ecgs Flashcards by Maryam Garkuwa

SVT VS ventricular arrytmias

SVT - narrow comlex ?

ventricular - wide QRS

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ecg features a fib

irregular r -r
narrow complex-usually
unduluting or evn flat baseline

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nomral qrs

less than 0.12

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a flutter charactristics

generally has regular R-R intervals (not always)
saw tooth

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normal pr interval

0.12 - 0.20 (3-5 small squares)

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when someone is intoxicated with something what are we looking at mainly in ecg

qtc interval

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relationship of qtc with HR

tachy means shortened QTC
brady means leghtned QTC

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what are we worried about in a long qtc

ventricular arrhythmias, especially Torsade’s de Pointes

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causes of prolonged Qtc

Hypokalemia
Hypomagnesaemia
Hypocalcemia
Hypothermia
Myocardial ischemia

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causes of shortene QTc

hypercalcemia
digoxin

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normal eletcrical axis

-30 + 90

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where is lead 1 , 2 , and AVF in realtion to cardiac axis

lead 1 - 0 degress
lead 2 - like 45 degrees
lead AVF - straight down at 90 degrees

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normal axis leads

lead 1 +
lead 2+
lead avf + +

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left axis

lead 1 = +
lead AVF=negative
lead 2 = you have to check its negative to confirm for some reason

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causes of right axis deviation

RV hypertrophy

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what’s the little saying we use for Right axis deviation

right is reaching

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what’s the little saying for Left axis devaition

left is leaving

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septal leads

v1 -v2

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anterior leads

v3 +v4

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what lead can we use to calibrate the ecg

AVR should always be pointing RIGHT DOWN if not then you need to repeat the ECG

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normal postion of v1

should be negative but the initial has a tiny peak of postive deflection

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normal v6

postive

hyperkalemia ecg

tall tented t waves
flattend p waves
prolonged PR
broad qrs

HYPOKALEMIA

t wave inversion u waves st depression

in hyperkalemia will you see all fetaures

no depends on severtiy initially will be the tall tented

where do we find U waves

hypokalemia and bradycardia

When looking at ischemia which parts do ecg do we focus on

1. J point St T wave

When looking at ischemia which parts do ecg do we focus on

1. J point St T wave

J point

The transition before ventricular depolarisation and ventricular depolarisation

When having ischemia to the heart which part will be affect ed first and why

The subendocaridal because coronary a bring blood from outside to the inner most heart, so if there is obstruction the first part to suffer is the endocardium as blood supply is less! Then as it prolongs it gradually spreads to the outside

What to look out in a stemi

St elevation Lbbb Hyperactive t waves (symmetrical and tall) Pathological q waves

Stages of a trans mural mi

1. Hyperactute t waves 2. St elevation 3. St elevation and t wave inversion 4. Pathological q waves

How do you tell the difference between ischemia or infarction

Q waves deep

How to tell years after if someone had an mi

Q waves (should be more than 1 small box width or more than 1/3 the R wave

What are precocial leads

V1-6 Looking at the heart from front side

What are precocial leads

V1-6 Looking at the heart from front side

Where is a right bundle branch Block most best seen

V1 RSR pattern M

Where is the left bundle branch Block best scene

V6 M Which

Is a Bondo branch Block, always a dangerous thing

Some people have right bundle branch block and are normal so long as the QRS complex is within range around three squares. However, if you have a left bundle branch Block that almost always needs to be investigated because it’s a pathology

Where do you see a deep slurred S wave

Right bond branch, Block

Superventricular rhythms versus ventricular rhythms

Supraventricular rhythms had narrow QS complexes, because it’s the atria, that’s the problem, and the impulse still passes through the ventricles, normally whereas ventricular rhythms, having broad, qrs complex

what is type 2 mobitz 2

pr interval is lenghtened or normal howver you get a non conducted QRS

type 2 mobitz 1 wenkebach

PR interval gets progressivel longer than qrs drops

whats the danger of 2nd degree heart block

progression to third

what are the limb leads

1,2,3,AVR,AVF, AVR

which are the lateral limb leads

1and AVL

criteria for stemi

st elevation in 2 contigious leads new onset LBBB

PROCESS OF STEMI IN PATIENT

DO A TROP ECG PCI WITHIN 120 MINS OF CONTACT IF NOT POSSIBLE DO FIBRONOLYSIS

TPA CI

recent stroke have a bleeding disorer on warfarin had a surgery recent 3 months

the 300mg aspirin dose what route

preferably chewable for faster absorbiton sub lingual if ot can get the dissolvavle tablet

should all t waves be upright in an ecg

NO in AVR should always be negative and its abnormal if its upright

what differentiates between NSTEMI AND UNSTABLE

the troponin

indications for an ecg

ACS arrythmias syncope!nB - need to figure out why the person fainted syncope during exercise big red flag electrolyes intoxication/drugs

apparenlty there is an inferior MI what should you always look for reciprical depression in

AVL!!! apparnely always and if its not then you even doubt its a inferior one uusally your high lateral leads are reciprical (1 + aVL) but depending on the area you may not have a chnage in 1 but you 99% have in lead avl

qrs normal lenght

no more than 3 squares 0.12