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CARDIOLOGY > [ECGmadeasy][arrhythmias] > Flashcards

[ECGmadeasy][arrhythmias] Flashcards

1
Q
A

extra beat supraventricular arryhthmias bradyarryhthmias ventricular arryhthmias

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2
Q
A

yes

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3
Q
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yes

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4
Q
A

smoking alcohol caffiene

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5
Q
A

Mg2+ Ca2+ K+

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6
Q
A

thyroid disease

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7
Q
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phaechromocytoma thyroid disease

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8
Q
A

hypoxia hypercapnia

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9
Q
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pneumonia

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10
Q
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metabolic acidosis

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11
Q
A

palpitations chest pain syncope/pre-syncope

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12
Q
A

hypotension pulmonary oedema

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13
Q
A

depolarisation begins at the sinus node

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14
Q
A

the place in the heart where depolarisation occurs

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15
Q
A

P waves present? P+QRS wave relationship (should be 1 QRS per P) width of QRS

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16
Q
A

less than 120 ms

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17
Q
A

most frequent depolarisation (SA node usually has the highest frequency of discharge)

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18
Q
A

Lead in which the P wave is most easily seen.

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19
Q
A

AVN atria (anywhere) Ventricles (anywhere)

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20
Q
A

junctional nodal

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21
Q
A

sinus atrial junctional *the depolarization waves spreads normally through His*

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22
Q
A

Normal as the depolarisation wave is spreading normally through the bundle of His. i.e. it is the same if the initiation is at the AVN/atrial/SA node

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23
Q
A

Depolarisation spread through the purkinje fibres (slower/abnormal)

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24
Q
A

Repolarisation is also abnormal.

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25
Q
A

supraventricular arrhythmia *with a few exceptions

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26
Q
A

ventricular arrhythmia

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27
Q
A

Wolff-Parkinson-White (WPW) Supraventricular + LBBB Supraventricular + RBBB

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28
Q
A

activation of the atria/ventricles is totally disorganised.

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29
Q
A

early single beats

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30
Q
A

the SAN has the highest intrinsic frequency of depolarisation

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31
Q
A

70bpm

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32
Q
A

50bpm

33
Q
A

30bpm

34
Q
A

slow and protective rhythms which initiate depolarisation if SAN fails. ‘escape from their normal inhibition’

35
Q

Explain why.

A

Atrial escape.

Initial sinus beat. Then failure to depolarise.

There is atrial ‘escape’ of SAN inhibition.

Abnormal P wave seen (depolarisation starts elewhere in atrium).

Normal QRS complex - normal His.

Returns to sinus.

36
Q

Why?

A

Junctional escape.

No P wave in junctional as atria do not contract or hidden by QRS.

QRS normal width.

This cannot be ventrucular as there is normal QRS width.

Cannot be atrial escape as no abnormal P wave.

37
Q
A

Complete heart block

38
Q
A

Accelerated idioventricular rhythm (AIVR)

39
Q

Why?

A

Ventricular escape

3 sinus beats. SAN failure.

No atrial or nodal escape. Single wide and abnormal QRS. Abnormal T wave.

Sinus rhythm restored.

40
Q

Why?

A

Complete heart block.

Normal P waves.

Abnormal QRS (due to ventricular escape).

No relationship between P an QRS.

41
Q

Why?

A

AIVR

3 sinus beats.

SAN failure.

Ventricular escape - continuous regular rhythm with wide QRS and abnormal T waves.

42
Q
A

the accompanying heartbeat to any earlier than usual depolarisation. (‘ectopic’ = abnormal location)

43
Q

[arrhythmias]: what is the difference between an ‘extrasystole’ and an escape beat?

A

escape = late

Extrasystole = early

44
Q
A

Junctional/nodal extrasystole.

No P wave.

45
Q
A

Atrial extrasystole. Abnormally shaped P wave.

46
Q
A

Abnormal QRS complex early in the T wave of the preceding beat. (?ventricular fibrillation?)

47
Q
A

Ventricular extrasystole.

5 sinus beats.

early abnormal beat close to abnormal T wave.

48
Q
A

ventricular extrasystole.

‘R on T’ phenomenon.

i.e. ventricular extrasystoles have occured at the peak of the preceding sinus beats.

49
Q
A

Atrial extrasystole

50
Q
A

supect ventricular problem - supraventricular tend to produce the same shaped QRS complexes.

51
Q
A

ventricular beat

52
Q
A

supraventricular beat.

53
Q
A

it resets the P wave cycle (i.e. it does not come at the expected time)

54
Q
A

No effect - the P wave comes at the expected time.

55
Q
A

c. 200/min

(above this you get AV block - which differs from 2nd degree as the AVN is functionin properly)

56
Q
A

Atrial tachycardia.

150/min. P wave superimposed on T waves. QRS are the same as the first 3 sinus beats.

57
Q
A

atrial rate > 250/min

no flat baseline between P waves. (‘sawtooth’ appearance’)

58
Q
A

atrial contracting at 250/min with 2:1 block = ventricular contraction at a rate of 125/min

59
Q
A

Atrial flutter.

P waves at a rate of 250/min (sawtooth)

4:1 block

ventricular activation at 75/min

60
Q
A

Atrial flutter (250/min) with 2:1 block = ventricular rate of 125/min.

(T waves cannot be identified)

61
Q
A

Junctional

62
Q
A

QRS are essentially normally shaped. No P wave. Regular QRS. Tachycardic. = Junctional tachycardia

63
Q
A

carotid sinus pressure

64
Q
A

Reduced frequency of SAN discharge

Increase in the delay of conduction in the AVN

65
Q
A

May make identification of underlying patholgy clearer. E.g. atrial flutter on image

66
Q
A

high frequency ectopic ventricular depolarisiation focus

67
Q
A

ventricular tachycardia (ectopic focus) and R/LBBB

68
Q
A

Ventricular tachycardia

Broad QRS complexes

T waves difficult to identify

69
Q
A
  1. if QRS is wider than 160 ms it is usually ventricular in origin
  2. if the QRS is very irregular thatn it is probably AF with BBB
  3. Does the patient have BBB in sinus rhythm as well (if you can see it - the QRS will be the same shape)
70
Q
A

bradycardia

71
Q
A

tachycardia

72
Q
A

no focal point of depolarisation - muscel fibres are contracting independently.

73
Q
A

AVN threshold - all or none conduction. Irregularly timed but of regular shape.

74
Q
A

Atrial fibrillation

No P waves

irregular baseline

Irregular QRS

Normal shaped QRS

(looks a bit like flutter in lead v1 - normal)

75
Q
A

presence of an accessory conducting bundle between the atria and ventricle - WITH NO AVN TO PAUSE CONDUCTION. (usually it runs down the left side of the heart).

76
Q

[arrhythmias]: in WPW syndrome there is a ‘pre-excitation’ as a depolarisation wave reaches the ventricles before the main wave. what would be seen on ECG

A

Short PR interval

Delta wave on QRS (early slurred upstroke of QRS - 2nd part is normal - main depolarisation catches up )

77
Q
A

Paroxysmal tachycardia

(depolarisation down the His then back up accessory to reactivate the atria = ‘re-entry’ circuit = sustained tachycardia.

78
Q
A

Sustained tachycardia in the WPW syndrome (re-entry tachycardia - no P waves)

79
Q
A

CARDIOLOGY (11 decks)

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