhythms have wide QRS
What can happen to make super ventricular rhythm have a wide QRS
LBBB or RBBB
What are the protective rhythms call
Escape rhythms
What happens in an Atrial escape
SA node fails to depolarise.
After a delay an abnormal p wave is seen then a normal QRS
Nodal (junctional) escape rhythm
no relationship between QRS and any atrial activty ( p wave) eg af af
rate 40-60
QRS typically narrow
Ventricular escape is most commonly seen When
Conduction between the atrial and ventricular is interrupted by Complete heart block
But can occur without heart block and can also be single
Extra systoles can also be know as
Ectopic Premature
The heart can occasionally be controlled by a Ventricular focus with an intrinsic frequency of discharge faster than seen in complete heart block This rhythm is called
Accelerated idioventricular rhythm
5 things to ask yourself when analysing an ECG
1 does an early QRS complex follow an early P wave. If so it must be an atrial extra systole.
2 can a P wave be seen anywhere. A junctional extra systole may cause the appearance of a P wave very close to and even after the QRS complex
3 is the QRS the same shape throughout Super-ventricular beats look the same ventricular beats look different
4 is the T wave the same way up as in the normal beat? Super ventricular beats it’s the same way up ventricular beats look different
5does the next P wave after extra systole at an expected time .
Which node has the highest rate of discharge?
Which nerve has influence over this area
SA node
Vagus nerve
Tall P waves means what ( peaked)
Right atrial hypertrophy
Broad P waves means what ( bifid)
Left atrial hypertrophy
Broadening QRS complex indicates what
Abnormal intraventricular conduct Seen in BBB
Increased height of the QRS indicates what What leads indicate which side
Ventricular hypertrophy
RVH seen in V1
LVH seen in V5-V6
Q waves greater than 1mm across and 2mm deep indicate what
Mi
ST segment elevation indicates what
MI
Pericarditis
ST segment depression and T wave inversion may be due to what
Ischaemia
Ventricular hypertrophy
Abnormal intraventricular conduction
Digoxin
T wave inversion is normal in what leads
VR and V1
T wave inversion is associated with what
BBB
Ischaemia
Ventricular hypertrophy
T Wave flatten or peaking with an unusually long or short QT wave interval may be due to what
Electrolyte abnormalities
Many ST -T changes are what
Nonspecific
A supra ventricular extrasystole resets what
The p wave
When a tachycardia occurs intermittently it is called what
Paroxysmal
Atrial flutter Giving the wave what appearance
Sawtooth appearance
Junctional tachycardia ,node The p waves may what?
May be seen very close to the QRS or not at all
CSP stands for what
Carotid sinus pressure
During super ventricular tachycardia What may be helpful 1 2
CSP may have be therapeutic effect
could make the nature of the arrhythmia more obvious
Applying CSP Does what
Activates a vagal stimulation of the sa and AV nodes
Ventricular tachycardia starts where In the heart
What do the the QRS look like
In the ventricles Wide QRS
Wide QRS are seen in VT
Name other
BBB
Atrial fibrillation Describe
No p waves
Irregular base line Irregular Q
RS Normal shaped QRS
What are delta waves
QRS Early slurred upstroke
Short PR interval Delta wave Second part of QRS normal
RAD
What could this be
WPW Wolff Parkinson white
AVNRE
Atrioventricular nodal re-entry
Most parts of the heart are capable of what
Spontaneous depolarisation
Abnormal rhythms can arise in which part of the heart
Atrial muscle
The region around the AV node ( Junction)
Ventricular muscle
Escape rhythms are what
Slow and protective
Frequent depolarisation causes what
Tachycardia
All super ventricular rhythms have normal what Providing their is no BBB
QRS
Ventricular rhythms cause what
QRS and abnormal T waves
