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4th Year ECGs > ECGs > Flashcards

ECGs Flashcards

1
Q

Where are Chest Lead Electrodes positioned anatomically?

(*need to know)

A

V1- 4th right intercostal space

V2-4th left intercostal space

V3-midway between V2 AND V4

V4- 5th intercostal mid-clavicular line

V5-same level as V4, anterior axillary line

V6- Same level as V4,V5

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2
Q

What leads are used on an ECG to interpret the cardiac axis?

A

Leads 1 and aVF

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3
Q

What are (QRS complex deflections) on leads 1 and aVF for:
a) Normal cardiac axis
b) Right Cardiac Axis Deviation
c) Left Cardiac Axis Deviation

A
  • positive lead II + Positive aVF = normal cardiac axis
  • Negative lead II + Positive aVF = right axis deviation (*positive as moving neg to positive of lead values)
  • Positive lead II + negative aVF = left axis deviation
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4
Q

What do leads I and avF show in an ECG with normal cardiac axis?

A

leads I- positive
leads aVF- positive

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5
Q

What do leads I and avF show in an ECG with right cardiac axis deviation?

A

leads I- negative
leads avF- positive

(from negative > positive is the ‘right’ thing)

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6
Q

What do leads I and avF show in an ECG with left cardiac axis deviation?

A

leads I- positive
aVF- negative

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7
Q

What does each segment on an ECG mean?

A

P wave- atrial depolarisation

PR interval- start atrial depolarisation to ventricular depolarisation

QRS complex- ventricular depolarisation

T wave-ventricular repolarisation

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8
Q

Name a type of Polymorphic Ventricular Tachycardia

A

Torsades De Pointes

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9
Q

What are the key features of 1st degree heart block?

A

Features:

  • PR interval >200ms
  • Normal Axis (lead II and aVF)
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10
Q

What are the key features if 2nd degree heart block?
a) Mobitz 1
b) Mobitz 2

A

Mobitz 1:
- Dropped beats (where some p waves are not followed by a QRS complex)
- Progressive PROLONGATION of PR intervals (whereas mobitz 2 PR interval is the same)

Mobitz 2:
- Same PR interval duration (normal 0.12-0.2)
- Dropped beats (some p waves not followed by QRS complex)

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11
Q

How does the PR interval present in Mobitz 1 and Mobitz 2 (2nd degree heart block)

A

Mobitz 1:
-progressive prolongation of the PR intervals

Mobitz 2:
-CONSTANT same PR interval duration

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12
Q

What does shortened and prolonged PR interval indicate?

A

shorter- (electrical signals too short)- WPW (e-entry syndrome)

prolonged- heart block (heart not conducting)

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13
Q

What are the key features of 3rd degree heart block?

A

Features:

  • NO relationship WHATSOEVER between the p wave and QRS complexes
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14
Q

What is the duration on a normal ECG:
a) P wave
b) PR interval
c) QRS complex
d) QT interval

A

a) P wave- 0.12 secs
b) PR interval- 0.12-0.2
c) QRS wave- 0.1 (100ms)
d) QT- 40/460ms

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15
Q

What is Bundle Branch Block?
b) Name the x2 types

A

-takes longer for excitation of one side (right or left branch) of the heart

-defect in the Purkinje fibers and bundle of his

b) right and left bundle branch block

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16
Q

What are characteristic features of Bundle Branch Block:
a) Right Bundle Branch Block
b) Left Bundle Branch Block

A

Right-MarroW (V1-M shaped and V6-W shaped)

Left-WilliaM (V1- W shaped and V6 is M shaped)

17
Q

What are the only x2 shockable rhythms?

A

-pulseless VT and VF

18
Q

‘irregularly irregular rhythm’ is buzzword for which arrythmia

A

Atrial Fibrillation

19
Q

‘saddle shaped waves’ are buzzword for?

A

Pericarditis

20
Q

‘delta wave’ indicates

A

Wolf Parkinsons White Syndrome (re-entry syndrome, shorter PR interval)

21
Q

What is the mechanism of Adenosine?

A

Adenosine- blocks conduction through AV Node

22
Q

What charge between electrodes causes:
a) Upward deflection on ECG
b Downwards deflection on ECG

A

a) negative > positive (things getting better going ‘up’)
b) positive > negative charge

23
Q

What arrythmia is ‘epsilon wave’ associated with?

A

-right ventricular cardiomyopathy

24
Q

‘tall tented t waves’ s associated with?

A

Hyperkalemia

25
Q

How does an NSTEMI present on an ECG?

A

ST segement depession

26
Q

What does T wave inversion indicate

A

ischemia
hypokolemia
hypertrophy

27
Q

What mneumonic is used for ECG territories?

A

-big LII, small LI, ASS (backwards) and ALL

28
Q

What is the characteristic ECG feature of a PE?

A

inverted t waves

29
Q

What is the difference between type 1 heart block and type 2 mobitx heart block?

(both have constant prolonged PR interval)

A

type 1 heart block- no dropped beats (*so all p waves are followed b a QRS complex)

Type 2 mobitz heart block- there are droped beats!

30
Q
A

4th Year ECGs (2 decks)

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