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Cardio > ECGs > Flashcards

ECGs Flashcards

1
Q

In an anterior MI, what is the most likely occluded artery and in what leads does this cause ST elevation in?

A

Left Anterior Descending

V2-V5

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2
Q

In an inferior MI, what is the most likely occluded artery and what leads show ST elevation?

A

Right Coronary Artery

II, III aVF

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3
Q

In a lateral MI, what is the most likely occluded artery and what leads show ST elevation?

A

Left Circumflex Artery

I, aVL

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4
Q

In a posterior MI, what is the most likely occluded artery and what leads show ST elevation?

A

Right Coronary Artery or Left Circumflex
No leads show ST elevation

Reciprocal changes occur: in VI-V3, prominent R waves, flat ST depression, and T wave inversion may be seen

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5
Q

In an anterolateral MI, what is the most likely affected artery and what leads show ST elevation?

A

Left Anterior Descending

V4-V6, I, aVL

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6
Q

If someone is in complete heart block, what will show on an ECG?

A

JVP Cannon A waves

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7
Q

What artery supplies the SA and AV node with blood?

A

Right coronary artery

The right coronary artery also supplies the septum of the heart with blood

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8
Q

How do you work out the rate of an ECG?

A

Divide 300 by the number of big squares in between two R waves

Each big square represents 0.2, each small square represents 0.04

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9
Q

What is the way to remember left axis deviation and right axis deviation?

A

LAD: lovers leaving. The QRS complexes in I and II point away from each other.

RAD: lovers returning. The QRS complexes in I and III point towards each other

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10
Q

What can cause left axis deviation?

A

Inferior MI
WPW
Left ventricular hypertrophy
Left anterior hemiblock

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11
Q

What can cause right axis deviation?

A

Right ventricular hypertrophy
PE
Anterolateral MI
WPW

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12
Q

What are Q and S waves?

A

In a QRS complex, if the first deflection from the isoelectric line is negative, it is a Q wave
Any negative deflection after R is an S wave

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13
Q

What do broad QRS complexes represent?

What is the normal duration of a QRS complex?

A

Ventricular conduction defects e.g. Bundle branch block, metabolic disturbance

The normal duration is <0.12 seconds

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14
Q

In what leads would T waves have to be inverted in to be abnormal?

A

If T waves are inverted in I, II and V4-V6 this is abnormal

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15
Q

What are J waves and what do these represent?

A

The J wave is the point where the S wave finishes and ST segment starts

They are seen in hypothermia, hypercalcaemia and SAH.

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16
Q

What are the causes of sinus bradycardia?

A 
Physical fitness
Drugs (beta blockers, digoxin, amiodarone)
Sick sinus syndrome
Hypothyroidism, hypothermia
Raised ICP
17
Q

List some common causes of AF

A 
Thyrotoxicosis
Hypertension
Obesity 
Heart failure 
Alcohol
18
Q

What happens in first degree heart block?

A

If R is far from P, you have a first degree

The PR interval is prolonged and fixed

19
Q

What happens in second degree heart block?

A

Mobitz Type 1 (Wenkebach)

The PR interval becomes longer and longer until a QRS complex is dropped

20
Q

What happens in third degree heart block?

A

Mobitz Type II

QRS complexes are dropped without any warning
Can progress to complete heart block so it is worrying

21
Q

What happens in complete heart block?

What can cause complete heart block?

A

No correlation between P waves and QRS complexes

Inferior MI, aortic valve calcification, digoxin toxicity

22
Q

What pathologies cause ST elevation?

A

acute MI (STEMI)
Acute pericarditis
Left ventricular aneurysm

23
Q

What pathologies cause ST depression?

A

Digoxin toxicity
NSTEMI
Acute posterior MI

24
Q

What are the ECG changes that you see in a MI?

A

Within hours, T waves becomes peaked and ST segments begin to rise
Within 24hours, the T waves invert
Pathological Q waves may form

25
Q

What are the ECG changes that you see in PE?

A

Sinus tachycardia
RBBB
Right axis deviation

Rarely, the S1Q3T3 pattern

26
Q

What ECG changes would you see with hyper and hypokalaemia?

A

Hyperkalaemia: tall tented T waves, widened QRS complexes, absent P waves

Hypokalaemia: in hypokalaemia U have no Pot and no T, but a long PR and a long QT (in order of most common to least common)

27
Q

What does a LBBB look like on an ECG?

A

WiLLiaM
W pattern in V1 and a M pattern in V6
Widened QRS complex
Dominant S in V1

28
Q

What are the causes of LBBB?

A

IHD
HTN
Cardiomyopathy
Aortic stenosis

29
Q

How does RBBB present on an ECG?

A

M wave in V1 (RSR pattern), W wave in V6

Widened QRS complex

30
Q

What are the causes of RBBB?

A

Cor pulmonale
Right ventricular hypertrophy
PE
MI

31
Q

How does digoxin toxicity present on an ECG?

A

Down sloping ST depression
Inverted T waves
Short QT interval

32
Q

What are the causes of ST depression?

A

Ischaemia
Digoxin
Hypokalaemia

33
Q

What may a short PR interval point towards?

A

WPW syndrome

34
Q

What is a mnemonic that can be used to remember the reciprocal changes that occur in the ECG leads?

A 
PAILS
Posterior
Anterior
Inferior
Lateral
Septal

ST elevation in one lead causes reciprocal changes in the one below

35
Q

What are the normal variants on ECGs that athletes may have?

A

Sinus bradycardia
Wenkebach phenomenon
First degree AV block

36
Q

What does bifascicular block look like on an ECG?

A

Combination of RBBB with left anterior or posterior hemiblock (e.g. LAD)

37
Q

What ECG findings will you see in hypothermia?

A

Bradycardia
J wave
First degree heart block
Long QT interval

Cardio (10 decks)

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